THE BLOG
10/15/2010 08:21 am ET Updated Nov 17, 2011

The Problem with Interventional Drug Therapy for Coronary Heart Disease

To fully grasp how so many smart, right-minded people could get it so wrong, it might help to start with a quick review of medical history. Take the radical mastectomy, conceived by William Halsted in the late 19th century. The procedure was intended to remove all cancer cells of the breast, the overlying skin, the underlying muscle and regional lymph nodes. It was mutilating, permanently disfiguring and no more effective than less radical, less disfiguring procedures.

Still, because of the prestige and respect Halsted commanded as a teacher of surgeons, his disciples defended and taught the radical mastectomy at the most revered medical colleges. His extreme procedure was perpetuated for almost a century, until challenges by courageous physicians in Europe and America, along with a prospective randomized study by Dr. Bernard Fisher, finally sounded the death knell of this standardized surgical error of the century.

The 21st-century analogue to this unfortunate chapter is the interventional and pharmaceutical treatment of coronary artery disease. This approach results in significant mortality, morbidity and unsustainable expense. Neither the procedures nor the drugs that accompany them treat the cause. Standard care for coronary artery disease is nothing more than palliative. The purveyors of this treatment acknowledge that it is but a stop-gap therapy. And as in the case of the radical mastectomy, there is a far more effective, cost-effective and sustainable treatment. It's simple: advocate a lifestyle of plant-based nutrition, make a bold leap toward a world free of heart disease and lessen our use of scalpels and drugs.

For the minority of heart patients, specifically those in the midst of heart attacks or acute coronary syndromes, stents or coronary artery bypass may be lifesaving. For the rest, none of the present therapies targets the cause: the Western diet. As a consequence, the disease marches on in all patients, which leads to more drugs, stents and bypasses, increasing heart damage, heart failure and, too often, death.

In 1985, I initiated a study that treated seriously ill patients with coronary artery disease with plant-based nutrition and succeeded in the arrest and reversal of their disease. This program has been published at 5, 12 and 16 years, and most recently summarized at 20 years in my book, "Prevent and Reverse Heart Disease," making it one of the longest investigations of its type in medical research. The duration of the study is testimony that patients with coronary disease will adhere to these food changes for decades and beyond. Patients lose weight, blood pressure normalizes, and Type II diabetes improves or resolves, as do angina, erectile dysfunction and peripheral vascular and carotid disease. Angiographic reversal can be striking. Even more remarkable is the sense of control patients achieve when it comes to containing and reversing their disease.

Our success in counseling patients in how to arrest and reverse heart disease is directly related to the time and effort we expend to help them understand the connection between diet and disease. We succeed where others may fail because of attention to detail. The result: Patients report that this is the most significant and enduring medical encounter they have experienced. More importantly, they acquire an understanding of what caused their disease and how they can stop and reverse it.

Contrary to the argument that "patients won't do this," we find that patients rejoice once they understand their disease and how they may halt it. It is condescending to suggest that patients have no interest in healing themselves. Is the problem that they will not follow advice, or how the advice was offered, if at all? One of my surgical mentors used to say, "Inappropriate application of the method is no excuse for its abandonment."

Present cardiovascular therapy has become a standardized error as it does nothing to prevent disease. In the history of our profession, have we ever before developed an expensive, painful, non-therapeutic treatment of the leading killer of women and men, while failing to inform them of the cause of their illness?

The time is long overdue for legendary work. We can hardly be proud of an interventional and drug therapy, which results in death, morbidity, inordinate expense, disease progression and can never halt this food-borne epidemic. Every patient with this disease should be made aware of this safe, simple, enduring option to cure himself or herself. Most coronary disease need never exist, and where it does exist, it need not progress. Present coronary artery disease therapy need not become the radical mastectomy of this century.