Investing in heart health: Steps to Prevent Heart Disease
There are very few people that I know that would deny themselves a medicine or a procedure to avoid a major illness. Some would even add "no matter what the cost" to the last sentence. Many people would also say "an ounce of prevention is worth a pound of cure." And they are right. It is obvious that some simple preventive strategies are far more than the "cures." This follows the same reason of why we teach children to look both ways before crossing the street.
Unfortunately, all such preventive strategies are not effective in avoiding catastrophe. Often, the cost of such strategies often exceeds any possible gain and the entrenched idea that these strategies work or are helpful is difficult to overcome. A February 14, 2008, article in the respected New England Journal of Medicine (http://www.nejm.org/) reflected on the economics of preventive care in this year of presidential candidacy.
The American Heart Association review of endocarditis statistics last year concluded that for many people with heart murmurs, antibiotic prophylaxis increased cost and worsened health. Likewise, it has been noted that for the average 70 year old with new prostate cancer, surgery likewise increased cost while worsening health. While this data may be surprising to and resisted by certain individuals, it should be heeded. But what does this mean for each of us in pursuing our own individual and family health?
I would submit that it means looking at the true cost of any preventive strategy or therapy. Here are some examples:
- Start an exercise program (time commitment, walking shoes, attire, membership if needed, risk of injury, etc.). The cost is relatively inexpensive, the risk is minimal, and a huge and robust amount of scientific evidence demonstrates major benefits (lowering blood pressure, cholesterol, blood sugar, prolonging life).
- Change your diet and lose weight. Finding a target weight is easy. There are numerous ways to calculate body mass index (bmi) available on the web or from your doctor.
Underweight: Below 19
Overweight: 25 to 29
Obese: 30 and above
- Again, the cost is inexpensive (fresh fruit and vegetables do not cost more in the long run than packaged meals. An interesting study in Scandinavia recently had people eating nothing but fast food for four weeks, which resulted in the development of fatty livers). A huge and robust body of evidence demonstrates major benefits (lowering blood pressure, cholesterol, blood sugar, prolonging life)
- Assess whether alternative agents can help your health because you heard that (as an example) "Lavender is antibacterial, antifungal and helps prevent scar tissue. It is an insect repellant, cleaning agent and purifies the air. The oil is used to combat acne, eczema, and sunspots. The oil can also be used applied to the bottom of the feet providing relief from insomnia as well as on the temples for headaches". "Its harmonizing and therapeutic nature provides mental clarity as well as emotional balance". The cost is relatively inexpensive, the risk probably minimal, but no scientific literature shows benefit.
- Consider getting annual CT scans to look for coronary arterial disease or occult cancers. The cost is quite expensive (ignoring the money aspect: radiation from a coronary CT is the same as a cardiac catheterization or 250 chest x-rays, risk to the kidneys is the same, risk of later development of cancer or leukemia is as high as after Hiroshima if you are young when you start. Also, all small lesions or blockages don't cause problems, but if you find something, you are sure to get further perhaps risky testing or procedures). So the risk is no longer minimal. And the scientific literature regarding "early diagnosis" by such testing demonstrates no long-term benefit.
- Screen blood testing for markers: CRP (C reactive protein), PSA (prostate specific antigen), CA 1-25, cytokines, chemokines and a host of other substances. Expensive, probably no risk except for overdependence on the results. No long-term benefit demonstrated. This is not to say that these tests are not useful in certain instances. They help doctors understand the nature of disease and therefore will help in finding cures.