Winning the battle of heart disease

Majority of the $350 billion pharmaceutical product sold worldwide go towards healing hearts; this may soon change. New discoveries and techniques have turned the table on war with heart ailments. The gold standard of diagnosis of the blockage of arteries supplying blood to heart is now replaced with a spot ultrasound that would tell if there are any hidden fat deposits in the arteries that can burst at any time to block the artery. This explains why many who have been cleared from angiography testing fall prey to heart attacks. The good news is that by drastically lowering the low density lipids to a level of 90 or below shrinks this soft mass of fat in the wall of the arteries that proves lethal to many (over half a million in the US alone per year). When plaques are discovered, the current arsenal of technique that involve inflating it (angioplasty) or removing and replacing the artery (bypass surgery) is enhanced with a new technique that attacks the plaque with radiation. Since half of those who receive angioplasty revert to original blockage sooner or later, radiation offers an excellent alternate since it inhibits cell growth at the point of treatment. (A proprietary technique of Beta-Cath is now used worldwide.) On the surgery side, the new techniques do not require opening up the chest, hooking on the patient to a heart-lung machine, stopping the heart and then hoping it will restart. Now surgery is performed on a functioning heart by holding parts of heart at a time to do the surgery; also using arterial rather than venous graft proves more beneficial. Growing new vessels in the heart is another radical approach that is yielding good results (angiogenesis) using a compound called fibroblast growth factor applied to heart tissue directly in the form of capsules. In addition, surgeons are now finding that drilling laser holes in the heart increases the blood flow to heart tissue works as well—we still do not know this technique works and it remains experimental.

Using drugs to combat heart disease has taken a new turn as well. Infections with organisms like Chlamydia pneumoniae enhances the chances of having blocked arteries. Now treatment with antibiotics has become a routine to prevent clogging of arteries. At least this is one factor that we can control; the other factors, well known, are more difficult to manage.

On the prevention level the good old diet proves again to be the most important tool. But new knowledge drawn from the great genome project is now telling us that there are genetic connections as well that we can diagnose ahead of time.

The bad news comes for women, who, though less prone to heart attack before the age of 50. are much more drastically affected should they get a heart attack; and they are getting it in a higher proportion now than they did a few decades ago. Heart disease has become an “equal opportunity illness.” Besides the risk factors inherent in men, women have menopause to deal with, which increases their risk of heart disease. Men are able to develop alternate arteries when they are blocked, but women do not because their arteries remain flexible, obviating the need to develop alternate routine. The textbook symptoms of disease also do not appear well in women and thus they are less apt at taking preventive measures. For example, women might complain of pain in the back and other parts of the body, exhaustion, stomach discomfort or plain anxiety as a precursor to heart attacks. Just like the increased incidence of lung cancer in women, heart disease is quickly catching up with the sex differences.