Preventing a Heart Attack: Part One

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In honor of our good friend who recently died from a Heart Attack, I am writing a three-part series on how to prevent one:

Part One: What is a heart attack and how it happens

Part Two: Beyond Cholesterol – the blood markers to use to reduce your risk

Part Three: Science-based lifestyle practices that work to prevent a heart attack

What is a heart attack and how it happens

Last Friday night, at about 9 pm our good friend Harry died from a heart attack.

His three daughter, all 15 year-olds (triplets) took turns in performing CPR on their dad. Despite their valiant effort, their dad succumbed to the #1 killer in the world. If an AED leader defibrillator had been in local vicinity, then there is a chance the outcome could have been different.

At 2 am, his now widowed wife looks at his phone when she hears a text coming in. It was one of the triplets texting him. “Dad, I know you are still here, right? You are still going to see me graduate from school, right? Please, dad, tell me you are still here.”

I am tearing right now as I write this. Dealing with something like this is never easy. I never want anyone to go through something like this. So if you or anyone you know has recently suffered from a heart attack or a high risk health condition, it may be in everyone’s best interest to take a look at sites like, just so you know that you are finding out the right information about how to stay covered after an unfortunate event like this. Not many people think about getting life insurance, especially as dealing with what happened to them is their priority, but this is very important. You just never know what can happen, so it is best to take every form of protection you can. It is better to be safe than sorry when it comes to your health.

Harry admittedly struggled with his weight and addiction to food. His wife is nearing the third stage of grieving, anger.

Of course, I feel guilty that as a healthcare practitioner, I didn’t do more for him.

Harry died at the young age of 63.

The whole thing just sucks.

The funeral services are in a few hours.

Yep, Harry was not a celebrity like Alan Thicke and Gary Shaddling who also died from a heart attack within the last year or two. He was just one of us, regular men who wished he could walk his daughter down the aisle one day.

I don’t know about you but this crap scares the hell out of me.

What the heck is going on here?

Here’s some alarming stats on heart attacks:

  • Heart disease is the #1 cause of death for both men and women. By far, most deaths occur to men. If this doesn’t make you want to look into Toronto first aid training to learn about what to do if you witnessed someone in this position, then I don’t know what would. You don’t expect to see this whenever you’re out, but it can happen. You could be the person who could potentially save a life.
  • About 610,000 Americans die from heart disease each year—that’s 1 in every 4 deaths.
  • Someone in the United States is having a heart attack right now as you read this – as a heart attack occurs every 43 seconds.
  • Coronary heart disease alone costs the United States $108.9 billion each year. This total includes the cost of health care services, medications, and lost productivity.

Exactly what is a heart attack?

Before I explain what a heart attack is, I must first briefly describe an artery.

Arteries are long muscular tube-like structures that carry oxygen-rich blood that’s pumped from your heart to every single cell of your body, including heart cells.

Unlike a plastic tube which is hard and rigid, the arteries are flexible and expand and contract smoothly. In fact, if an artery hardens enough where it loses its flexibility that’s called arteriosclerosis.

Arteries consist of three layers: an outer layer, a middle layer and the inside layer known as the endothelium.

Atherosclerosis (athero: pasty material, sclerosis – hardening) is a specific form of arteriosclerosis which an artery wall thickens as a result of invasion and accumulation of white blood cells(WBCs), in this case, caused by foam cells creating plaque.

When the plaque gets large enough that it blocks blood flow in an artery, that’s when a heart attack occurs – only if the blocked artery is in the heart. If the blocked artery is in the brain that’s a stroke.

Are you with me?

Now, here’s the deal. The endothelium (the inner most layer) plays a huge role in protecting the rest of the arteries from hardening and forming plaques. The endothelial cells (which makes up the endothelium) is a barrier to prevent toxic substances in the blood from entering the middle part of the arterial wall.

Another specialized function of the endothelium is to react to mechanical forces such as blood pressure and blood flow generated by the heart’s beating action. The endothelium releases substances into cells of the middle layer smooth muscle that changes the tone or firmness of the artery.

