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Medicine, diet and exercise may do more to heal your heart than stents or surgery says study

"What it really is a statement of, is that our medicines are really, really good nowadays," said Dr. Robert Hendel, Tulane's Chief of Cardiology.

NEW ORLEANS — Recent headlines about a major heart study may have confused you.

It read that heart stents and surgery are no better at preventing heart attacks and death than pills with diet and exercise are.

So if you're one of the many people with cardiovascular disease, what should you do?

Jim Breland has always been active, but suddenly in August, he woke up sweating.

"I woke up and I had a burning feeling coming through my throat and I was having trouble catching my breath and chest pains," said Breland, 56.

At the hospital, doctors found four blockages in arteries going to his heart. Some were 100 percent blocked. He was having a heart attack like so many others in his family.


"My dad and his four brothers all died of heart disease and I have four brothers and now I'm the fourth one with heart disease," he said.

Jim got two stents to open up blockages. He's scheduled to have two more.

A new heart study may change the treatment some patients choose with their cardiologists. The ISCHEMIA  Trial, an international study with thousands of patients with blocked arteries to the heart, was designed to answer two questions. Would stents to open up blocked arteries, or bypass surgery help patients live longer, and reduce heart attacks. The answer was no.

"What it really is a statement of, is that our medicines are really, really good nowadays," said Dr. Robert Hendel, Tulane Chief of Cardiology and Director of the Tulane University Heart and Vascular Institute.

Dr. Hendel says those medications are cholesterol-lowering medicines, such as statins, medicines to lower blood pressure and even aspirin to get the blood flowing. Then, he says, couple those with better diet and exercise.

"And I think the ISCHEMIA Trial reinforces the idea that these lifestyle changes and medicines really are the way to go to improve survival," Dr. Hendel said.

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So while Dr. Hendel says that surgical procedures did help people feel better, his take-home message is, if you are not having symptoms from your blockages, there is no need for stents or surgery.  And if you are having symptoms, like chest pain and it goes away with the medications, that's all you need. If symptoms don't go away, then you may need stents and surgical procedures. This decision affects many in this area.

"And unfortunately, here in the New Orleans area, we have a real propensity for this problem, largely due to genetics, our high blood pressure rates, our diet, a lot of things that really cause heart disease," explained Dr. Hendel.

Jim is one of those patients. He's now teamed up with the American Heart Association for the Northshore heart walk this year. He's following his doctor's medical advice and doing his part for good health.

"I feel good. I've started cardio rehab. I've done half of the 36 sessions. I'm playing a good bit of golf. I'm walking. I fish a lot," he said.

All of that helps so he can be around a lot longer for his children and grandchildren.

And the doctors say since each of you, and your heart condition, is unique, ask your cardiologist about the pros, cons, benefits and risks when you need to make a treatment decision.

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