History of Heart Disease

We're talking wellness at MemorialCare Health System. It's time for Weekly Dose of Wellness. Here's Deborah Howell.

Deborah Howell (Host): Hello and welcome to the show. I am Deborah Howell, and today's guest is Dr. Greg Thomas, Medical Director of MemorialCare Heart and Vascular Institute at Long Beach Memorial. Today we'll be discussing the history of heart disease. Welcome, Dr. Thomas.

Greg Thomas, MD: Thank you.

Deborah Howell (Host): Heart disease is the number one killer of American men and women. While most people blame modern, lavish lifestyles for the prevalence of heart disease, you know, there could be more to the history of heart disease. So, Doctor, when did heart disease become a popular topic in modern medicine?

Greg Thomas, MD: Well, in the last 200 years, since we figured out as societies how to decrease the impact of infections by understanding germ theory, for example, and why people would die early, instead of the average time of death as it was for, say, the last 10,000 years of being around 40, People were able to live into the 50s, 60s, 70s, and 80s and such. So heart disease or blockages of the heart arteries doesn't affect us until generally after 40. So as we conquered infections, heart disease over the last 200 years reared its head, in particular.

Deborah Howell (Host): Interesting. Okay. Now, why do people assume that heart disease is from a modern lifestyle?

Greg Thomas, MD: Well, to some extent, it reminds me of the pictures of a king, an obese king on his throne, perhaps, with a hot foot because of gout. We blame the gout, for example, on excesses, and excesses cause problems. But it also is that as we gain weight, and particularly with eating saturated fat and high cholesterol diets, we do increase the chance of heart disease. But much of heart disease actually is genetic. And so that's something we're understanding more and more.

Deborah Howell (Host): That was my next question, actually. If heart disease could be caused by genetic factors?

Greg Thomas, MD: Well, what we found in studying ancient mummies, we've studied our team called the Horace team that's led from our group here at the Heart Institute at Long Beach, that heart disease has been around for at least 3,500 years. We discovered, actually, by doing a CT scan of a princess who was in her early 40s that she had arteries that were blocked to her heart. She actually represents the first human found to have heart disease.

Deborah Howell (Host): Can I just stop you there? So you have bones to work with, so how can you figure out about the arteries?

Greg Thomas, MD: Well, it turns out the Egyptian scientists, and they were priests at the time, figured out how to mummify the elite. In their religion, to go to their version of heaven, their soul would go up to heaven, but their soul needed to come back to get sustenance from a body on earth periodically. So they mummified the dead so that their soul could come back, get sustenance, and then go back up to heaven, which they called the field of reeds. So these persons were mummified, and these were mummies that we scanned in Cairo with a CT scan or actually used to scan King Tutankhamen. And to our surprise, they actually had calcium, that's part of the blockages of the heart, calcium on the CT scans of these 25-pound mummies. They were bones, but they had skin and many of the organs they left intact.

Deborah Howell (Host): Incredible. Incredible.

Greg Thomas, MD: That's what we said.

Deborah Howell (Host): What does your research say about heart disease throughout history?

Greg Thomas, MD: Well, it turns out that about that same time, there is a papyrus written, essentially a textbook of medicine, from what they knew at the time. And they did have, as you might imagine, herbs and plants and such that did help some of the illnesses at that time. They did say in the papyrus that if a man or woman had pain in their chest and it went to their arms, that they were going to die. And that is actually the first reference to angina or heart pain, which could be a warning of a heart attack that's been seen in the literature in the history of mankind. So we know that a person's head blockage of their arteries at that time at 1500 BC, 3,500 years ago, and that they actually had pain from it. But most of the people didn't live into their 70s or 80s, did not live to be grandparents, for example. They died of infection early. So we are looking to try to understand without excess cholesterol and fat, which they didn't have back then - they're mostly lean and exercised a lot, what other causes of heart disease exist might actually be one of the mysteries of the ancient Egyptian mummies.

Deborah Howell (Host): So in your opinion, what else could have caused their heart disease?

Greg Thomas, MD: Well, I think the chance of having heart disease is baked into our genetics, into our DNA. That it may well be there's a gene or genes that can predispose to heart disease, that maybe they protect us against something else, like protect us against malaria or infection. So maybe there is something good about these genes that people had in ancient times and presumably now that protected them so they could live to old age. But when they got old age, they suffered from blockage of the heart arteries that would cause either heart attack or blockage of the arteries up to the brain that could cause a stroke.