When endothelial cells sense an injury, they produce signals that prompt smooth muscle cells in the middle arterial wall to change. Then endothelial cells also produce substances that signal circulating blood cells to stick to the endothelium (instead of effortlessly flowing through the vessel).

Cholesterol is Not the Cause of a Heart Attack

Part of the material the body uses to form a plaque is cholesterol largly due to its sticky nature.

But cholesterol is not the cause of plaques, it is just found as part of the material of a plaque.

In other words,

Cholesterol is not the criminal. It was just found in the crime scene.

Atherosclerosis gradually forms in response to this initial injury to the endothelium.

So, a heart attack is caused by an injury to the endothelium which then causes plaques in the arteries, not by cholesterol.

In fact, statins, the group of pharmaceutical drugs that lower cholesterol, has shown to not prevent heart attacks or dying from anything despite its ability to lower cholesterol.

In other words, like the news reporter Tim Russert who suddenly also succumbed to a heart attack ten years despite having lower cholesterol with pharmaceutical help, statins poorly protect from a deadly heart attack.

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The CaPLESS Retreat is coming in September to help prostate cancer (CaP) thrivers to live their best life by implementing science-based lifestyle practices. I to connect with you there. There is limited space.

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by Dr. Geo

11 comments… add one
  • Matthew Sweetwood 07/19/2018, 4:21 PM

    I had a moderate coronary calcium score of 300. Everything else about me is great and I am in amazing shape. Can I reduce it?

    • Dr. Geo 07/19/2018, 6:58 PM

      Stay tuned to Part two which will be discussed. 🙂

  • George Ledwith 07/19/2018, 7:54 PM

    Very helpful and timely, Dr. Geo. As you point out above, heart disease is the leading cause of death among both men and women.

    I know that all too well. My first wife, Marge, died of a sudden heart attack at home. Marge was barely 50-years-old and although on medication, it was very unexpected.

    I’m compelled to suggest to everyone that this three-part series is worth sharing with wives, female partners, and other women in your life. I hope it helps.

    • Dr. Geo 07/19/2018, 9:17 PM

      Thank you, George. I know your story very well and you are an inspiration. Keep thriving.

  • Jason 07/19/2018, 11:08 PM

    Dear Dr. Geo,
    Thank you for being so open and informative to all of us. so sorry for the lose of your dear friend Harry. We (men and women both) need more sincere medical professionals like you to keep us accurately and honestly informed as to all health care issues, particularly as we all age.
    I’m 64 this month and just diagnosed with Gleason 6 level 1 PC. Not happy about this news. My father was too very late in life and did not die of this cancer. I’m 6′ and 170 lbs, eat and hydrate very well, vegetarian with some fish, take all the correct supplements you recommend, physically active and just about to open your book “Thrive”. Wondering about the CapLess retreat and whether or not this would be a good fit for me (along with my wife) or mostly a repeat of what we are already doing? Wish you were in the Northwest so I could be a patient.

    • Dr. Geo 07/20/2018, 12:02 AM

      Jason, thanks for your note. I have many patients I do virtual consults with.
      Regarding the CaPLESS Retreat, I can guarantee it is different, new and specific to your health goals. Connecting with CaPLESS thrivers is a special component as well.

  • Walter Zernis, M.T. 07/20/2018, 10:07 AM

    Dear Geo, so sorry to hear about the passing of your friend way too young for sure! Your message is very spot on and well written in a way we can all understand sadly at times it takes a tragedy to bring these topics to the fore front. My deepest sympathy to all concerned, blessings, Walter. (Designs for Health)

  • Gela 07/20/2018, 6:14 PM

    I am so sorry for your lose. You are honoring your friends memory by doing this blog post. What is frustrating despite the frightening statistics you quoted and the study results that show cholesterol lowering do not save lives, the AHA has not wavered in their recommendations. Even their own president had a heart attack during their conference last year. I assume he was following his own recommendation. Pretty insane.

  • Frank Armocida 07/22/2018, 3:59 PM

    Dr. Geo great post can you put these in pdf format as well. I keep these in hard copy too and refer back to them and annotate them with my future questions .As of now the printout of the blog is really messy.

    frank armocida

  • Norman Wellen 07/22/2018, 6:50 PM



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