$100 million dollar study shows there’s a better way than surgeries and stents

Every cardiologist in America had an eye on Philadelphia a couple of weeks ago, and it wasn’t for the Eagles-Patriots game.

The results of a major $100-million study on the effectiveness of stents and bypass surgery were announced at the annual conference of the American Heart Association — and they were stunning.

The analysis dealt with stable coronary artery disease — meaning blockages discovered during a stress test or other non-emergency evaluation. We already know that stents and bypass surgery can save lives in the middle of a heart attack.  But whether they impact outcomes outside of that scenario is less well understood…

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To go under the knife or not

Smaller studies had hinted that the benefits of these procedures in stable coronary artery disease were less impressive, but most cardiologists brushed those studies aside.

Once again, the research revealed that the best way to treat disease is to address the root cause of it. In the case of artery blockages that means adherence to a healthy lifestyle and taking medications as indicated.

The researchers found that invasive procedures — stents and bypass surgery — were no more effective in terms of influencing outcomes. In fact, the only upside of invasive procedures seemed to be that in some cases, they lessened chest pain.

And if you think about it, that makes complete sense. After all, atherosclerosis, the process that leads to heart artery blockages, is a systemic health issue — meaning it affects arteries EVERYWHERE.

So why would repairing one blockage in one artery with a stent (for example) be expected to affect the overall impact of this disease?

Related: Triple vitamin cocktail could stave off heart attack and stroke

Because stents and surgery are not only invasive and risky but also incredibly expensive, the new study may help change the way cardiologists treat patients. In other words, cardiologists may be more likely to practice like me and focus on addressing the drivers of disease. It’s the only TRUE way to deal with high cholesterol, high blood pressure, high blood sugar and atherosclerosis at a systemic level.

One thing is for sure: This study should at least prompt a broader discussion between doctors and their patients regarding the options that are available for managing stable coronary artery disease.

Will we see real change?

In cardiology circles, the strengths and weaknesses of the study are being intensely scrutinized, and pushback is already occurring.

And the common refrain that the lifestyle measures required to really impact atherosclerosis are “extreme” and unlikely to be embraced by patients will be heard again and again.

But I have to agree with Caldwell Esselstyn: it’s not the whole-food plant-based eating system that’s extreme.  What’s extreme is sawing through someone’s breastbone, harvesting veins from their legs and putting them on a bypass machine. Shouldn’t that be reserved only for life and death scenarios?

Especially since artery blockages can be improved in a more effective, less risky and less expensive way with improved diet and medication adherence. For example, one of the participants in the trial told The Washington Post that after switching to a plant-based diet, exercising and taking medication for the study, he was doing well and extremely thankful to have avoided surgery.

Step One’s foods were created to make switching to a more whole-food plant-based eating approach easy and convenient.  And we’ve proven that even small shifts in this direction can yield marked health benefits. There IS a better way — and it starts with what’s in your pantry.

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Dr. Elizabeth Klodas MD, FACC

By Dr. Elizabeth Klodas MD, FACC

"Diet is a major driver of high cholesterol, but instead of changing the food, we prescribe medications. This never seemed logical to me.” Dr. Klodas has dedicated her career to preventive cardiology. Trained at Mayo Clinic and Johns Hopkins, she is the founder and Chief Medical Officer for Step One Foods. Dr. Klodas is a nationally sought out speaker and has an active role at the American College of Cardiology. Her clinical interests include prevention of heart disease and non-invasive cardiac imaging and she has published dozens of scientific articles throughout her career. Dr. Klodas has been featured on CNN Health for her mission to change how heart disease is treated. An independent study performed at leading medical institutions affirmed the ability of Step One Foods to deliver measurable and meaningful cholesterol-reduction benefits in the real world. The results of the trial were presented at the 2018 American Heart Association’s Scientific Sessions. Dr. Klodas has also authored a book for patients, "Slay the Giant: The Power of Prevention in Defeating Heart Disease," and served as founding Editor-in-Chief of the patient education effort of the American College of Cardiology. In addition to her practice and her duties at Step One Foods, she also serves as medical editor for webMD.