Deborah Howell (Host): Wow. This is just absolutely incredible. I can't believe how much you're understanding from just a CT scan.

Greg Thomas, MD: It's pretty remarkable. Our team, which is composed of scientists and physicians from across the world, we did not expect to find blockages in these ancient people. We scanned actually almost 300 mummies, from South America, North America, Europe, and Egypt. And we've scanned actually seven different cultures, and we could not find a culture that does not have arteries that are blocked.

Deborah Howell (Host): Maybe it's a lot of animal fat. They did eat a lot of meat.

Greg Thomas, MD: They did. In fact, interestingly, we can't also find a culture that's vegetarian. While eating plants is probably better than...eating more and more plants, I think, is better and does decrease the chance of heart disease, cultures generally do eat meat. But in terms of how we translate this to today, what are the ancient mummies telling us? They tell us that we're all at risk for it. It's like having a sibling, or a couple siblings who've had a typical type of cancer that you're predisposed to that. So as humans, we believe we're predisposed to these blockages. So what it tells us is we should do everything we can that we currently know to try to avoid getting these blockages. For example, staying lean, exercising, taking our medications if we have diabetes or high blood pressure. These can delay heart disease, but again, we've found that it's difficult to eliminate. One of our colleagues has said that one wants to die not of heart disease, but with heart disease.

Deborah Howell (Host): Right.

Greg Thomas, MD: That if we could slow it down so that we die a natural death of something else at a very ancient age, to use a mummy term, then we've prevented heart disease from being a problem.

Deborah Howell (Host): You've mentioned a few, doctor, but again, let's go over the main risk factors that people in this day and age should know about heart disease.

Greg Thomas, MD: I think one of the main risk factors is our weight. With the low-fat, low-cholesterol diet that the American Heart Association endorsed about 40 years ago, and many have recommended, including myself, we've taken away a good amount of the fat, and unfortunately we've replaced that not with fruits and vegetables, which was the original recommendation, but we've replaced it with a significant amount of processed foods and carbohydrates, not more natural foods that would be either grown from the ground or lean meat. So with that, we've gotten heavier. Our cultures, not just in the United States, but across the world, have gotten heavier. With that, cholesterol goes up, blood pressure goes up, cancer, diabetes goes up. So I think weight is key. And so eating more natural-type foods, not necessarily organic foods, but less processed foods, and trying to maintain our weight with diet and exercise. I think that's particularly important since we're all, again, at risk for developing these artery blockages in the heart and up to the brain, carotid arteries.

Deborah Howell (Host): You know, a lot of people hear processed foods, but they don't really know what they are. Could you give us some examples of what processed foods are?

Greg Thomas, MD: I think it's something we put in an oven that's like a cake or a carbohydrate type that's not a natural one. It's not something that's, again, an animal or grown. It's something that's put together often with saturated fats to keep it from decaying or not being able to put on a shelf. And then we add sugar, partly because we've taken some of the fat up. We add sugar to make it taste good. And so it sells, and then we've got those extra calories that we tend to pack away over the years.

Deborah Howell (Host): So anything in a box that you get at the grocery store or that you might bake. Also, are we talking about meats that are processed as well?

Greg Thomas, MD: I think that if we try to stay with the leaner meats, things that can fly, for example, they're leaner, they can get up in the air. We want to be, if we're eating beef, we want to certainly eat lean beef, but chickens, turkey, things they can swim, they're also not particularly high in saturated fat. It's a little hard to not eat anything out of box. That's pretty difficult to do. But I think that we should use moderation with them and try to, again, eat more of these natural foods. And if we're going to eat a big meal, then we better have taken a pretty good walk that day to balance that out.

Deborah Howell (Host): Or have one afterwards. Great. Well, that's a great start, Doctor. Where can our listeners go to learn their risk factors?

Greg Thomas, MD: Well, we have an excellent team that's available to discuss and do some screening at the Women's Cardiac Health and Research Center. The phone number is 562-933-2460.

Deborah Howell (Host): Let's get that again one more time.

Greg Thomas, MD: 562-933-2460. We'd be happy to help either men or women who call in.

Deborah Howell (Host): Thank you so much, Dr. Thomas. It's been fascinating to have you on the program today. Really, really informative.

Greg Thomas, MD: Our pleasure.

Deborah Howell (Host): I'm Deborah Howell. Join us again next time as we explore another weekly dose of wellness brought to you by MemorialCare Health System. To listen to the podcast or for more info, please visit memorialcare.org. That's memorialcare.org. Thanks for listening and have yourself a fantastic day.