Heart 411: The Only Guide to Heart Health You'll Ever Need [Paperback]

Marc Gillinov M.D. (Author), Steven Nissen M.D. (Author)

Book Description

Release date: January 31, 2012

The definitive guide to heart health from two of America's most respected doctors at Cleveland Clinic, the #1 hospital for heart health in America.

Are you one of the eighty-two million Americans currently diagnosed with cardiovascular disease—or one of the millions more who think they are healthy but are at risk? Whether your goal is to get the best treatment or stay out of the cardiologist’s office, your heart's health depends upon accurate information and correct answers to key questions. In Heart 411, two renowned experts, heart surgeon Marc Gillinov and cardiologist Steven Nissen, tackle the questions their patients have raised over their decades of practice: Can the stress of my job really lead to a heart attack? How does exercise help my heart, and what is the right amount and type of exercise? What are the most important tests for my heart, and when do I need them? How do symptoms and treatments differ among men, women, and children?
Backed by decades of clinical experience and up-to-the-minute research, yet written in the accessible, down-to-earth tone of your trusted family doctor, Heart 411 cuts through the confusion to give you the knowledge and tools you need to live a long and heart-healthy life.

Editorial Reviews

Amazon.com Review

Featured Interview: Marc Gillinov and Steven Nissen

Q. What are some of the risk factors of coronary heart disease that we are least likely to know about?

A. Unfortunately most people don't know the simple, basic risk factors--LDL (the "bad" cholesterol), blood pressure, and body mass index (a measure of obesity). Together, these three risk factors plus smoking and diabetes, predict more than 80 percent of the risk for heart disease. We also have a growing list of emerging and sometimes surprising risk factors for heart disease. These include rheumatoid arthritis, sleep apnea, periodontal/gum disease, and even air pollution.

Q. Do 1-2 glasses of wine a day really stave off heart disease?

A. People who drink moderately are less likely to develop coronary artery disease and more likely to live longer than people who abstain from alcohol. This makes biological sense, as alcohol increases HDL cholesterol and reduces blood clotting. The evidence is solid, but we don't have conclusive proof that wine staves off heart disease. Nevertheless, a glass of wine (or a beer or a scotch) a day can be part of a heart healthy lifestyle.

Q. How does stress affect the heart?

A. Today we understand the link between emotional stress and heart attacks. In the patient with coronary artery disease, stress can trigger a heart attack by causing release of hormones and chemicals that increase blood pressure and heart rate and also increase the tendency for blood to clot. Anger is a common heart attack trigger, with up to 3 percent of heart attacks preceded by bouts of intense anger. Managing emotional stress can be life-saving for the patient with coronary artery disease.

Q. Is red meat really that bad for the heart?

A. Red meat contains large quantities of saturated fat, which is linked to increased LDL cholesterol and an increased risk of heart disease. An occasional steak or hamburger is fine, but a diet that includes daily consumption of red meat, especially when compared to a diet rich in fish, is associated with an increased risk of developing coronary heart disease. If you do eat meat, choose less fatty cuts and limit portion sizes.

Q. Why is this book so important? How is it different than other books on heart disease?

A. This book is about proven strategies to achieve and maintain heart health. Today there is simply too much health information on the Web and on the bookshelves. Some of it is accurate, but much of it is completely wrong. Your heart-health is too important for you to get sucked in by ridiculous fads. You can't afford to make critical mistakes based upon incorrect and confusing information. In this book, we detail the evidence, dispel the myths, and distill the truth. Let us guide you to a life of sustained heart health.

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From Booklist

In this empowering, lifesaving primer, cardiac surgeon Gillinov and cardiologist Nissen, who between the two of them have cared for more than 10,000 cardiac patients, authoritatively lay out what Americans must do to lessen their risk of dying of heart disease, the nation’s number-one killer. For starters, don’t get fat, and don’t smoke. But the authors also mix in surprises. For example, they say cold weather can increase the risk of heart attack, while more education can lower it, and too much alcohol can increase the risk of high blood pressure (and breast cancer); and they explain why, medically speaking, husbands should stay faithful. Gillinov and Nissen also cover the warning signs of heart attacks and early symptoms of heart disease. The book is full of interesting asides (for example, in 1900, pneumonia was the leading cause of U.S. deaths, and the average life expectancy was 47), but impatient patients can skip to the end of chapters, which typically end with an “Rx” summary. In sum, an understandable and definitive guide by two top heart docs. --Karen Springen

