I was fascinated by material my husband Bryan Hubbard wrote about in our current issue of What Doctors Don’t Tell You (website: http://www.wddty.com). Bryan was attempting to answer why heart disease is still the number 1 killer in the West. In the US alone, every 37 seconds, someone’s heart fatally packs up.
What Bryan found was nothing short of revelatory: namely, in fingering cholesterol as the bad guy in heart disease, medicine essentially is taking aim at the cavalry.
Far from being the enemy, cholesterol appears to be the body’s chief means of eleventh-hour cardiovascular repair. It also is essential for keeping the brain sharp, which is why people taking statins often suffer cognitive deficiencies and even staggering memory loss.
So why do people have heart attacks in the West? Susan Sontag once famously said, ‘illness is metaphor’. I’ve been thinking about heart disease a good deal lately, and I grow more and more convinced that heart disease is chiefly a disease of emotional pain.
Dying of a broken heart
Lately scientists have been intrigued by a phenomenon called ‘broken heart syndrome’, where an emotional upset, such as the loss of a loved one, causes dysfunction in the ventricular chamber and heart failure in people without previous heart disease. Researchers at Johns Hopkins found that women with this syndrome, which often brought on heart failure, had none of the usual predisposing factors of heart disease. What they’d suffered was purely psychological — the divorce or the death of a loved one.
Nevertheless, the bereavement or sadness had released such toxic levels of stress hormones, particularly adrenalin,that these had ‘stunned’ the heart, literally causing it to break.
Every so-called lifestyle risk factor laid at the door of cardiovascular illness by the medical community has less to do with someone having a heart attack than simple loneliness.
The role of social ties in heart disease was highlighted in a famous study by S. Leonard Syme, a sociologist at the Unversity of California at Berkeley School of Public Health. Syme has made it his lifetime study to examine what’s usually called ‘social capital’ in societies.
Social capital measures the strength of any given area’s social fabric: the trust between citizens, the level of reciprocal behavior, the number of associations and groups.
Syme was fascinated by the fact that even though the Japanese smoke like chimneys, they have very low heart disease in Japan. Once they move to America, however, their heart disease escalates, although it is lower than American white — even if they quit smoking.
So he decided to compare the heart attack rates in Japanese Americans in Hawaii and smoke-free California with those of the Japanese in their native land.
He discovered a clear upward graph: the lowest statistics in Japan, higher in Hawaii and higher still in California. None of the usual risk factors like smoking or higher cholesterol made any difference to the mortality statistics.
The only thing that made any difference was the strength of social ties – the social capital. In Japan and to a slightly lesser extent Hawaii, the Japanese maintained their close social and familial bonds. In California, however, once they abandoned those ways to Western lifestyle, they started dropping like flies.
Diets make no difference
In some native populations, heart disease is a rarity even when the inhabitants adopt Western diets. For instance, a group of researchers studying the native populations of the Solomon islands found that they had no coronary heart disease or high blood pressure even after they’d adopted Western diets and religious practices. This puzzled the researchers until they discovered one area that had remained constant: the social ties and roles within the family.
The role of social ties in heart disease was highlighted in a study in Nevada versus those of Utah. They are neighboring states, their ethnic mix is similar, they both have similarly high education statistics, and to all appearances, Nevada is the more successful state, with 15 -20 per cent higher income.
Nevertheless, their statistics on mortality from heart attack were on opposite ends of the spectrum. Nevada had one of the highest death rates in the country, while Utah had one of the lowest.
The primary difference between the two states was the stability of the social structure and close-knit families in predominantly Morman Utah, compared with the high degree of broken and dysfunctional family life in Nevada. It was the weakening of the social fabric, concluded the researchers, that had mostly to do with the difference in mortality.
Rather than worrying about your cholesterol levels, your doctor should be more concerned about the most important diagnostic test of all: the state of your friendships.