Heart Smarts

Heart Smarts
Coronary Heart Disease Update

by Donald L. Smith

Did you know that coronary heart disease (CHD) is the leading cause of mortality in the United States today?

Did you also know that CHD is the fastest-growing cause of mortality for women in the United States today?

Sobering Statistics

2000 there were slightly more than 750,000 deaths attributed to coronary heart disease (CHD) in the United States, an increase of 3.3 percent from 1997. There were more than 25 million individuals treated for CHD (the "incidence") during 2000 which, when compared to the mortality total of 750,000, means that there was a 33.3 to 1 incidence to mortality ratio for the year.

Approximately 5 million of those afflicted with CHD required hospitalization one or more times during the year with an average stay of slightly more than five days per admission, which resulted in a total of 25 million hospital days utilized in treating this disease.

Since approximately 50 percent of the 750,000 deaths (375,000) were sudden cardiac deaths (SCDs) whereby the patient was dead upon arrival at the hospital, it is obvious that achieving better means of preventing CHD is more important than improving treatment modalities. Keep in mind that a CHD causing death and/or requiring hospitalization usually is referred to as a "heart attack" or by the medical term of a "myocardial infarction."

In 1998, for the first time, the number of women who died from coronary heart disease exceeded the number of deaths among women from all forms of cancer. Therefore, the mortality rate from CHD for women rapidly is approaching the rate for men and this startling change is attributed to the fact that women now have as much, or more, stress in their lives as men do.

The CHD Mortality/Vitamin D Connection

A study by Scragg, et al, titled "Myocardial Infarction is Inversely Associated with Plasma 25-Hydroxyvitamin D3 Levels: A Community-Based Study" was published in the International Journal of Epidemiology. The authors showed that individuals with sub-optimal levels of vitamin D3 are three times more likely to suffer a heart attack than are those who maintain optimal levels year-round. Thus, individuals who maintain an optimal level of vitamin D3 year-round reduce their risk of suffering a heart attack--that could lead to death--by 66 percent.

High blood pressure is also a major contributing factor to CHD. Two papers presented by Rolfdieter Krause, M.D. of Germany at the "Biologic Effects of Light Symposium" last June showed that UVR-induced vitamin D was more effective in lowering blood pressure than was supplemental (ingested) vitamin D and brought about a significant decrease in both heart rate and blood pressure. In fact, Krause's research showed that the UVR-induced changes in heart rate and blood pressure were equal to the changes brought about by endurance training and that supplemental (ingested) vitamin D did not bring about these beneficial changes.

Would A Drug Promising A 66-Percent Reduction In CHD Be Important?

Imagine what would happen to the stock price of a company that announced the development of a drug that promised to reduce the incidence of coronary heart disease by 66 percent. Needless to say, the announcement would be well received, and the stock price would go through the roof.

That is why it is important to understand why the medical profession has ignored the UVR/coronary heart disease connection. The reason is that the physicians treating coronary heart disease are afraid to alienate their dermatology colleagues who preach that any and all exposure to UVR should be avoided.

The Risks Of Overexposure And Underexposure To UVR

When one considers the fact that there were only 600 deaths from non-melanoma skin cancer in 2000 that could be attributed to overexposure to UVR and approximately 500,000 deaths from CHD (66 percent of 750,000) that might have been caused, or partially caused, by underexposure to UVR, one can readily see that our public health policy is sadly and drastically out of balance. For every one person who died prematurely because of overexposure to UVR in 2000, 2,500 may have died prematurely because of underexposure to UVR.

Sensible, Moderate And Responsible Exposure To UVR

I am proud of the fact that only the indoor tanning industry is willing to warn the public about the risks of both overexposure to UVR and the risks of underexposure to UVR.

The dermatology community warns against any and all exposure to UVR, and this failure to warn the public about both the hazards of overexposure and the hazards of underexposure is inexcusable given the fact that they are doctors of medicine charged to "first do no harm" to the patients who rely upon their professional judgment.

The Bottom Line

The inescapable "bottom line" is that the benefits of sensible, moderate and responsible exposure to UVR outweigh the minimal and manageable risks involved. In addition, the U.S. public has a constitutional right to be warned about both the risks of overexposure to UVR and the risks of underexposure to UVR--and the indoor tanning industry is ready and willing to disseminate this information.

Unfortunately, current FDA regulations prohibit indoor tanning salons from making any statements about the beneficial effects of UVR even if those beneficial effects are supported by peer reviewed scientific data! Obviously, the indoor tanning industry no longer can accept being prohibited from exercising our constitutional right to tell the truth when the dermatology community is allowed to tell only half the truth.

There are too many people who die prematurely each year from coronary heart disease and cancer that might live if they increased their exposure to UVR. We must find a way to convince the FDA that the indoor tanning industry can play an important role in the improvement of the health and wellness of the U.S. public.