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What we can learn from Bush's heart issues

by STEVE DORFMAN The Palm Beach Post on August 20, 2013 10:40 AM

WEST PALM BEACH, Fla. — As if we needed any further proof that pursuing an active, apparently healthful lifestyle doesn’t, by itself, protect you from being vulnerable to heart disease, let George W. Bush be the latest example.

Last week, of course, the 67-year-old former president — who once ran a marathon and, by all accounts, still maintains a vigorous exercise regimen on his Crawford, Texas, ranch — underwent a minimally invasive cardiac procedure to clear up blockage in a coronary artery.

What Bush had done — balloon angioplasty to flatten the arterial plaque and the insertion of a stent to maintain “vessel patency” — is a rather commonplace treatment for minor coronary issues.

But his condition should serve as a stark reminder than none of us — no matter how healthy we think we are — is immune from heart disease.

Heart disease, and related coronary-artery diseases, are the nation’s No. 1 cause of death.

According to the U.S. Centers for Disease Control, more than 26 million Americans have been diagnosed with some form of heart disease, and around annually 600,000 will die from it.

We all know the primary — and controllable — risk factors: Being a smoker. Being overweight. Having high cholesterol and/or hypertension. Living a sedentary lifestyle. Eating a diet heavy on fried/rich foods.

Oftentimes, though, the risk factors, and the disease’s presentation, are far more subtle, says Atlantis, Fla., cardiologist Dr. Arletta Marunowska.

“Genetic predisposition and family history are factors that play a large part and need to be considered,” she explains. “And many people with heart disease are completely asymptomatic.”

Indeed, Bush’s condition was diagnosed not because he was complaining of any discomfort, but rather during his routine annual exam. Bush’s physician determined that his stress test came back “abnormal” and necessitated further investigation.

A cardiac catheterization revealed that there was significant blockage in one of his coronary arteries, which led to him undergoing the procedure.

What’s instructive about Bush’s case is to remember that, while we can all picture him during his presidency cycling vigorously on his mountain bike and running with his Secret Service detail while maintaining a seven-minute-per-mile pace, he wasn’t always so diligent about his fitness.

When he was younger, he had been a smoker, and didn’t become a truly dedicated exercise enthusiast until 25 to 30 years ago. What’s more, he’s always been partial to the hearty food of his adopted home state — and that has famously meant a diet highlighted by red meat, fried food and barbecue/Mexican dishes.

“Coronary artery disease is a chronic process which may start early in life and that slowly progresses.

“Once this happens, there is no therapy which can eradicate the disease, but there are things you can do to slow down that progression,” notes Marunowska.

In all likelihood, Bush’s fanatical exercise regimen over the last two decades helped mitigate some of the damage his previous habits potentially wrought. But last week’s news meant there was still the inevitable — though non-life-threatening — price to pay.

Which brings us to the other lesson from Bush’s episode that all baby boomers would be well-advised to heed: Don’t skip your routine annual physical exam. Your life just might depend on it.

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