Dr. Harlan M. Krumholz - The Expert Guide to Beating Heart Disease

This book contains advice and information relating to health care. It is not intended to replace medical advice and should be used to supplement rather than replace regular care by your doctor. It is recommended that you seek your physicians advice before embarking on any medical program or treatment.

All efforts have been made to ensure the accuracy of the information contained in this book as of the date published. The authors and the publisher expressly disclaim responsibility for any adverse effects arising from the use or application of the information contained herein.

The author has no financial interests or relationships with companies that would pose a conflict of interest with any of the recommendations or information provided in this book.

The names and identifying characteristics of people featured throughout this book have been changed to protect their privacy.

In The Expert Guide to Beating Heart Disease , respected cardiologist Harlan Krumholz has built the bridge between the lifesaving research results of our laboratories and the ultimate beneficiaries of the research, the patients. Our medical journals are replete with bench research and clinical trials whose results contain remarkable insights that have changed our thinking about the prevention, diagnosis, and treatment of heart disease, yet the sluggish way that this critically important information often makes its way into practice limits its usefulness. A neglected way to speed the process of incorporating new advances is to rely on the publics great interest in matters related to their own health, and that is just what Dr. Krumholz has accomplished.

People want to be in a position to benefit from the latest medical knowledgeand yet not be a victim of the hype and unfounded claims of so-called miracle cures. Patients must be willing to get involved, to believe that it is their business to know about the options for tests, for treatments, and for preventive measures that will help them avoid the serious consequences of disease. Patients must be their own advocates and participate actively in decisions with their doctors and nurses. Good doctors welcome such involvement. Nobody needs a medical degree to learn about what is best for them; what they need is the right attitude and accurate, simple-to-understand information.

The Expert Guide to Beating Heart Disease provides a way for patients with heart disease to ensure that they are giving themselves the best chance for good health and health care. Knowledge is the best tool for any patient to guarantee that they are getting the best care. What they need is a source that is credible, trustworthy, and understandable, and Dr. Krumholz, an international expert on cardiovascular diseaseand a leader in improving the quality of health careprovides it. Dr. Krumholz has distilled the most important information that every patient with heart disease (or a potential for developing it) should know.

His guide should be read by every patient with heart disease and those who want to protect themselves against the ravages of a disease that kills and disables so many.

Jerome P. Kassirer, M.D.

Distinguished Professor, Tufts University School of Medicine

Editor-in-Chief Emeritus, New England Journal of Medicine

If youre reading this book, its likely that you or someone you care about has heart disease. Heart disease is the leading cause of death in America and most other industrialized nations. This condition is usually caused by fatty deposits accumulating and building up inside the arteries that supply nutrients and oxygen-rich blood to your heart. When that blood flow becomes restricted by the narrowing of the arteries, your heart starts sending distress signals. The first sign of trouble may be shortness of breath when climbing stairs. Or sudden chest pain, called angina. Or a heart attack.

Whatever the first sign is, heart disease changes your life forever. It is chronic; that is, we dont yet know how to cure it. Of the millions of Americans with heart disease today, one million will have a heart attack this year and more than half of them will die as a result. Thats the bad news.

The good news is that recent scientific breakthroughs have made it possible to control and in some cases even reverse your heart disease. Today, as a result of these advances, more people are surviving heart disease and heart attacks than ever before. Ironically, this also means that more people now have to live with heart disease every day. What you need most now is information: trustworthy, scientifically accurate, and easily understandable information about what you can do to give yourself the best chance of taking charge of your heart disease.

Youd think that would be easy, given all the information thats currently available. But its not. Sure, there are lots of books, magazine and newspaper articles, TV reports, pamphlets, advertisements, and websites offering information on heart disease. But its nearly impossible to sort out what information is reliablethat is, grounded in the best science and unbiasedand what is not.

Fortunately, there are highly regarded sources of thoroughly credible information on the best strategies for treating your heart disease. The sources with some of the most helpful information for people with heart disease are guidelines published by the American Heart Association and the American College of Cardiology. Compiled by the best heart specialists in the country and updated regularly, their recommendations provide the very best information available on various aspects of heart disease.

The problem is that these guidelines are written for doctors.

Thats where this book comes in. The Expert Guide to Beating Heart Disease translates these expert guidelines and the best evidence about heart disease into plain English. This book gives you the key strategies that researchers have found work best. It equips you to monitor and enhance your own care. It also explains new, unproven, and even controversial treatments so you know exactly where the research on these treatments stands.

Theres another reason why this book is important for you. Research into the treatment of heart disease patients has shown time and again that there is a substantial gap between what scientists and expert cardiologists know about treating heart disease and how much of that knowledge is put to work for patients. In truth, the quality of care heart disease patients receive varies from place to place and from doctor to doctor. This book will help you ensure that youre getting the best, most effective treatment possible. It will also make it easier to understand the relative importance of each treatment your doctor recommends. This book encourages you to be engaged actively in your own treatment plan. After all, no one has a greater stake in the outcome of your treatment than you. With this book, youll have the tools to make informed choices so you can beat heart disease.

My intention is to place the best medical knowledge on heart disease directly in your hands so you can take charge of your heart diseaseand your health.

Harlan M. Krumholz, M.D., S.M.

Professor of Medicine (Cardiology)

Yale University School of Medicine

This book is organized so you can find the heart disease treatment information you need easily and quickly.

Chapter 1, Understanding Heart Disease, explains, clearly and concisely, what you need to know about your disease. We explore what heart disease is, how its caused, the risk factors that cause it to occur in some people but not others, its most common symptoms, and how doctors investigate those symptoms.

Chapter 2, Seven Key Strategies for Taking Charge of Heart Disease, contains some of the most important information in this book. It describes seven key strategies for treating heart disease. Each of these strategies is based on the official expert guidelines published for doctors, nurses, and other health care professionals by the American Heart Association (AHA) and the American College of Cardiology (ACC), among others. The scientific evidence behind the strongest recommendations in these guidelines is very solid. These recommendations represent the proven strategies and treatments that the best doctors and scientists in cardiology agree really work. Everyone with heart disease should know them. Now you can. By using these strategies as a checklist, you can make sure youre getting the best care available. Youll have the tools you need to help yourself get better.