Invasive Cardiology Practices Not Effective
By Joel Fuhrman, M.D. www.drfuhrman.com
Bypass Surgeries And Other Medical Therapies Are Substandard And Outdated!
Based on the latest medical research, cardiology (as it currently is practiced) should be considered malpractice. Invasive cardiology procedures and surgeries are not effective.
With the documented effectiveness of lifestyle and dietary intervention, it is unconscionable that patients are not given this lifesaving information prior to dangerous medical interventions. (Most patients who are treated with modern cardiologic methods still die of their heart disease.) Up-to-date lifestyle and dietary advice can prevent an enormous amount of needless morbidity and mortality.
The practice of cardiology is comprised of a mixture of unproven and disproven surgical and invasive techniques that attempt to reduce the damage that results from the consumption of a diet that causes heart disease. Drugs to lower cholesterol and blood pressure are prescribed. But almost nothing is done to remove the dietary causes of high blood pressure and high cholesterol levels.This failure to address dietary factors allows the heart condition (atherosclerosis) to advance.
Coronary bypass surgery is overused, frequently ineffective, and absurdly expensive.“It is the epitome of modern medical technology, yet, as it is now practiced, its net effect on the nation’s health is probably negative,” says Thomas Preston, M.D., professor of medicine at the University of Washington School of Medicine and Chief of Cardiology at Pacific Medical Center, Seattle,Washington.1
The past 30 years has seen a proliferation of bypass surgery and angioplasties performed on Americans, despite strong scientific evidence that neither may be helpful in the long run for the overwhelming majority of patients. In general, the main reason why one million such procedures are undertaken each year is the high number of working cardiologists and cardiovascular surgeons in the medical community and the extremely high profitability of these procedures (around $100,000 for a bypass and $40,000 for an angioplasty).
The landmark Coronary Artery Surgery Study (CASS) demonstrated the irrelevance of bypass surgery and angioplasty to survival after a diagnosis of coronary artery disease is made. No statistical difference in survivability was observed between patients who had surgery and were treated medically and patients who were treated medically without surgery. 2 Likewise, the 10-year outcome after angioplasty shows no better results compared with similar medically treated patients who did not undergo the intervention.3 The study following cardiac patients for the longest period (22 years) concluded:
“There was no long-term survival benefit for high-risk patients assigned to bypass surgery. The number of patients who did not have another heart attack in this twenty-two year time frame was significantly higher in the group treated conservatively without surgery (57%) compared with those undergoing bypass surgery (41%). This trial provides strong evidence that initial bypass surgery did not improve survival and that it did not reduce the overall risk of myocardial infarction.”4
(Imagine the potential benefits to the group who did not undergo bypass if they had adopted my program of nutritional excellence.)
The bottom line is that bypass, angioplasty (with or without stenting), and medical therapy are all substandard and outmoded therapies. The war on heart disease cannot be won while patients continue eating a heart disease-promoting diet.
Since bypass surgery has not been documented to extend life, proponents claim it increases the “quality of life.” Wow, is that ever a ridiculous claim. Who would logically want a surgery that included the following: 1) your chest is cracked open, 2) veins from your legs are removed and surgically placed in your heart, and 3) you will have decreased circulation and oxygenation to your brain (decreasing your mental function) forever? Compare that nightmare with my approach: 1) eating only fresh fruits and vegetables for a few weeks, 2) resolving your chest pains, and 3) getting dramatically more benefit.
Rather than doing the actual surgeries, you could get far superior results by simply 1) going into the hospital, 2) pretending you had bypass surgery, and 3) eating in accordance with my dietary approach for a few weeks. We could put a few scars on your chest and add some stitches while you are under general anesthesia. Afterwards, you would eat three fresh fruits a day, an ounce of raw nuts, and a couple of pounds of vegetables. You would be free of your chest pain in the same amount of time it would take to finish the recovery and rehab from the bypass. (Saving $100,000 would make you feel pretty good, too.) Nutritional intervention is almost never discussed with patients. Patients are being lied to when they are told that surgery is necessary or they will die.
