Why are heart attacks still happening?

I'm a cardiologist. I see patients with heart disease in the form of coronary artery disease every day.

These are people who have undergone bypass surgery, received one or more stents or undergone other forms of angioplasty, have survived heart attacks or sudden cardiac death, or have high heart scan scores. In short, I see patients every day who are at high-risk for heart attack and death from heart disease.

But I see virtually no heart attacks. And nobody is dying from heart disease. (I'm referring to the people who follow the strategies I advocate, not the guy who thinks that smoking a pack of cigarettes a day is still okay, or the woman who thinks the diet is unnecessary because she's slender.)

Two high-profile deaths from heart attacks occurred this week:

Davy Jones--The iconic singer from the 1960s pop group, the Monkees, suffered sudden cardiac death after a large heart attack, just hours after experiencing chest pain.

Andrew Breitbart--The conservative blogger and controversy-generating media personality suffered what was believed to be sudden cardiac death while walking.

It's a darn shame and it shouldn't happen. The tools to identify the potential for heart attack are available, inexpensive, and simple. The strategies to reduce, even eliminate, risk are likewise available, inexpensive, and cultivate overall health.

The followers of the Track Your Plaque program who

1) get a heart scan that yields a coronary calcium score (for long-term tracking purposes)
2) identify the causes such as small LDL particles, lipoprotein(a), vitamin D deficiency, and thyroid dysfunction
3) correct the causes

enjoy virtual elimination of risk.

Comments (10) -

  • Alexandra

    3/4/2012 1:02:04 PM |

    Just read this about Davy Jones:
    http://blog.sfgate.com/dailydish/2012/03/01/micky-dolenz-bewildered-by-davy-jones-death/

  • nina

    3/4/2012 9:30:09 PM |

    I saw some recent photos of Davy Jones and thought ''wheat belly''.  Sad, but avoidable.

  • PeteKl

    3/4/2012 11:00:30 PM |

    I don''t claim to entirely know the answer to this question, but I am willing to venture a guess to what might be part of the answer.  My suspicion is that in the end, for better or worse, most people value the opinions of their social group more than they value their health.  Currently Doctor, your recommendations are just too far from mainstream opinion and sadly will be ignored by all but the most thoughtful people.

    As anyone who has tried to modify their diet has probably discovered, the greatest challenge often isn''t dealing with cravings for a missing food.  Instead it is dealing with the social backlash to your lifestyle change from friends and family.  

    At first everyone is interested in knowing why you have made the change and they attempt to accommodate your choice.  However eventually they become annoyed as they realize the change you made is permanent.  I can''t tell you how many times I have heard some variation on the following when deciding where to eat with friends (usually given with a thinly veiled snide tone of voice):

    “I would really like to check out that new Italian restaurant, but Pete won''t eat pasta, so I guess we have to go back to the usual place.”

    It doesn''t matter how many times I tell people that I can always find something to eat no matter where we go.  Someone will still insist on making an issue of my dietary choices.  Things aren''t always this blatant, but it is frequent enough that I eventually start wondering whether I should change my eating habits or stop eating with friends.

    While dietary modifications elicit the most direct response, these types of responses seems to occur with almost any health related change.  If your friends and family aren''t themselves doing something or think the change is a dumb idea (no matter how flimsy the reasoning), most people will avoid making a change.  

    Even my own partner, whose father died suddenly of a heart attack last month and whose relatively young mother has been diagnosed with chronic heart failure ignores my suggestions (which are based on your recommendations).  He has asked me several times for advice that might help his mother and the response to my suggestions is always that it won''t work.

    I finally realized that he simply doesn''t want to challenge the rest of the family.  His older brother, a pharmaceutical representative, is viewed as the “expert” on family health issues and my partner refuses to butt heads with him despite what is at stake.  So I keep quiet and wish his mother the best.

    Much of this is understandable.  Humans are social animals and we have evolved to depend on our social group for survival.  On a savannah in Africa 50,000 years ago this made perfect sense.  But in a modern world of science and technology these natural social instincts are increasingly an obstacle to our health and many of us know it.

    Yet it still takes a strong, independent personality to ignore these impulses.  While I have been able to make a number of changes in my life based on your recommendations, it has still been difficult to consistently follow through.  

    Just a few days ago I was invited over to someone''s house to celebrate a birthday.  So what was on the menu?  Several wheat pizza''s, of course.  So did I tell the host that because of my heart problems I no longer eat wheat?  Sorry Doctor, I didn''t.  Instead I shut up, ate the pizza and  proceeded to raise my small LDL particle level for the next week (http://www.trackyourplaque.com/blog/2011/11/friday-is-my-bad-day.html).

