Speaking from the heart
CMAJ 1997;157:1736
Re: "Death by coronary" (CMAJ 1997;156[12]:1733-4), by Dr. David Rapoport
In response to: P. Neumann
Dr. Neumann's advice on chelation therapy is useful, and I sincerely hope that it will join the growing list of treatments and preventive measures available for coronary artery disease.
To lower our lipid levels, my at-risk patients and I have tried garlic and fish oil, with limited success, and lipid-lowering agents, with outstanding success. We are taking coated Aspirin, vitamin E and so many other remedies that I am reminded of 19th-century snake-oil days. We walk quickly. We jog. We watch our waistlines with variable results. In our leisure time we exchange remedies and we eagerly acquiesce to angioplasty and bypass grafting without so much as a second opinion. We feel disappointed if we are denied such interventions.
Neumann received his grafts in 1986 and they proved fruitless, but we are fortunate that this rarely occurs today. The 1980s and 1990s have brought life-saving advances that benefit most patients.
If we really want to attack heart disease, though, we should seek out the real culprits. I blame the cigarette companies, the fast-food companies and everyone else who is at work clogging our arteries. As we jog by the evil fast-food dens in our flashy track suits we can give "the Colonel" and his colleagues a glare, but this is best done in our 20s and well before a CABG rather than in our 50s and well after it.
David Rapoport, MD
Downsview, Ont.
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