Bypass surgery and angioplasty only attempt to treat a small segment of the diseased heart, and benefits are usually only temporary. Atherosclerotic plaque blankets all of the vessels in the heart, so bypassing or removing only the most diseased portion does not significantly reduce the potential for a deadly heart attack. Since all of the shallow and non obstructive lipid deposits in all of the other vessels are left intact, the overall burden of disease is largely unaffected. The vast majority of patients who undergo these interventions do not have fewer new heart attacks or longer survival.5 In fact, the procedures themselves expose the patients to increased risk of new heart attacks, strokes, infection, encephalopathy, and death. Is all of this worth it just to get symptomatic benefits that erode with time?
Because these mechanical interventions do not address the cause of the disease and only treat the symptoms, it is not surprising that the patients who undergo bypass and angioplasty experience disease progression, graft shutdown, restenosis, and need additional procedures because their heart disease continues to advance. The vast majority of these treated patients needlessly die prematurely from heart disease because their (nutritional) disease remains essentially untreated.6
Patients mistakenly think that if the results of their stress tests or cardiac catherization (angiography) are “normal,” they are not at risk.
Heart attacks result from a defect in the plaque wall, which leads to a thrombus (blood clot). Even a small coating of vulnerable plaque, invisible to cardiac testing, can cause a heart attack, and typically does. The important point to remember is this: Individuals without major blockages of their great vessels—with only 30- 50 percent stenosis (narrowing)— are more likely to develop a fatal cardiac event than those with more significant blockages. Yet these individuals are not even shown to have heart disease with a stress test or angiography. Stress testing only identifies blockages that obstruct greater than 85 percent of the vessel lumen.
A normal stress test is meaningless and does not mean that you do not have significant heart disease or that you won’t shortly have a heart attack. Even coronary catherization (angiography) is unable to identify these shallower lesions. As a result, interventional strategies do not treat these significant lesions, in spite of the fact that they are the cause of most heart attacks.7 It is not the extent of the blockage that determines risk, it is the vulnerability of the plaque or its propensity to rupture. Seventy to 80 percent of all myocardial infarctions (heart attacks) are caused by plaques that are not obstructive or detectable by angiography or stress tests.
When atheromas (lipid deposits) first develop on the wall of a blood vessel, the walls remodel outward, preserving the lumen. These are the most vulnerable or lethal plaques, and they do not obstruct or encroach on the blood flow. These heart attack-prone lesions have dangerous characteristics that are not revealed by cardiac testing.
Inflammatory cells and a large lipid core of cholesterol in the plaques are characteristic of the most dangerous lesions. The breakage or rupture of these vulnerable lesions causes heart attacks. Cardiac surgery and angioplasty does not address one’s risk of a later heart attack, as it does not remove or reduce the probability that these unrecognized vulnerable plaques will rupture and create a clot. Most people think going to cardiologists and radiologists to get evaluated to see if they have a significant coronary blockage will enable an intervention at an early enough point to save their life. They are dead wrong. Angioplasties and stent placements, as well as cardiac surgery, treat symptoms, not the disease.
Since a proven effective nutritional strategy is available, the risks and complications of cardiac interventions and bypass surgeries are simply not necessary. Instead of expensive and invasive medicine, we need doctors to educate and motivate patients to take charge of their own health. Patients are unwittingly committing slow suicide with their knives and forks, then running to doctors expecting to escape the predictable results of their dietary folly.
The medical answer to heart disease is both financially devastating and futile. An entire industry has blossomed to attempt to deal with the dangers of heart disease-causing food. This situation wouldn’t be as bad if patients were told that there is a more effective option that can reverse their heart disease and protect their lives with certainty. If sufficient information were distributed to patients, they could choose the approach that is right for them.
If all of the physicians in America gave patients this information, we would have an unusual new problem. As patients got well, doctors and hospitals would lose most of their business—and drug companies would lose billions. People in these industries would need to embark on new careers. Human nature being what it is, this is not a likely scenario. Most people—doctors included— would rather die than change their bad habits. Nevertheless, my goal is to recruit an army of heart disease-proof individuals, who will be the winners in the war against unnecessary heart disease deaths.
