Wednesday, February 7, 2007

Defining a Cure for Heart Disease

This is a blog I have been meaning to write for a while. We all want a cure for heart disease, but would we know one if we saw it? Exactly what does it mean to us as heart disease sufferers to be cured? Here is a "shoot from the hip" debate I have been having with myself.

First of all, you can't cure everybody. Hell, even today we can't cure ALL infections and people still die from them. So what percentage of heart disease sufferers must be "cured" before we say we have a cure. My guess is 95% would be a good start. I want to have a 95% cure rate before I acknowledge a "cure" has been found.

Next, what does it mean to be "cured?" How do we measure it? Does it mean a halt to growing heart disease, an active reversal, or a complete remission (zero heart score scan). Do we measure it by heart scan score or some other means. Right now it appears as though zero calcium score growth or reversal significantly reduces heart attack.

A cure cannot necessarily mean no heart attacks because there are other mechanisms at work such as vasospasm. Also, we all get old and die of something. Sooner or later our genes fail us and systems such as our arteries begin to fail or become frail even with perfect lipids. Can we really say a "cure" is no good because it will not prevent all genetic failures? If you have a heart attack at 90 does it mean the "cure" failed. For me, I would have no problem anointing a "cure" if it keeps me alive one year longer than the average lifespan. You have to die of something sooner or later (Yeah, that sucks but what ya gonna do?).

Finally, does the "cure" have to be durable. Antibiotics are a cure for most infections yet we all keep getting them and the effects, though minor, can be cumulative. If I take the "cure" and it stops my heart disease, but then I quit exercising and snack on "chicken fried bacon" or resume smoking and have a heart attack is that a failure of the cure. Does a true "cure" have to be effective no matter how poorly I discipline myself?

So, here is my definition of a "cure" for heart disease.

1. It stops or reverses the accumulation of plaque (as measured by calcium score) in 95% of otherwise healthy individuals with no unusual genetic defects.

2. I must live beyond the average life expectancy before dying of a heart attack.

3. The cure need not be durable (i.e. if I stop taking it heart disease can return) but must remain effective while I am taking it.

4. The cure does not need to be a single "magic bullet" or pill but can be any set of products and disciplines that achieves goals 1,2, and 3.

So, what is YOUR definiton of a cure for heart disease?



David said...

This is not on topic directly, but what is the low down on alcoholic intake and heart health? I like a few pints at the local pub (not every day) ... maybe 2 or 3 spread over a 2 hour sitting. Is this too much, particularly when I occasionally have a glass of red wine at dinner too. I drink lots of water daily too (3 liters). Also your views on what possible harm drinking at this level has on heart health. I've read there are beneficial effects from "moderate" drinking, but maybe my drinking is more than moderate.

Blog Directory - Blogged