Most doctors know the risk factors for heart disease. Far fewer act on the one that matters most. A professional look at where the conventional story and the evidence part ways.
Most doctors know many of the risk factors for heart disease. There is a clear understanding that coronary heart disease is a lifestyle-management problem — poor food choices, lack of exercise, smoking, alcohol, high blood pressure, age, lipid profile, diabetes, gender and family history. Yet standard management tends to focus on statins, lowering blood pressure, getting blood sugar under control and telling the patient to stop smoking. Very little real focus is on lifestyle, despite it probably being the most important change the patient could make.
In the INTERHEART study, which examined acute myocardial infarction across fifty-two countries, abnormal lipids, hypertension, diabetes, abdominal obesity, psychosocial factors, low fruit and vegetable intake, alcohol and lack of physical activity accounted for most of the risk of heart attack worldwide — in both sexes, at all ages, in all regions. None of this would surprise an integrative doctor. What might is the evidence on reversal.