Compelling data from numerous population and interventional studies, as well as dramatic results applying this new research in clinical practice, illustrate that a carefully designed natural plant-based diet will prevent, arrest, and even reverse heart disease.8 Only via nutritional excellence can you address all of the invisible, but potentially dangerous, plaque throughout your coronary arteries.
In my new book, Cholesterol Protection For Life, I describe a program of nutritional excellence that protects you far beyond what is possible with the “best” medical care. Unlike surgery and angioplasty, the dietary approach addressed in the book does not merely treat your heart, but rejuvenates and protects your entire body against heart attack, stroke, pulmonary embolism, venous thrombosis, peripheral vascular disease, and vascular dementia. Nutritional excellence is your most valuable insurance policy to secure a longer life, free of medical tragedy.
The choice is up to you: nutritional excellence or inevitable heart disease. If you are taking the time to read this newsletter, I am virtually certain you do not want to have a heart attack. So, I urge you to take steps today to dramatically improve your diet and lifestyle.
Cholesterol Protection For Life should be distributed to every heart patient in America because conventional care—with the usual poor outcome— is bad medicine. Withholding simple nutritional advice that could make the difference between life and death should be considered malpractice. Patients need to be given the information they need to make a definitive decision to not have a heart attack. I have no doubt that many people will choose to keep eating the heart disease-causing standard American diet, hoping to lessen the risk a bit by sprinkling in a few drugs. But others (and I hope this is you) will take steps to enhance their diet and health and say “No” to angina and heart attacks. They will have understood that nutritional excellence can totally prevent and even reverse heart disease, and they will want to take advantage of that knowledge.
1. Preston TA. Marketing an operation: Coronary artery bypass surgery. J Holistic Med 1985;7(1): 8-15.
2. Myers WO, Blackstone EH, Davis K, et al. CASS Registry long-term surgical survival. Coronary Artery Surgery Study. J Am Coll Cardiol 1999; 33(2):488-98. Alderman EL, et al. Ten-year follow- up of survival and myocardial infarction in the randomized coronary artery surgery study (CASS). Circulation 1990;82:1629-46.
3. Espinola-Klein C, Rupprecht HJ, Erbel R, et al. Ten-year outcome after coronary angioplasty in patients with single-vessel coronary artery disease and comparison with the results of the Coronary Artery Surgery Study (CASS). Am J Cardiol 2000; 85(3):321-6.
4. Peduzzi P, Kamina A, Detre K, et al. Twenty-twoyear follow-up in the VA Cooperative Study of Coronary Artery Bypass Surgery for Stable Angina. Am J Cardiol 1998; 81(12):1393-9.
5. Forrester JS, Shah PK. Lipid lowering versus revascularization—an idea whose time for testing has come. Circulation 1997;96:1360-1362.
6. Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part II. Circulation 2003;108(15):1772-8. Naghavi M, Libby P, Falk E, et al. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I. Circulation 2003;108(14):1664-1672. Wexberg P, Gyongyosi M, Sperker W, et al. Pre-existing arterial remodeling is associated with in-hospital and late adverse cardiac events after coronary interventions in patients with stable angina pectoris. J Am Coll Cardiol 2000 Nov 15;36(6):1860-9.
7. Ambrose JA, Fuster V. Can we predict future coronary events in patients with stable coronary artery disease? JAMA 1997;277:343-344. Forrester JS, Shah PK. Lipid lowering versus revascularization— an idea whose time for testing has come. Circulation 1997;96:1360-1362.
8. Ivanov AN, Medkova IL, Mosiagina LI et al. Vegetarian diet in treating elderly patients with ischemic heart disease (clinico-hemodynamic, biochemical, and hemorheological effects). Vopr Pitan 2002;71(3):11-4. Jenkins DJ, Kendall CW, Marchie A, et al. The Garden of Eden—plantbased diets, the genetic drive to conserve cholesterol and its implications for heart disease in the 21st century. Comp Biochem Physiol A Mol Integr Physiol 2003;136(1):141-51.