Alternatives

What Your Doctor May Not Tell You about Cholesterol: The Latest Natural Treatments and Scientific Advances in One Breakthrough Program
by Stephen R. Devries, M.D., Winifred Conkling

Heart disease is largely preventable, but conventional cholesterol management is often inadequate. According to university cardiologist and leading prevention specialist Dr. Stephen R. Devries, avoiding heart disease requires a far more comprehensive approach that balances new high tech testing with low tech treatments.

Now, in What Your Doctor May Not Tell You about Cholesterol, Dr. Devries combines natural treatments with the latest scientific advances. New types of cholesterol tests are highlighted that go far beyond routine testing to identify hidden risks. Expanding the traditional medical model, Dr. Devries illustrates the role of mind/body interventions, lifestyle, supplements, vitamins, and conservative use of medication for optimal prevention.

Chapter 1

Five years ago, the well-known coach of a Chicago professional sports team came to see me because he was concerned about his risk of having a heart attack. One look at him and you'd think he was worried about nothing: At age forty-six, he was fit and trim; he didn't smoke; his blood pressure was normal; he had no history of diabetes; and his cholesterol levels appeared very desirable.

Still, the coach did have one significant risk factor: Ten male members of his immediate family had died of heart disease before age fifty-three. This remarkable family history gave him cause for concern, but one doctor after another had looked him over and told him that he was in excellent shape; no problem could be identified. These physicians offered no treatments and recommended no lifestyle changes.

Of course, there were steps the man could take to minimize his risk, but to identify them his doctors needed to look a little deeper into his health profile. When the coach came to my office, I performed a series of blood tests, including several that his previous physicians hadn't recommended. The results: His Lp(a) level - a genetically determined risk factor for heart disease - was six times the upper limit of normal. It was, at that time, the highest level I had ever seen. Left untreated, this imbalance would have left him at great risk of heart attack. Fortunately, his Lp(a) level has since improved with treatment, hopefully giving him the opportunity to escape the fate of his relatives.

If this coach had relied on conventional cardiovascular tests - remember, his cholesterol profile was desirable - he may never have learned that he was, in fact, at great risk of heart attack. Millions of Americans share the same fate: They are at high risk of heart attack despite having normal cholesterol levels. In fact, more than half of all heart attacks occur in people with normal cholesterol levels.

Each year, about 650,000 Americans suffer their first heart attack. Many of these people have been careful about diet and exercise and have never had any cardiac symptoms. About half of them have had a recent medical checkup that indicated that their cholesterol levels were normal. Clearly, to know your risk of heart attack, you must look at more than your basic cholesterol numbers.

Beyond Cholesterol

Elevated cholesterol is a significant risk that should not be ignored. If a patient comes to me with elevated cholesterol, I recommend he or she take steps to lower it, often by starting with the natural options described in this book. Still, the standard cholesterol tests are incomplete when it comes to determining risk. In order to dig deeper and identify risks hidden by the routine cholesterol profile, additional tests that go beyond cholesterol are needed. (These specific tests are described in detail in chapter 4.)

If cholesterol isn't the all-encompassing risk factor many doctors make it out to be, why don't other physicians look beyond cholesterol to other risk factors? In my opinion, there are two main reasons:

• Many doctors don't emphasize prevention. Instead, the focus tends to be on treatment of existing medical problems. I believe it makes a lot more sense to prevent heart problems than to treat them after the fact.

• Fewer data are available for the newer risk markers of heart disease than for standard cholesterol tests. Yet it's clearly recognized that more than one out of three patients with a heart problem has a normal cholesterol level. Obviously, factors beyond cholesterol play a significant role in bringing on heart disease.

Discovering Alternatives

In the past decade or so, patients have led their doctors toward a deeper appreciation of alternative therapies, those approaches to healing not traditionally taught in medical schools. According to the National Center for Complementary and Alternative Medicine, a branch of the National Institutes of Health that was founded in 1998, more than one out of every three Americans uses some form of complementary medicine.

Of course, alternative therapies aren't new; many of the "newly discovered" approaches to healing have in fact been used for thousands of years by other cultures. The new wrinkle involves integrative medicine, an approach to patient care that involves a combination of conventional medicine and natural approaches, including simple yet powerful dietary changes, exercise, vitamins, supplements, and mind-body relaxation techniques. In my opinion, integrative medicine makes the most sense and will be the medicine of the future. Why shouldn't both doctors and patients embrace the best of both conventional and alternative therapies?

My belief in integrative medicine has been affirmed by my experiences with the heart disease prevention program at the University of Illinois. When we launched this program, my colleagues and I first focused on reducing cholesterol with medication. Over time, the same patients returned with ongoing symptoms of heart disease despite our best efforts. It became clear that our approach to treatment - however valuable in some circumstances - was woefully incomplete. Although the powerful medications we relied upon did a great job at lowering LDL (the "bad" cholesterol), we were not addressing a host of other (often inherited) risk factors. There was more to the story.

I was able to explore these other risk factors when I opened the Healthy Heart Center, a suburban satellite of the University of Illinois in Deerfield, Illinois, dedicated exclusively to heart disease prevention, one of the first such sites in the nation. Many of my patients in this Deerfield site were very interested in exploring more natural approaches to heart health. They often asked me: "I am willing to use medicine as a last resort, but can't we first try something else before a prescription?"

Copyright © 2007 by Stephen R. Devries, M.D.

About the Author

Stephen R. Devries, M.D., is the director of the Integrative Program for Heart Disease Prevention and an associate professor of Clinical Medicine, Cardiology, at the University of Illinois at Chicago. He lives in Deerfield, Illinois.

Winifred Conkling is the co-author of What Your Doctor May Not Tell You About IBS.