FROM THE EDITOR'S KEYBOARD

FOCUS ON HEART DISEASE

Heart disease--it's still the leading killer in America--for both men and women. We turn attention in this issue to some pertinent elements of this disease.

Our issue concludes with abstracts dealing a variety of subjects. All are drawn from Phylis Austin's Science/Health Abstracts archives.

COMING NEXT ISSUE:

Special feature: "A Pharmacist's Perspective on Homeopathy." You'll find this new manuscript will generate much interest and dialogue!

Also  a radio script on "Social Contacts and Mortality" and Phylis Austin's Science/Health Abstracts.

SECTION II

TRANSCRIPTS FROM THE WELLNESSWISE RADIO PROGRAM

(All scripts copyright 1995 and 1996 by David J. DeRose, MD, MPH)

SILENT "HEART KILLERS"

You feel great--but you may be on the verge of a heart attack. I'm Dr. David DeRose, in a moment we'll look at America's leading killer on WellnessWise.

In 1987 the American Journal of Preventive Medicine published a vital series of reports entitled "Closing the Gap--The Burden of Unnecessary Illness."

One critical disease that the authors looked at is still America's leading killer--heart disease. Although those 1987 reports will soon be a decade old--their message still needs to be heeded: much of the burden of heart disease in America could be prevented by attention to three lifestyle areas.

One risk factor accounted for more premature heart deaths than either of the other two combined. It was cigarette smoking.

Now, although you don't need a doctor to diagnose whether you smoke or not, you may not realize whether you have the other two risk factors.

The second risk factor is high blood cholesterol. It alone accounted for over 5 million cases of heart and blood vessel disease with 100,000 deaths per year. The third risk factor--high blood pressure resulted in nearly 300,000 lives lost annually from heart and blood vessel causes. High blood pressure, like high cholesterol, often does its work silently.

Even though it's not new news-- we still need to hear it. All Americans should know their blood pressure and blood cholesterol. And if those values are high--or if they smoke-- they should think now about changing those risk factors _before_ they become a statistic.

For WellnessWise, I'm Dr. David DeRose

Reference: Tolsma, DD and Koplan, JP, "Health Behaviors and Health Promotion", in Last, JM and Wallace, RB, (ed) Maxcy-Rosenau-Last Public Health and Preventive Medicine, 13 th edition, Appleton and Lange, 1992, p. 701-702.

LDL DENSITY AND HEART DISEASE

Good news for your heart. I'm Dr. David DeRose in a moment: "new insights on cholesterol" on WellnessWise.

Higher blood cholesterol levels _do_ increase one's risk of heart disease. However, how can some people with high cholesterol values escape disease while others with lower cholesterol values succumb to heart attacks and other ailments.?

We learned one explanation years ago when we realized that cholesterol traveled through the blood stream in different "vehicles." The two most important seemed to be HDL and LDL. Individuals with higher HDL values tend to be protected from heart disease. Higher LDL values tend to increase heart disease risk.

However, we're now learning that not even all LDL is the same. The size of the LDL vehicle seems to affect its ability to cause hardening of the arteries. Smaller dense LDL particles are more dangerous than larger fluffier ones.

Two facts make this technical subject very practical. First: regular physical exercise is associated with the less dangerous LDL.

Second, body fat--if it is stored around the waist--makes you more likely to have the dangerous dense LDL.

The bottom line--all cholesterol is not created equal--if you trim your waist line and exercise more--even if you don't lower your cholesterol much, you are probably decreasing your risk of heart disease.

For WellnessWise, I'm Dr. David DeRose.

Reference: Slyper, Arnold H., Low-Density Lipoprotein Density and Atherosclerosis: Unraveling the Connection, JAMA, 272(4):305-308; July 27, 1994.

HYPERTENSION IN YOUNG MEN

Young adults face a particular problem with one of America's most prevalent diseases. I'm Dr. David DeRose High blood pressure in young adults-- in a moment on WellnessWise.

A recent national survey interviewed over 8000 adults about practices that can help control blood pressure. The interviewers asked about high blood pressure medication use, reducing weight, limiting salt intake, and exercising. They found that among all adults with high blood pressure, over three quarters of them took at least one of these forms of action.

However, among men 18-34 years old, only about half of them implemented even one of these actions. Why were the younger men less likely to take action? There may be several explanations. First, younger individuals generally feel that they are in better health. This study found that those who felt they were in "excellent health" were less likely to take action to control their blood pressure.

Second, younger individuals who feel well may be less inclined to take medications that can cause _real_ side effects. In harmony with this, the study indicates that physicians should do better at prescribing non drug therapies for hypertension. For example, the blood pressure lowering effects of weight reduction and exercise are well recognized. When patients are so advised, the study found that they generally follow the advice.

High blood pressure is a serious problem across all age groups. Just because you feel fine doesn't mean that high blood pressure isn't adversely affecting your blood vessels, your heart or your kidneys.

Young men who feel well may be at particular risk to neglect the seriousness of the condition. It behooves us all to know what our blood pressure is and to recognize that there are other steps besides medication that can help control it.

For WellnessWise, I'm Dr. David DeRose.

References: MMWR, Adults Taking Action to Control Their Blood Pressure--United States, 1990, 43 (28):509-511., July 22, 1994.

SECTION III

SCIENCE/HEALTH ABSTRACTS

Infants whose mothers smoke or who are exposed to the smoke of others may suffer a decrease in their spatial information processing abilities. (Teratology 47(5)462-463, May 1993)

SECTION IV

PARTING WORDS

OFFERS FROM OUR SPONSORS

Our sponsors continue to offer special services to WEJ readers

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