“Coronary artery disease begins in childhood, so
that by the teenage years, there is evidence that
plaques that will stay with us for life are formed
in most people. Preventive
measures instituted early are thought to have
greater lifetime benefits. Healthy lifestyles will
delay the progression of CAD, and there is hope that
CAD can be regressed before it causes heart
disease,” said Edward A. Fisher, M.D., Ph.D.,
M.P.H., who is the Leon H. Charney Professor of
Cardiovascular Medicine and also of the Marc and
Ruti Bell Vascular Biology and Disease Program at
the NYU School of Medicine.
scientific research regarding my specific case's
variables I cannot say with 100% certainty that my
survival of a Widowmaker heart attack with no
discernable heart damage is solely due to the
lifestyle choices I've made... but research supports
Variables such as diet, exercise, stress,
are key factors in the progression of CAD,
but they are not the sole contributors.
Genetics plays a greater role according the the
American Heart Association, World Health
Organization, and the American College of
In my specific case I
can't say that my childhood was stress free for it
wasn't; but the stressors I endured are no more or
less significant than those experienced by people
who will never develop CAD. There is research
to support that people with obsessive (type-a)
tendencies are more prone to heart disease.
This is because when stressed your body's blood
pressure increases and over time this can have
negative effects on vascular health. People
who live in a constant state of stress exert
constant stress on their cardiovascular system and
in time it can cause permanent damage.
can say that in the past 40 years our general
understanding of what healthy nutrition is has
improved overall in general society. Yet
obesity and nutrition related conditions are at an
all-time high. When I was growing up - and
more specifically where I grew up - fried foods were
so common they should have been considered a 5th
food group; to many Southerners fried foods are in
fact just that.
In my specific
diet I was very fortunate to have avoided several
"habitual" dietary habits that have been shown in
recent studies to be extremely unhealthy. For
instance I have never been a soft-drink/soda fan.
Growing up in Savannah, Georgia - one of the
humidity capitals of the South, I just never felt
that my thirst was quenched with sodas. In
fact I felt worse. That much sugar is truly
unhealthy. I kept coolers of water in my
refrigerator and when I came inside from riding my
bike through the woods and I was thirsty I reached
for some refrigerated water. A habit I have
kept to this day.
In the past 20 years
I've cut fried foods, junk food such as potato
chips, candy bars, etc..., dairy such (milk, butter,
creams), and certain meats (beef, pork, dark meat
poultry, shellfish) completely out of my diet.
Other risk factors such as smoking and
alcohol use were things I also avoided as a teen.
I can look back and it's shocking to me now to think
about how many of my friends in high school were
using tobacco products and alcohol by the time we
were 14 and 15 years old. I avoided these
traps too. Smoking and excessive alcohol use
are considered significant risk factors for CAD.
The simple fact about my own history with
CAD is that where there is smoke there must be
fire... when I had my heart attack and was taken
into the cardiac cath lab the story of my history
with CAD was made clear. My right coronary
artery had been picking up the slack for my clogged
left coronary artery for a long time.
Collateral arteries - or remodeled branches as they
are called by medical professionals - are not grown
overnight. It takes years for them to develop.
This means that the stenosis (blockage) of my LAD
must have happened much earlier in my life.
When you take the time to dive into the
mountain of research on the subject a consensus
among researchers, doctors, surgeons, etc...
appears. In most cases where a young (under
the age of 60), healthy (meaning healthy diet and
lifestyle) person experiences an unexpected heart
attack, heredity/genetics always plays the largest
For me, I was shocked but then
again I wasn't. One of my father's brothers
(my uncle) was one of the first early successful
heart transplant recipients. He was also one
of the longest living heart transplant recipients.
He had a heart transplant in his early 40's.
Some of my earliest memories from childhood were of
my grandfather's funeral - he died in his early 60's
from CAD. I remember seeing the scars on my
grandmother's chest peek above her shirt from her
triple bypass surgery (CABG - Coronary Artery Bypass
Graft). She would live 2 years past that
surgery and die from heart failure in her early
60's. These were my father's parents! My
father's oldest brother died from CAD while walking
on a treadmill - in his mid 60's. My father
would have stents and heart surgery in his late
50's. Heart disease and family members dying
as a result of it has been a constant theme in my
What I figured I was doing
better than everyone who had come before me was I
didn't smoke or drink (which truly my father didn't
either), and I wasn't overweight from lack of
regular exercise or an unhealthy diet (something my
father was). I honestly figured that I was on
the smart side of my "family curse". It's just
known that the men in my family typically die young
from heart disease.
some things to look for in your own family history:
- IMMEDIATE FAMILY - This is
your parents, their siblings (aunts & uncles),
grandparents, and your siblings. If any of
these people suffer from CVD (Cardiovascular
Disease) - which included high blood pressure,
CAD, clotting issues (thrombosis), stroke, or
birth related (congenital) heart conditions -
you are potentially at greater risk for
developing CVD yourself.
- CHOLESTEROL - This is one
risk factor that I had and was masked by my
better than average physical condition and above
average fitness level. If you have
borderline high cholesterol (Total Cholesterol
from 200 to 239). If your HDL is on the
lower side of normal or is below (you want HDL
to be a high number - think of the "H" in HDL as
"Healthy"). If your LDL is on the high
side of normal (you want LDL to be a low number
- think of the "L" as "Low" - this is the "bad"
cholesterol). If your triglycerides are on
the high side of normal or above normal.
These indicators when found together -
borderline high total cholesterol, low HDL, high
LDL, high triglycerides - in a fit and generally
healthy person (doesn't have other risk factors)
- is in itself a great cause for alarm.
This was me. 16% body fat. Lean and
fit. Able to ride 100 miles on a bicycle
at near professional energy output. No
smoking, drinking, or other significant risk
factors... other than a significant family
history. I had a widowmaker heart attack
at age 46. Cholesterol was my smoking gun.
The fact that every blood test I've had my
entire adult life has shown the exact same set
of cholesterol reading also says that I was born
to develop CAD. It's in my genetics.
- DIABETES - Diabetes is the
leading cause of kidney failure, nontraumatic
lower-limb amputations, and new cases of
blindness among adults in the United States.
Diabetes is a major cause of heart disease and
stroke. Diabetes is the seventh leading cause of
death in the United States. Diabetes is
hereditary and therefore if anyone in your
immediate family has diabetes you are at a
greater risk for it.
- ETHNICITY - African
Americans, American Indians, Pacific Islanders,
and Mexican Americans are all at higher risk for
CVD and CAD. If you are a member of any of these
groups, or like me - one of your parents is a
member - you should be aware of the fact that
environmental factors such as diet and lifestyle
are not the primary indicator for the
development of CVD and CAD.