Heart attacks cannot always be prevented

When Tim Russert died unexpectedly of a heart attack, millions of Americans mourned his passing and wondered what he had been doing wrong. The answer is nothing.

Unlike most people, Tim Russert got superb medical care. Although he suffered from high blood pressure and elevated cholesterol, he was controlling them with blood pressure pills and a statin-type cholesterol-lowering medication.

Tim Russert also exercised vigorously almost every day. He passed a recent treadmill stress test designed to evaluate heart health.

According to the autopsy report, the rupture of plaque in one of Russert’s coronary arteries led to ventricular fibrillation, an abnormal heart rhythm that resulted in sudden cardiac arrest. Such a heart attack is often so quickly fatal that even emergency care is not fast enough.

The American Heart Association says that roughly 300,000 other Americans will also die suddenly this year because of cardiac arrest.

Most people think that a heart attack evolves slowly, with chest pain as the prime symptom. Russert experienced no such early warning.

Something very similar happened to James Fixx on July 20, 1984. He died of a sudden massive heart attack at age 52 while running in Vermont. He had no symptoms, though he regularly ran 10 miles daily.

Fixx was a poster child for changing lifestyle and becoming more active. When he started running at age 35, he was grossly overweight and a heavy smoker. But his intense exercise program enabled him to lose 60 pounds and keep them off. He gave up smoking and became an apostle for jogging. His book “The Complete Book of Running” sold more than a million copies. He was a vegetarian and advocated a low-fat diet.

People were as shocked with Fixx’s death in the 1980s as they are today with Russert’s tragic demise. The lesson is that there are no guarantees.

It still makes sense to quit smoking, lose weight and control familiar risk factors like high blood pressure and cholesterol. These are easy to measure, and many can be treated with medications.

But there are nearly 250 other potential contributors to heart disease. One that is frequently overlooked is stress. It is very difficult to assess or treat stress, but it may be equally as important as cholesterol in determining heart health.

While covering the primary campaign, it is likely that Russert was under constant deadline pressure, and he reportedly was getting too little sleep. Certainly, he had a very high-stress job.

Another important risk factor is low HDL, or good cholesterol. This seems to have been a problem for Russert. Unfortunately, it is hard to raise HDL, although exercise can help somewhat.

We discuss those elusive risk factors, including triglycerides, Lp(a) and CRP (a marker of inflammation), along with natural ways to control cholesterol in our book “Best Choices From The People’s Pharmacy.” It is available in libraries, bookstores and online at www.peoplespharmacy.com.

Fixx and Russert were working hard to avoid heart attacks. Their tragic deaths remind us that there is still a lot to learn about keeping hearts healthy.

XJoe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of The Vindicator or e-mail them via their Web site: www.PeoplesPharmacy.com.

2008 King Features Syndicate, Inc.