European Stars and Stripes (Newspaper) - September 18, 1990, Darmstadt, Hesse                                To our health hints of cure for heart disease by John Lewis United press International responsible nutritionists have carpet about diet and heart disease for More than three decades. The american heart association has Sermon Zed about its Quot prudent Quot 30 percent fat diet for almost As Long. Prevention the Battle cry went. Practice prevention. But prevention is a crusader s game lacking punch. We want cure. At last after decades of scholarly bickering and academic hype we do have the hint of a cure Dean Ornish of san Francisco and his associates reported recently in the the lancet the British medical journal that a strict Low fat vegetarian diet moderate aerobic exercise stress management training abstinence from smoking and group support a including meditation but no medication a can actually turn the disease atherosclerosis around. In work going Back More than a decade another group led by David a Blankenhorn of los Angeles who also made its evaluations with before and after a rays angiogram showed that atherosclerosis in leg arteries and in heart arteries the Coron Aries can be made to regress a another hint of a cure. Blankenhorn used cholesterol lowering drugs however along with a moderate diet while Ornish forgoes drugs. His program features a diet with Only a third of the fat 10 percent fat that the american heart association has recommended. This 10 percent fat program by the Way is similar to a regimen advocated by diet expert Nathan Pritikin since the late 1970s without in Pritikin Scase enough scientific evidence to win Over the nutritional establishment if the nutrition experts should be persuaded now their concept and management of the disease will be changed. Although practising physicians May have proffered Hope they have believed that atherosclerosis once evident advances like a tank Force overrunning a Village relentlessly. Hence the stress on prevention deter the invasion. Therefore we have had the american heart association prevention diet which has been bedevilled by controversy. There also has been controversy associated with cholesterol control with some expressing doubt about the life saving value of Low cholesterol intake. Responsible Medicine likes Good evidence but its collection on these matters could take decades. Meanwhile coronary heart disease must be managed. Current management utilizes drugs and surgery As Well As diet and lifestyle advocacy when they Learned that a blood clot May be the final episode that blocks a diseased blood vessel causing a heart attack researchers turned to clot dissolving drugs a As we turn to drano for a plugged pipe. These important drugs May have reduced heart attack mortality by As much As 40 percent. One of them spa tissue Plasmin Ogen activator at $2,200 per treatment became the fastest Selling new drug in history. Cholesterol lowering drugs too such As the ones Blankenhorn used play a role and by reducing the likelihood of heart attacks a whole array of Antihypertensive medications have an indirect effect on the ravages of coronary heart disease. After decades of blundering surgical attempts prospects for invasive treatment changed dramatically in 1967 with coronary artery bypass grafting. A medical Industrial Complex of instrument makers hospitals and practitioners materialized to be nourished by the not quite bottomless resources of medicare and private insurance. Sound reasons for performing this operation emerged slowly. There is evidence unfortunately that As Many As one half of the operations As now practice May be unnecessary. Coronary angioplasty a less invasive less expensive a has intruded on the bypass terrain with a confusing fanfare of technical innovations and a Host of relatively inexperienced practitioners but without adequate evidence of precisely when it might help. In any Case local repair by either of these invasive techniques is something like putting out Small flare ups while the Forest Burns. They May be disconcertingly late and temporary often they Are not clearly better than non surgical management. Thus we return to the possibility of diet As a decisive alternative to both drugs and surgery what now coronary heart disease americans biggest killer threatens each of us in the Long run far More vitally than does Iraq or cocaine. By Middle age we re Apt to Harbor a few hardened arteries. If a vegetarian regimen will reverse the dread process in those already disabled should t we All heed the message and go on the 10 percent diet Ornish is cautious. Quot the Point of our study Quot he says Quot was to determine what is True not what is  adherence to the lifestyle program needs to be very Good he adds for regression to occur his austere diet provides no animal products except egg White and one cup per Day of non fat milk or Yogurt. His study is sure to come under criticism. It was Small 28 patients in the experimental group and 20 in the control group and it tells us nothing about the most important end Point does the program prolong life the Only death during the yearlong study occurred in the experimental group involving what the study described As a patient who greatly exceeded exercise recommendations in an unsupervised gym. Could the regimen actually harm some people As May be the Case with cholesterol lowering regimens this in t known. At any rate in the program s favor even if death is not postponed or postponed Only a Little one might Hope that restoration of a vigorous blood flow would somehow ease the pain of aging. Heart disease As Many As 1.5 million americans will suffer heart attacks this year and More than one third of them will die. Here is a look at risk factors for heart disease and its major forms and symptoms. Americans number one killer someone Dies of every 32 seconds of cardiovascular disease in the United states. 1987 figures accidents 95,000 5% other cardiovascular disease risk factors a heredity parents had heart disease a age Over 65 years a High blood pressure a High blood cholesterol a smoking diabetes mellitus obesity More than 30 pounds overweight physical inactivity sex men at greater risk than women two major kinds of heart disease atherosclerosis hardening and blockage of the arteries caused by buildup of fatty substances cholesterol and other material a can cause bleeding or formation of blood clots a can cause heart attack or stroke arrhythmia irregular heartbeat caused when the heart s natural pacemaker develops an unnatural rate or rhythm a can cause heart attack a May be regulated by an artificial pacemaker artificial pacemaker when heart attack happens left coronary artery and vein warning signs a uncomfortable pressure fullness squeezing or pain in the Center of the Chest lasting two minutes or longer a pain spreading to the shoulders neck or arms a severe pain and lightheaded Ness fainting sweating nausea or shortness of breath sources american heart a Apoc Structure and function Cut the body world Book ency Cywia fee search by Pat Carr what to do a Call medical Rescue sen ice immediately a give car Mouth to Mouth breathing / and Chest compression if it is necessary and you Are properly trained. Page 16 the stars and stripes tuesday september 18, 1990