See all Editorial Reviews

Product Details

• Paperback: 550 pages
• Publisher: Three Rivers Press; 1 edition (January 31, 2012)
• Language: English
• ISBN-10: 0307719901
• ISBN-13: 978-0307719904
• Product Dimensions: 7.3 x 1.4 x 9.2 inches
• Shipping Weight: 1.8 pounds (View shipping rates and policies)
• Average Customer Review: 4.7 out of 5 stars  See all reviews (53 customer reviews)
• Amazon Best Sellers Rank: #27,188 in Books (See Top 100 in Books)
  • #20 in Books > Health, Fitness & Dieting > Diseases & Physical Ailments > Heart Disease
  • #52 in Books > Health, Fitness & Dieting > Reference

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Most Helpful Customer Reviews

44 of 46 people found the following review helpful

5.0 out of 5 stars Engaging, informative and empowering February 7, 2012

By kctoso

Format:Paperback

A researcher by both temperament and profession, I normally run in the other direction from such inflated publisher claims as "the only guide to heart health you'll ever need." After all, knowledge is empowering, and even credible and informed sources often disagree, a reality that generally makes relying on a single source a foolish proposition at best. But in a real sense that claim can justly be made for Drs. Gillinov and Nissen's Heart 411.

Not because of any specific information or advice they offer (although there is a wealth of that, all backed up by the latest scientific findings explained in an engaging and accessible way for the intelligent layman), but rather because Drs. Gillinov and Nissen provide their readers the tools with which to evaluate the myriad health claims that daily clamor for our attention. Can we really "Reverse Heart Disease" or "End [...] Illness" now, as the titles of recent bestsellers assert?

A chapter devoted to evaluating medical evidence (Chapter 9) explains how to interpret and judge the scientific evidence behind the day's health headlines. The qualitative difference between the validity of observational studies and that of randomized controlled trials is thoroughly explained, as well as such concepts as surrogate endpoints (just because a drug is effective at raising HDL, or "good" cholesterol, does not necessarily mean that it saves lives), confounding factors (what else may be responsible for this result?) and causality (an "association" between low vitamin D levels and heart disease does not necessarily mean that vitamin D deficiency causes heart disease.) With this knowledge, the reader can begin to navigate the tricky shoals of medical information with confidence....

Unlike many other medical "experts" writing today who make authoritative-sounding claims but bring little beyond anecdotal "evidence" to support them, Drs. Gillinov and Nissen first present the scientific background of any given controversy, clearly explain the conflicting opinions, then guide the reader along the path of their scientific reasoning so that ultimately the reader understands not just what the authors believe, but also why they believe it. I, for one, am far more likely to follow the advice of a doctor--or anyone else, for that matter--who shows me the data and takes the time to explain why they are convincing.

Heart 411 thoroughly examines the major controversies in the field of heart disease today: the role of vitamin D, the risks vs. benefits of daily aspirin, the safety of hormone replacement therapy, the appropriate (and often inappropriate) use of stents. The authors go on to explore other popular topics such as the cardiac benefits of daily exercise, a proper diet, and red wine. (Disclosure: Four years ago Dr. Gillinov operated on my husband and uses his story to begin the chapter on alcohol and the heart.) An entire chapter devoted to the mind-body connection discusses the emotions anger, depression, anxiety, and grief, and lays to rest any doubt about the heavy physical toll that they exact.

Kudos to the authors for producing a work that is --as the very best teachers are-- engaging, informative and empowering; one that arms you not just with information you need at the moment, but also with the kind of knowledge and critical thinking skills you can rely on to guide your choices and decisions far into the future. Read more ›

16 of 17 people found the following review helpful

5.0 out of 5 stars Excellent book, very informative February 29, 2012

By Jack Reese

Format:Paperback

Last year I had a brush with heart surgery. I was scheduled to have valve repair and replacement, waited two months, went thru a three days work up prior to the scheduled date, and was asymptomatic throughout all of this. It turned out I had a surgeon that didn't like to open patients and fix things that weren't necessarily broken. I had valve problems that could be managed medically. The surgeon was Dr. Gilinov so when I saw this book I immediately placed an advanced order. I have now read it cover to cover. It is easy to read and certainly is, as the title says, "The only guide to heart health you'll ever need". I recommend it to anyone who has a history of heart problems or has a family history of heart disease, or just wants to be knowledgeable on the subject. Young or old it will guide you. It should greatly reduce your odds of ever having an emergency meeting in OR with Dr. Gilinov or any other heart surgeon. It brings a certain knowledge to the problem, solutions and preventive measures. You will be able to intelligently discuss problems with your primary care physician or cardiologist. It is money well spent and a read that just may save your life or the life of a loved one.

38 of 49 people found the following review helpful

1.0 out of 5 stars Wrong on diet and coronary artery disease June 20, 2012

By JJC

Format:Paperback|Amazon Verified Purchase

Heart 411 is a very comprehensive and well written book, but the authors are very wrong on the optimal diet for heart disease.