  • Robert

    3/5/2012 7:42:48 PM |

    Since adopting a paleo/low carb diet in the last year, I am looking into getting an NMR lipoprofile test to get a baseline of how my particle count looks.  Under the section of treatment options on this particular site, the first line of start with eating right reads "Eat more whole grains, fruits and vegetables."  The very first thing listed is whole grains.  This is so frustrating to see on a site promoting a very useful tool in CVD risk evaluation.  I have read "wheat belly" and "track your plaque", both very good books.  I am also reading primal body, primal mind.  Heart disease runs heavily in my family and I''m pretty much going against what most people in my famliy do by following low carb/paleo eating habits.  I just dont understand why these larger blood test companies, even with all the evidence continuing to pile up, still suggest foods that will worsen the problem the tests are evaluating in the first place.  I guess you have to have confidence in the test they provide (NMR), but just ignore what they say are the best options for treating abnormalities of that test?

  • Dr. William Davis

    3/6/2012 3:47:32 AM |

    It is unbelievable, isn''t it, with all their insights?

    Give them time and they''ll catch on. In the meantime, ignore this nonsense, Robert.

  • Julie

    3/6/2012 6:40:58 AM |

    Dr. Davis,
    What would you recommend for someone who had recently one stent put in and is currently on a statin and plavix post -op?
    Is it necessary to take statins in this case? Any additional supplements etc.?

    Thank you in advance for your help!
    P.S. Loved your book!

  • Catherine

    3/7/2012 12:41:32 AM |

    Dr. Davis,
    Could you please consider changing your "categories" back to the old way you had them organized--single file, alphabetical and one type size? Although it may give a more creative look to the website, it is harder to find the material being sought. I send many new people to your site and they often complain about it.

  • Dr. William Davis

    3/10/2012 3:51:20 PM |

    Hi, Julie--

    This is precisely what the Track Your Plaque program is about.

    In a nutshell:

    1) Identify the causes specific to you, including lipoprotein abnormalties/lipoprotein(a)
    2) Supplement and normalize vitamin D and iodine/thyroid status
    3) Supplement omega-3 fatty acids
    4) Do the diet

  • [...] patients so that they avoid having a cardiac.   "Why are heart attacks still happening?"  Why are heart attacks still happening? | Track Your Plaque Blog     I’m a cardiologist. I see patients with heart disease in the form of coronary artery [...]

  • margaret

    5/25/2013 6:05:53 AM |

    Dr Davis
    Just found your interesting website.  I am trying to get my partner to cut out wheat (overweight, high chol and high BP).  Unfortunately, I can't find a doctor who conducts the tests you recommend.  Do you know of such in Australia (particularly Western Australia)?  

    Many thanks and I'll continue reading till we catch up down here!!

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Pecan Streusel Coffee Cake

Pecan Streusel Coffee Cake


This is about as decadent as it gets around here!

Here’s a recreation of an old-fashioned coffee cake, a version with a delicious chewy-crunchy streusel topping.

I’ve specified xylitol as the sweetener in the topping, as it is the most compatible sweetener for the streusel “crumb” effect and browning.

Variations are easy. For example, for an apple pecan coffee cake, add a layer of finely-chopped or sliced apples to the cake batter and topping.

Additional potential carbohydrate exposure comes from the garbanzo bean flour and molasses. However, distributed into 10 slices, each slice provides 7.2 grams “net” carbs (total carbs minus fiber), a perfectly tolerable amount. Be careful not to exceed two slices!

Yield 10 slices

Cake:
2½ cups almond flour
½ cup garbanzo bean flour
1 tablespoon ground cinnamon
1 teaspoon baking soda
Sweetener equivalent to ¾ cup sugar
Dash sea salt

3 eggs separated
3/8 teaspoon cream of tartar
1 tablespoon vanilla extract
4 ounces butter, melted
Juice of ½ lemon

Topping:
½ cup almond flour
¼ cup pecans, finely chopped
1 tablespoon ground cinnamon
½ cup xylitol
1 tablespoon molasses
6 ounces butter, cut into ½-inch widths, at room temperature

Preheat oven to 325º F. Grease bread pan.

In bowl, combine almond flour, garbanzo flour, cinnamon, baking soda, sweetener, salt, and mix.

In small bowl, whip egg whites and cream of tartar until stiff peaks form. At low speed, blend in egg yolks, vanilla, melted butter, and lemon juice.

Pour liquid mixture into almond mixture and mix thoroughly. Pour into microwave-safe bread pan and microwave on high for 3 minutes. Remove and set aside.

To make topping, combine almond flour, pecans, cinnamon, xylitol, and molasses in small bowl and mix. Mix in butter

Spread topping on cake. Bake for 20 minutes or until toothpick withdraws dry.

Comments (1) -

  • Bob Kikkert

    9/8/2012 7:31:12 PM |

    The recipes you provide are not useful to me because of the requirement to use a sweetener equivalent to x amount of sugar.  All the sweeteners I have access to do not have enough information to determine how much to use.  I have thrown out two batches because thery were not sweet enough even though I used twice the amount of sweetener I thought was equivalent.  Why can you not indicate what sweetener you use in the recipes and the quantity? Then I wouldn't have to guess....

    Cheers...Bob

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