Cardio Study Aids Prevention Tactics

"You live in the food grease capital of the world ... and East Texas is a little worse off than the rest of the country."

That's the way Dr. William P. Castelli , retired senior investigator for The Framingham Heart Study, described heart problems during a presentation called "Prevention and Treatment of Heart Disease in the New Millennium" and luncheon sponsored by Pfizer Inc.

Castelli explained a proper diet, exercise and not smoking could eliminate many cardiovascular diseases.

Castelli said Americans could reduce their cardiac problems and diabetes by walking two miles a day. He also stressed eliminating white flour, sugar and excess calories.

After 30 years as the third director of the Framingham Study, Castelli started the Wellness Clinic in Framingham , Mass. , a town about 20 miles west of Boston , to help people who were part of the fourgeneration study fight cardiovascular diseases.

"I started the clinic because I felt we owed the people in Framingham something. ... I could count on one hand the number of people who had gotten their cholesterol down to where it should be, so I started this clinic to see how to motivate someone to focus on making the changes to these numbers," he said.

He said the Framingham study, started in 1948, "gave us numbers, allowing us to be able to predict when people could have heart attacks or strokes. These numbers became known as risk factors and Framingham was the first study in the history of medicine to do this.

He listed these numbers as cholesterol, blood pressure and blood sugar readings, along with cigarette smoking and weight.

Castelli said genetics also play a part in some heart attacks. "When you have a bad gene for cholesterol, five percent of those people will have a heart attack before they get to age 30, 20 percent by age 40, half of them by the age of 50 and 85 percent by age 65.

"But heart attacks coming from this gene are preventable today ... I can find these people when they are five years old and start some powerful therapies. It is not hard to do ... but we are not doing it," he said.

Besides using statins, fish oils, folic acid, antioxidants and niacin, other ways to help fight high cholesterol exist.

He said women have more heart attacks than men, "but women are protected before menopause. We had a little over a half dozen women get heart attacks prior to menopause, but after women go through menopause, within six to 10 years they have caught up with men."

Castelli also said diabetics double and triple their rate of heart attacks. He cited aggressive therapy can be used, but must be closely checked with the hemoglobin A1C test (evaluates the long-term blood-glucose concentration). "We need to get the numbers down under 5.5 and as close to 5 as possible."

Since 1948, The Framingham Heart Study has produced many major discoveries that have helped scientists understand the development and progression of heart disease and its risk factors.