My qualifications for writing this review are four college degrees, research in many fields, extensive study of experimental design, and a history of three heart attacks, two angioplasties (before stents), and a triple bypass 22 years ago. At that time, I went on the Pritikin/Ornish/Esselstyn diet and have had no problems since. I run 5k races with full exertion and no chest pain.

The authors recommend the Mediterranean Diet and statins. They say: "If you follow our advice, our waiting rooms will empty out, and you just might put us out of business." (p.531). Let's examine the truth of their assertions.

In the Lyon Diet Heart Study (1999), the Mediterranean Diet was compared to the standard American diet. The subjects were patients who had one heart attack. The Mediterranean Diet did better than the standard American diet, but here is the bad news. Nearly one quarter (24%) of those on the Mediterranean Diet had another heart attack or died. Is a 1 in 4 chance of dying or having a second heart attack satisfactory for you? Those are bad odds in my opinion. The Pritikin/Ornish/Esselstyn diet has a success rate of nearly 100% in preventing future cardiac events. Although the Mediterranean diet may slow disease progression, you can actually stop your heart disease on the Pritikin/Ornish/Esselstyn diet.

Do statins reliably stop heart disease? On page 53, the authors celebrate the, Scandinavian Simvastatin Survival Study, the 4S Study (1994), calling the study "proof" of the effectiveness of the statin and the results "stunning". They cite the dramatic reduction in the relative risk of those taking the statin.... However, let's take a closer look.

In the 4S study, there were 4,444 subjects, divided into two nearly equal groups. The subjects had either a heart attack or angina pectoris. Over 5.4 years, a major coronary event occurred in 622 (28%) of the control group and 431 (19%) of the statin group. This 9% absolute reduction of risk translates into a relative risk reduction of 30%. The overlooked finding is that 431 of the 2221 subjects treated with the statin (19.4%), had another major cardiac event, so your odds of avoiding a major cardiac event are 80.6% if you maintain your statin treatment (72% if you do not take the statin). This improvement in risk justifies treatment, but the numbers do not provide much reassurance. You have reduced the absolute risk by 9%. Compare this with the nearly 100% effectiveness of a totally plant based, whole food, no oil diet.

In another recent statin study, called the SATURN study (2011), of which Dr. Nissen was an author, statins also failed to provide protection to 18% of the participants, despite the subjects taking "Maximal doses" of Crestor and Lipitor. There was a total of 1,380 subjects, and 244 (18%) continued to have negative cardiac events in two years. To illustrate this probability, think of a number between 1-6, then role a die. If your number comes up, you just had a major cardiac event despite a high statin dose. Although the study reports these doses were well tolerated, bear in mind that the FDA warned in February, 2012, of additional side effects of "memory loss, forgetfulness, and mental confusion" from taking statins. The Pritikin/Ornish/Esselstyn diet will raise your odds of avoiding all cardiac events from 82% to nearly 100%, without the risk of these side effects.

Now let's turn to the positive alternative. Dr. Esselstyn reported in the American Journal of Cardiology (1999) his study of 18 patients who had 49 negative cardiac events prior to commencement of his plant based nutrition program. At the end of 12 years there had been one death from an arrhythmia. (An angiogram of this patient had revealed, however, that narrowings of the coronary arteries had improved.) There were no cardiac events in the other subjects during the 12 year period.

My point is that the Mediterranean Diet and statin treatment are not reliable treatments to stop coronary artery disease. Their benefits are overblown and bring about complacency in patients. To be serious about stopping, rather than slowing, coronary artery disease you should examine the research and clinical results of Pritikin, Ornish, and Esselstyn (as well as Drs. John McDougall and Neal Barnard).

Further evidence of the efficacy of the Pritikin and Ornish programs is that Medicare Part B, will pay most of the cost if you have had a heart procedure or angina.

It is indeed a conundrum that Dr. Nissen and Dr. Esselstyn, both highly respected physicians can coexist in the same medical institution, the Cleveland Clinic, world renowned for treatment of heart disease. It is a testament to the openness and freedom within the Cleveland Clinic that both can express their opinions and practice medicine there. I do believe, however, that the authors of this book have failed their readership by not presenting a dietary program that will reliably stop coronary artery disease. Read more ›

3 of 3 people found the following review helpful

5.0 out of 5 stars Excellent Information March 10, 2012

By GLK

Format:Kindle Edition|Amazon Verified Purchase

Disseminating pertinent information from the Internet is woefully difficult at times particularly regarding complex subject matter and when marketing interest runs high. By consolidating portions of their knowledge, experience and expertise the authors have created an accessible, easily readable guide to heart health and in so doing have done society a great service. Kudos to Dr. Gillinov and Dr. Nissen for taking the time to create a guide that will help people acquire the correct information they need to live longer happier lives.