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Hal Higdon's 7-7-70 Quest - For the Future

Yesterday's ideas of how to detect and treat coronary heart disease are already obsolete today (like last year's computer), and who knows what the future will bring in the area of heart medicine? Here are some promising areas:

* Immunology
: Can you catch heart disease like a common cold? Some scientists have begun to suspect that you can, that a virus can trigger the development of the disease among people most susceptible. If so, it might be possible to develop a vaccine so that you can be vaccinated at an early age and be free of coronary heart disease. Clinical trials involving antibiotics are now under way.

* Cholesterol
: Once, it was sufficient to maintain your cholesterol level below 200, a strategy promoted by various heart health agencies. But that overlooks the fact that there is "bad" LDL cholesterol and "good" HDL cholesterol. Now scientists believe there are two forms of LDL cholesterol, "large" cholesterol platelets that tumble safely through the bloodstream and "small" platelets that stick. Even lowering your cholesterol level reduces risk only 20 to 30 percent, according to Dr. Wefald. "That leaves 70 percent risk untouched." The public has the right to be confused, meanwhile many safe and effective drugs have been developed to manage cholesterol levels.

* Homocysteine
: Homocysteine is an amino acid found in the blood, easily measurable during standard blood tests. It may be a better predictor of heart health than tests for cholesterol and tryglicerides, or blood pressure. Score much more than 10, and you're at risk for a heart attack. Lower your homocysteine count, and you lower risk. Physicians prescribe Folic acid and Vitamins B6 and B12 to combat this problem, but modifying diet also works.

* Early Detection
: Heart disease often begins by age 15. "By the time you get the symptoms several decades later, the disease is well advanced," says Dr. Gibbons. Knowing your family history may not be enough. Fast X-rays and Cat scans can detect early calcification around arteries. Lifestyle changes can effectively prevent the disease from developing. Diagnosing heart disease is the easy part; getting teenagers to think much beyond next Saturday's date is the real problem.

* Phytochemicals
: Antioxidants have gotten a lot of press recently, but nutritionists now identify phytochemicals as the non-vitamin and non-mineral most likely to reduce heart disease. Foods with certain phytochemicals can lower cholesterol levels and prevent platelets from forming in the bloodstream. "The more variety you get with fruits, vegetables and whole grains, the better you are," says Dr. Applegate.

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