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[OM] OT Coronary Heart Disease (CHD) [was Cholesterol again...]

Subject: [OM] OT Coronary Heart Disease (CHD) [was Cholesterol again...]
From: Moose <olymoose@xxxxxxxxx>
Date: Thu, 14 Dec 2006 20:41:54 -0800
I come to this subject from a very different direction. I was in a ten 
year study of treatment for heart disease using no conventional 
treatment at all.

Pretty much everybody here will recognize the phrase "Type-A behavior". 
Older folks may remember where it came from, a book, "Type-A Behavior 
and Your Heart", by cardiologist Meyer Friedman and his partner. Dr 
Friedman came to the realization that he and virtually all of his 
patients shared behavior patterns that were not generally typical of all 
the other folks he encountered. He theorized that these behaviors were 
predictive of CHD and further that modification of them might lower the 
incidence of CHD.

Subsequent to his best selling book, the phrase "Type-A behavior" became 
a part of the contemporary lexicon, with the usual reaulting 
misunderstanding of its correct meaning, and Dr. Friedman disappeared 
from the spotlight. In subsequent years, he did some small scale studies 
to see if his theories would be supported by more rigorous data.

The first major study was of patients who had already suffered a first 
heart attack, and were thus at high risk for further events and death. 
Planned as a six year study of a group given behavior modification 
treatment vs. a control group, it was ended early:

"Although this study was initially designed to continue at least six 
years, the National Heart, Lung and Blood Institute insisted that since 
we had been able to demonstrate that TAB modification decisively acted 
to prevent coronary recurrences, we should immediately give such TAB 
modification to the control groups. This we did and found that after one 
year, the percentage of recurrence dropped dramatically in the 
heretofore control group(10). As far as we can discern, /this abrupt 
transfer of a treatment modality from the experimental to the control 
group has never before been done in a cardiac study/. G. Burell and 
associates(11) have confirmed the results of this study."

After this study, Dr. Friedman and his assistant wrote a follow-up book, 
"Treating Type-A Behavior and Your Heart", which lays out the 
physiological and psychological basis of their theories and reports on 
the study. Unfortunately, it never made a blip on the public radar. I'm 
not sure all the reasons, but it is more clinical than the first book 
and doesn't measure up to the felicitous quality of writing that we've 
come to expect from popular books on medical subjects. I nonetheless 
found it an interesting and sometimes moving book.

His next effort was a 10 year study of people old enough that a 
significant number would be statistically expected to develop CHD during 
the study period and young enough that not too many could be expected to 
die of other causes during the study. To be in it, one needed to be 
between the ages of 45 and 65 and have no symptoms of existing CHD. I 
just made the lower age limit and was lucky enough not only to be 
accepted into the study, but to be in the randomly selected treatment group.

Although the thrust of the treatment is behavior modification, the 
nature of the small group work seems to inevitably lead many 
participants into introspection and various sorts of spiritual growth 
and change. It was certainly an important part of my path through life.

I don't know if the results of that study have been published. Dr. 
Freidman died near the end of the project and that may have delayed 
things. And I don't even know where to look; these things don't seem to 
show up in web searches. Probably only on subscription services? I do 
know that some results were shared with us during the study and they 
were clearly showing that the treatment group was doing better than the 
control group.

I offer all this in support of my personal conviction that it is 
possible to have a major positive impact on one's own heart health 
through actions that don't involve drugs, surgery, etc. At the time 
results of the first major study were published, it was statistically 
the single most effective treatment for people who had had a first heart 
attack.

Of course, such treatment is completely outside of conventional 
modalities for CHD, relatively expensive appearing (I don't know how it 
conmpares to long term drug treatment and otherwise avoidable 
hospitalization.) and requires special training for those administering 
it. So the chances of insurance paying for it are nil. And it flys in 
the face of the current movement towards drug treatment of everything, 
including the older "talking therapies" of the psychxxxy discliplines.

Anyway, I've nattered on too long. Anyone who would like to know more is 
welcome to contact me off list. Usual disclaimers apply; I am not a 
purveyor of goods or services mentioned, nor do I have any financial 
interest in any. Only a very satisified participant. I had no symptoms 
of CHD when I left the study and have none now.

Moose

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