Covering the Heart Disease ‘Big Three’

An article in the Feb. 26 issue of the medical journal The Lancet succinctly and accurately summarizes our knowledge about the preventable causes of heart disease, the nation’s No. 1 cause of death.

“From the 1950′s onward, epidemiological studies … identified personal characteristics as risk factors for the development of premature CHD [coronary heart disease] in previously health people. Of these modifiable factors,” The Lancet reports, “cigarette smoking, blood pressure and total blood cholesterol were most consistently and powerfully implicated.”

The bottom line is that cigarette smoking, elevated blood pressure and high serum cholesterol are the “big three” of heart disease causes. Yet despite the medical community’s knowledge of these factors, the message is still not getting out with proper emphasis in the popular media.

For example, the Feb. 21 issue of Newsweek published an American Heart Association sponsored advertorial on heart health. Both the group’s current president, Dr. Lynn Smaha, and President Elect Dr. Rose Marie Robertson, contribute commentaries to the magazine supplement titled, “A Heart Health Update.”

In his introduction, Smaha wrote about risk factors for heart disease, citing “high blood pressure and cholesterol levels,” but did not once mention cigarette smoking. When addressing “lifestyle factors” that affect heart disease risk, he refers to only two: living with an ill spouse, an alleged risk factor; and owning a pet, a purported protective factor.

In her commentary, Robertson’s first reference to heart disease risk factors omits cigarette smoking despite its significant role in causing heart disease. When she does mention smoking a few paragraphs later, it is only in passing and is given inappropriately low priority on the list of ways to reduce one’s risk of heart attack and stroke.

When asked to comment on the lack of attention given to smoking as a preventable cause of heart disease, both AHA doctors stressed that smoking is a key factor in causation, but said the intent of their articles was to focus on research strategies for treating disease. Unfortunately, general readers could not be aware of the authors’ intent, and the important message that smoking is one of the three major causes of heart disease is lost.

The American public has long relied upon the AHA for information about the causes of heart disease. But the message that young people will take home by reading the AHA’s Newsweek advertorial will not give them the guidance they need to resist the urge and pressure to smoke, nor will it help adults seeking information on ways to lower their heart disease risk.

If the AHA leadership cannot do a better job of alerting the public to the real risks of smoking, who can?

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