• Glenn Wilson
    Wall Street Journal: Stents and coronary artery bypass surgery are no more effective than intensive drug treatment and better health habits in preventing millions of Americans from heart attacks and death, a large study found, shedding new light on a major controversy in cardiology.

    Researchers and doctors have fiercely debated for years how best to treat people who have narrowed coronary arteries but aren’t suffering acute symptoms.

    The standard treatment has been to implant stents—wire mesh tubes that open up clogged arteries—or to perform bypass surgery, redirecting blood around a blockage. Those procedures are performed even though these patients either have no symptoms or feel chest pain only when they climb a few flights of stairs or exert themselves in some other way.
    Study Finds Limited Benefits of Stent Use for Millions With Heart Disease.

    For these patients, is diet alone or in combination with medication better than bypass surgery, stents or medication alone?

    Why is there a reticence to provide the public with guidelines that will spare them from preventable disease and premature death?

    Dr. Greger: Although it is uncertain to what extent people will adopt the advice, it is nevertheless scientifically and ethically imperative to inform the public what constitutes an optimal diet. We must tell the public the truth about what is best for their health, and let them decide their degree of compliance.

    ... dietary preference is deeply personal, and one can easily be offended. Nevertheless, the public has a right to know the truth as understood by experts in nutritive biology about what constitutes the safest and healthiest diet. Some criticize this exclusively plant-based diet as extreme, or draconian. Webster’s dictionary defines draconian as “inhumanly cruel.” A closer look reveals that “extreme” or “inhumanly cruel” describes not plant-based nutrition, but the consequences of our present Western diet. Having a breastbone sawed in half for bypass surgery, or a stroke that renders one an invalid unable to speak, can be construed as extreme, and having a breast, prostate, colon, or rectum removed to treat cancer may seem inhumanly cruel. That’s extreme. Eating a bean burrito is easy.

    Continue at NutritionFacts: Optimal Diet: Just Give It to Me Straight, Doc.

    To see the full transcript or links to cited sources go to the link above, then scroll below the video and click on View Transcript or Sources Cited.

    A way to reverse CAD?
    Though current medical and surgical treatments manage coronary artery disease, they do little to prevent or stop it. Nutritional intervention, as shown in our study and others, has halted and even reversed CAD.

    Results. Of the 198 patients with CVD 177 (89%) were adherent. Major cardiac events judged to be recurrent disease totaled one stroke in the adherent cardiovascular participants—a recurrent event rate of .6%, significantly less than reported by other studies of plant-based nutrition therapy. Thirteen of 21 (62%) non-adherent participants experienced adverse events.
    A way to reverse CAD?

    When doctors withhold dietary treatment options from cardiac patients, they are violating the cornerstone of medical ethics, informed consent.

    Dr. Greger: When he was a surgeon at the Cleveland Clinic, Dr. Caldwell Esselstyn published a controversial paper in the American Journal of Cardiology. Heart bypass operations carry significant risks, including the potential to cause “further heart damage, stroke, [and] brain dysfunction.” Angioplasty isn’t much better, also carrying “significant mortality and morbidity,” and often doesn’t work, in terms of decreasing risk of subsequent heart attack or death. “So, it seems we have an enormous paradox. The disease that is the leading killer of men and women in Western civilization is largely untreated.” “The benefits [of the invasive procedures] are at best temporary,…with most patients eventually succumbing to their disease.” In cancer we call that palliative care, where we just kind of throw up our hands, throw in the towel, and give up actually trying to treat the disease. So, why does this juggernaut of invasive procedures persist? Well, one reason is that “performing [surgical] interventions has the potential for enormous financial reward.”

    That’s considered one of the barriers to the practice of “preventive cardiology”—”adequate return.” Diet and lifestyle interventions “loses money for the physician.” “Although the practice of preventive cardiology is not…as lucrative…,” this article was hoping to nudge cardiologists in that direction by appealing to less tangible benefits. ...

    For example, before starting someone at moderate risk on a cholesterol-lowering statin drug, a physician might ideally say something like, “You should know that for [folks in your situation], the number of individuals who must be treated with a statin to prevent one death from a cardiovascular event such as a heart attack or stroke—is generally between 60 and 100, which means that if I treated 60 people in your position, 1 would benefit and 59 would not. As these numbers show, it is important for you to know that most of the people who take a statin will not benefit from doing so and, moreover, that statins can have side effects, such as muscle pain, liver damage, and upset stomach, even in people who do not benefit from the medication. I am giving you this information so that you can weigh the risks and benefits [of drugs versus diet] and then make an informed decision.”

    Continue at NutritionFacts: Fully Consensual Heart Disease Treatment.

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