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Exercise Heart Disease

Are Stents The Answer?

            In a previous newsletter I mentioned Dr. David Sabgir, an Ohio cardiovascular specialist, featured as a ‘CNN Hero’ in a news item titled “Doctor ditches white coat for walking shoes.”  What follows are more thoughts from the perspective of this cardiovascular specialist.

            There are several myths surrounding Coronary Artery Disease (CAD).  A big one is that stents prevent heart attacks in patients suffering from stable angina.  As it happens – they don’t.  More likely, they put you in shock when you see the hospital bill. Stents run around $4,000 with hospital bills that can often land between $30,000 and $100,000.  Curiously, we’ve known for almost a decade that several inexpensive medicines are as effective as stents.  For more about the back story read “Putting Stents to the Test.”

            Of course, if 911 is delivering you to the emergency room with an acute coronary event, a stent may be what saves your life.  Other than that, they help take care of chest pain and that’s pretty much it.  They don’t prevent death, heart attack or anything else better than an appropriate combination of aspirin, beta blockers, ACE inhibitors, and statins.

            You might ask, “If I get a stent, will I still need the medicines.”  Usually you will. You might also wonder why 500,000 people a year get stents.  Hmmmm…might be because emergency rooms typically lack a full medical history and aren’t likely to get it unless they can talk to your primary care doctor.

            As for what causes heart attacks, an easy way to remember the major risk factors is the mnemonic A, B, C, D’s

            A – Age

            B – Blood pressure

            C – Cholesterol

            D – Diabetes

            S –  Smoking and Sedentary lifestyle

            Other factors that contribute to risk include excess weight (especially abdominal fat), triglycerides, family history of Coronary Artery Disease (CAD) and stress. Although stress is not usually the direct cause of a CAD event, it does contribute to many other risk factors.

            Understanding the importance of cardiovascular health is the first step. The second step is to put one foot in front of the other.  While getting into a healthier routine of diet and exercise can be a challenge, you can be sure I’ll have good advice and be rooting for you.  For a pleasant morning, consider joining me Saturdays for a memorable morning walk.

            Nancy Neighbors, MD

By Nancy Neighbors, MD

... Dr. Neighbors provides a blend of traditional family medicine and evidence-based lifestyle medicine in Huntsville, Alabama. When indicated, lifestyle change is recommended as the first line of therapy.

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