Heart Disease Overview


  • Cardiovascular disease (CVD) begins in childhood and progresses silently for many decades to culminate in heart attack, stroke or sudden death in the prime of one’s life. Atherosclerosis (or plaque buildup) does not result in narrowing of the artery until very late in the disease process.
  • Heart disease is not an unavoidable degenerative disease that is found in all elderly people; it is actively promoted by a combination of genetic factors and lifestyle choices. The various risk factors such as smoking and high cholesterol damage the artery lining in a process called endothelial dysfunction. This lays a foundation for future heart attacks or other cardiac complications.
  • The mechanical view of plaque formation as a kind of “junk” that builds up layer after layer and clogs up an artery like a kitchen drain distorts the truth. The current view is that the composition of the plaque is more important than size of the plaque.
  • Most heart attacks are caused not by an artery narrowing due to the buildup of hard, large plaques detectable on an angiogram, but by a blood clot that forms after the rupture of a soft, inflamed, lipid-rich plaque, often quite small.
  • No correlation exists between the severity of heart disease and its symptoms. Very severe heart disease may have few or no readily identifiable symptoms (as was the case with President Clinton). Don’t wait for the onset of chest pain to begin a heart-healthy lifestyle. Angina (chest pain due to severe narrowing of the coronary arteries) rather indicates that your heart disease is already far along, because arterial narrowing does not begin until atherosclerosis is advanced.
  • Heart disease gives advanced warning in the form of angina only one-third of the time. Most of the time, it manifests as a heart attack or sudden death without warning (as happened with Tim Russert).
  • Half of all sudden deaths occur in people with undiagnosed heart disease, and two-thirds occur before the person reaches the hospital, even in major metropolitan centers in the US (where most patients arrives at the hospital by ambulance within 5-10 minutes of onset of symptoms).
  • Silent heart disease can be readily detected years before the first symptoms with tests paid by the individual. See Heart Scan.
  • We now have the knowledge, technology, medications, and solutions to drastically reduce the risk of heart disease and its complications.
  • The good news is that heart disease has now become the most predictable, preventable, and treatable of all chronic diseases; any heart attack, coronary angioplasty, stent or bypass surgery or stroke before age 65 can now be considered a medical failure. 1


1. Enas EA. How to Beat the Heart Disease Epidemic among South Asians: A Prevention and Management Guide for Asian Indians and their Doctors. Downers Grove: Advanced Heart Lipid Clinic USA; 2011.

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