Actually, it is a little of both.
Mort, Matt, and Seth.
Mort is a 78-year-old male who was brought in by his son Matt who was 58, and Matt's son Seth who was 35 years old.
Two years ago Mort had his fifth stent implanted into his coronary arteries to help repair the two bypass surgeries, which had failed over time to keep blood pumping into the heart muscle. Mort was told by his previous cardiologist that he was lucky to have a technology, which could "buy him a few more years", because he just had bad genetics.
Matt, Mort's son, had already had a heart attack at 45 with a nice little Mort starter kit of three stents. He felt that bypass was inevitable in the next few years. Seth joked with me that he was looking at his future, but uneasily.
Combined, Mort and Matt where on 14 medications. The cardiologist wanted to start Seth on cholesterol lowering medications even though he was without symptoms and still a young man.
First visit: I used a Dr. Holly analogy or as I like to say "Hollyism" and told them that their genetics had the gun, but that there lifestyles pulled the trigger.
I explained to them that heart disease is only 3-5% genetic (Duke and UNC Meta analysis studies) and even then, I felt heart disease could be prevented or reversed. I received the same confounded look that I usually get with an appropriate "Hollyism" applied to a critical medical issue and went to work.
I explained to them that the hallmarks of heart disease, oxidation of cholesterol, chronic inflammation, nutrient depletion/diet, obesity/exercise habits, hormones, and happiness (or lack there of), were the triggers of the disease.
Genetics can dictate your vulnerabilities such as higher cholesterol, but you have to be a willing participant in the disease.
As a family I recognized that they were mildly obese. I discovered during our initial conversation that Mort and Matt both had several sources of inflammation including bad gums, poor digestion, and joint pain. Seth commented that his father and grandfather had battled depression, a recognized risk factor for heart disease, over their lifetimes.
I started all three on a "Paleo" type diet with low organic meat; high cold-water fish content, and drew blood on all three as well.
Second Visit: The labs came back showing high inflammatory markers, triglycerides, and poor endocrine or hormone status. Since we already put the nutrition into place, I proceeded to start appropriate thyroid and testosterone support (Mort only) along with an alkalinizing/anti-inflammatory all natural supplement protocol.
Third Visit: We put all three gentlemen on a liver detox with lymphatic drainage/massage therapy and infrared sauna. Mort and Matt's weight where starting to normalize so medications where reducing as well.
Fourth Visit: I fully implemented exercise regimens for all three, including cardiac rehab for Mort.
Today
Mort is alive, on 1 medication and exercises 4-5 days per week with his fiancé Lila. (Matt's mother passed 25 years before.)
Matt fell off the program and had bypass surgery, but then came in again, and we are seeing if he is ready to heal this time.
Seth exercises with his grandfather 1-2 times a week, along with the prep for the sprint triathlons he participates in eight times a year. Seth is on a prevenative nutritional supplement regimen, watches his inflammation, and does not take cholesterol-lowering medication.
While Matt still battles depression, Mort and Seth feel that they have full lives and great futures.
I have always found these three patients of mine to exemplify the genetics versus lifestyle argument. I often say to my patients, "stop blaming your parents." I say to all my patients, and now to you, that heart disease is a choice not a sentence.
It is reversible and preventable for all people of all races at all times, but you have to make three choices first:
- Choose to recognize that heart disease is not a predestined genetic issue, but a lifestyle issue with independent genetic tendencies.
- Choose to find out those genetic tendencies, and than work hard on a daily basis to reduce their impact on your health.
- Choose to stick with your approach, for a lifetime.