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Differing lifestyle can yield a change of heart

June 17, 2002|bu KATE COLEMAN

The American Heart Association estimates that 61.8 million Americans have cardiovascular diseases, including high blood pressure, congenital heart defects and congestive heart failure, and coronary artery disease, which may lead to heart attack, angina and stroke.

Cardiovascular disease claimed 958,775 American lives in 1999 - 40.1 percent of all deaths.

Some 7 million Americans suffer from coronary artery disease, according to information on the Web site of the National Heart, Lung and Blood Institute of the National Institutes of Health at www.nhlbi.nih.gov.

Coronary artery disease most often comes from a condition called atherosclerosis. That is the term given to a buildup of fatty deposits inside the arteries, which narrows the vessels that carry blood to the heart. Arteries can be damaged by high blood pressure, cigarette smoke, diabetes, elevated cholesterol levels, elevated homoscysteine levels, use of cocaine and androgens, and infections.

When not enough blood reaches the heart, angina - chest pain - may result; if blood flow stops, depriving the heart of oxygen, a heart attack occurs.

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The part of the heart that doesn't receive oxygen dies and can be permanently damaged.

Medications and surgical procedures can help. But research - including studies published in the Journal of the American Medical Association in 1983, The Lancet in 1990, the American Journal of Cardiology in 1992 - has shown that lifestyle changes such as those in the Dr. Dean Ornish Program for Reversing Heart Disease can give patients a change of heart.

The program targets three groups:

People contemplating bypass surgery or angioplasty to repair or replace damaged blood vessels

People who want to avoid repeating heart procedures

People at risk for developing cardiovascular disease, including high cholesterol levels, high blood pressure, diabetes and/or a family history of heart disease

Mark G. Fuller, M.D., is medical director of Lifestyle Advantage, a joint venture between High Mark Blue Cross Blue Shield and the Preventive Medicine Research Institute (PMRI), the California-based center headed by Dean Ornish, M.D.

Fuller recently visited City Hospital in Martinsburg, W.Va., one of 10 hospitals in the state that have established an Ornish program.

West Virginia leads the country in heart disease, Fuller says.

Fuller, a graduate of North Hagerstown High School, studied medicine at West Virginia University. He believes in the Ornish program's proactive approach - helping to fight heart disease by preventing it and reversing it through lifestyle changes.

As an internist and psychiatrist, Fuller says the program's comprehensive - whole person - approach makes sense.

The Ornish program is a combination of nutrition, exercise, stress management and group support. City Hospital's Ornish staff includes a registered dietitian, exercise physiologist, stress management instructor, behavioral health clinician, nurse case manager, program administrator and medical director.

"The program isn't easy, and there are a lot of people who wouldn't want to do it. But if you want to do it bad enough ..." says Max Weaver, a member of City Hospital's Ornish program's first cohort.

He wants to.

Weaver, 70, a Harpers Ferry, W.Va., resident, had a heart attack in 1996. In the same year he had quadruple bypass surgery, another heart attack and a "roto-rooter" procedure to clear arteries.

He had known about the Ornish program for a long time and was excited to be able enroll. "I've been looking for ways to do more than the surgery was able to do," he says.

The year-long program costs $7,200 for each patient. Medicare covers 80 percent of costs and other health insurance plans also are providing coverage.

In contrast, Fuller estimates that coronary bypass surgery costs about $58,000.

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