Irreversible and unexpected, heart failure is the leading cause of death in Western countries. Coronary artery disease (heart attack) is the number one killer in the United States, yet it barely existed before 1900. A sampling of older cardiologists still working in the 1950s could not recall a case prior to 1910.

Most people are unaware of this and do not readily believe it. It is not a highly publicized fact, possibly because it glaringly reminds us of the cause: the way we now live, principally the westernization of diet (the consumption of commercially processed foods). Some take a position that people were more active then, and we are more sedentary now. This is true, but should not be used as an excuse to continue eating what we prefer, instead of what we should.

Before 1920 coronary heart disease was so rare that when a young internist named Paul Dudley White introduced the German electrocardiograph to his colleagues at Harvard University they advised him to concentrate on a more profitable branch of medicine. The new machine revealed the presence of arterial blockages, thus permitting early diagnosis of coronary heart disease. But in those days clogged arteries were a medical rarity, and White had to search for patients who could benefit from his new technology. The high prevalence of cardiovascular disease (CVD) is a major health concern for both health authorities and the general population. It is a leading cause of death and results in a considerable burden, in terms of illness, disability and economic costs. Although mortality due to CVD is declining due to advances in prevention and treatment, the risk of developing CVD continues to be a concern due to the significant prevalence of modifiable risk factors such as cigarette smoking, high blood pressure, high blood cholesterol levels, poor diet, obesity and limited physical activity. Many other risk factors can be reduced once they have been tested for. Laboratory testing is now going far beyond total cholesterol (HCL and LDL ratios) and triglycerides. Anyone with an elevated risk of heart disease should do specific testing to assess their risk and make the necessary changes. Such tests include hs-CRP, lipoprotein(a), homocysteine and fibrinogen among others.

There is a general misconception that CVD affects only men, leading women to believe that they are not at risk. Although CVD is more prevalent in men, it is not a gender-specific health problem. Between 40 and 59 years of age, as many as 1 in 12 women display clinical evidence of heart disease. This prevalence rises to 1 in 3 among women older than 65.

Holistic/alternative doctors are now talking about and distinguishing between two types of plaque. Type 1 is commonly associated with artery obstruction (though it is more stable and new collateral circulation develops). Type 2 causes only minimal occlusion. Unexpectedly, Type 2 appears to be responsible for as much as 80% of heart disease and strokes. This type of plaque, though not blocking the blood flow is dangerous because it has a looser fibrin coat, and a tendency to be more reactive. The treatment goal is to make it less reactive, to in effect turn it from Velcro to Teflon.

Coronary artery bypass surgery is one of the most widely performed and often unnecessary surgeries in the United States. While the surgery does increase long-term survival of those with the most severe forms (left main coronary artery occlusion and three-vessel disease) and gives relief of symptoms for 85%, the long-term results actually indicate a reduced survival rate for those with mild to moderate coronary artery disease and a return of symptoms within five years. Complications arising from coronary bypass operations are common, as this surgery represents one of the most technically difficult procedures in modem medicine.

The much maligned saturated fats which many Americans are trying to avoid are not the cause of modern diseases and should be considered beneficial for health. Saturated fatty acids constitute a high percentage of the fats in cell membranes, providing necessary stiffness and integrity. For calcium to be effectively incorporated into the skeletal structure, at least 50% of the dietary fats should be saturated. They also lower Lp(a), a substance in the blood that indicates proneness to heart disease. They protect the liver from alcohol and other toxins, such as Tylenol. They enhance the immune system.
They are needed for the proper utilization of essential fatty acids as omega-3 fatty acids are better retained in the tissues when the diet is rich in saturated fats. The evidence does not support the assertion that saturated fats cause heart disease.