Coronary Artery Disease, Abraham Lincoln, and Me

It is true you may fool all of the people some of the time; you can even fool some of the people all of the time, but can’t fool all of the people all of the time.

Abraham Lincoln (1809-1865)

February 7, 2012 - When I think of coronary artery disease risk factors, I think of Abraham Lincoln.

As someone who had a coronary three years ago and as a doctor, I know you can reduce some of the risk factors some of the time; you can even reduce some of the risk factors all of the time, but you can reduce all of the risk factors all of the time.

If you have coronary artery disease, soon or late, some devilish risk factor may get you. You don’t know how. You know when. The first sign 30% of the time is sudden death. As with John Wilkes Booth, that risk factor may come when you least expect it.

It may come from adverse blood lipids – a high total blood cholesterol, an elevated LDL, a low HDL, high triglycerides, an unacceptable LDL/HDL ratio – or some combination therein. But luckily, that is not the case with me. Besides you can control lipids with statins.

It may come from persistently high blood pressure but again you can control that with drugs, exercise, or weight loss.

It may come from diabetes – which I don’t have.

It may come from life style overindulgence – eating too much of the wrong thing too much of the time – or from under-indulgence in exercising – which you control by following caloric guidelines on myfitnesspal.com or by fitness programs pedometer-goal setting of 10,000 steps a day.

It may come from subtle inflammations – such as gout flare-ups or infections like urinary tract infection, prostatitis, and gingivitis – which you can identify and treat.

To some extent, you can control or anticipate these inflammatory conditions by measuring your blood counts or by recording your high-sensitivity C-Reactive Protein , which tends to be elevated in patients with coronary artery disease lurking in the shadows. You can even check for your CAC (coronary artery calcium).

There are factors you can minimize – like anger and unnecessary emotional and physical stress.

But alas, there are always those things that are beyond your control – your age and gender.

Tweet: When you have coronary artery disease, to a certain extent you can control its risk factors, but you can’t control your gender and your age.