HEART OF THE MATTER HEALTHIER LIFESTYLE, AWARENESS OF RISK FACTORS KEY TO CARDIAC HEALTH.

Byline: Evan Henerson Staff Writer

DAVID LETTERMAN shouldn't have to undergo a coronary bypass operation and Oprah Winfrey shouldn't have to get an electron beam CT scan to get people thinking about heart health. Nor, doctors and heart health experts say, should it even require an orchestrated public awareness campaign that accompanies American Heart Health Month every February.

Not when you're talking about heart disease - the leading killer in America. Heart disease claims more lives each year than cancer, automobile accidents, AIDS and Alzheimer's disease combined, according to the American Heart Association. According to the AHA's 2002 Heart & Stroke Statistical update, an estimated 61.8 million people suffer from some form of cardiovascular disease.

``It seems like we're long on information and short on compliance,'' says Dr. Jack Patterson, senior partner of the Cardiovascular Consultants Medical Group. ``I watch normal advertising on TV and I see a lot about cigarette smoking, cholesterol, healthy lifestyle. Yet I see so many young people smoking, it makes me sick.''

``The way I look at it, how long has terrorism been in the forefront of the country's mind?'' adds Mark Litman, chairman of the Heart Fund at Cedars-Sinai Medical Center, a nonprofit organization dedicated to bringing awareness of heart disease.

``People didn't pay attention before Sept. 11; the government didn't give it the proper attention. Now people are starting to look at it. Unfortunately, someone has to die. Unfortunately, it has to be someone famous before people pay attention to this tragic disease.

``Each and every one of us can't do something about terrorism,'' Litman continues, ``but we all can look at ourselves and take care of ourselves.''

A silent killer 

In 1996, Litman founded the Heart Fund in memory of his best friend, Steven S. Cohen, a 35-year-old father of two who died after suffering a massive heart attack while playing basketball. Litman's phones have been busy recently, following the January deaths of film director Ted Demme - who was later determined to have cocaine in his system - and Calabasas accountant Roger Goodman. Like Cohen, both men collapsed playing basketball. Both men were under 40.

The topic is so hot, Litman says, that the Heart Fund is assembling an informational meeting to take place in March.

``We'll explain what sudden cardiac death is, what's happening and why it's not as rare as people think,'' says Litman, adding that it kills 250,000 people each year.

Coronary artery disease, the most common form of heart disease, occurs when the inner lining of the artery becomes narrowed or blocked with plaque - the accumulation of cholesterol, calcium or other fatty substances. When arteries harden, the plaque reduces blood flow and can cause formation of a blood clot, or thrombosis.

Cardiac arrest can strike without warning and people without symptoms can drop dead instantly. If there's a way to ``die in good health,'' a heart attack is it.

But it's a mistake to believe we're impervious until we reach middle age, warns Dr. James Fleisher, chief of cardiology at Encino Tarzana Regional Medical Center. The nation is getting progressively heavier and more sedentary. Parents need to start getting potentially obese children to start moving. Student athletes should make sure they're in decent health before they start pushing themselves.

Prevention is key

And adults need to start thinking about exercise, diet, monitoring their cholesterol levels and getting regular checkups.

``You should have your blood checked as early as possible, even in your 20s,'' says Fleisher. ``There are people with normal cholesterol levels who are still at risk for heart disease. Once you've identified these people, I think you can monitor these people more closely.''

``These people,'' as cardiologists are finding out with increasing frequency, can be anybody. Heart disease doesn't discriminate based on race or socioeconomic factors. Although men are more likely to suffer from heart disease, the 2002 AHA Heart Month Campaign is targeting women because coronary artery disease is also the No. 1 killer of American women, according to the AHA.

Even people within the medical profession can be in denial about heart health. Dr. Alvin Chun, a West Hills Hospital physician, had been treating patients with heart disease for 30 years when he suffered a heart attack at the age of 60. Anesthesiologist Dr. Daniel Elman was 65 when he suffered a heart attack. He underwent a bypass procedure five days later.

Now retired, Elman says he is like ``the cigarette smoker who quit.''

``I'm an evangelist about this thing,'' said Elman, who now does fitness rehabilitation three days a week and exercises on his off days. ``I don't know how to get it through to the average guy out there who is going into McDonald's ordering double cheese, double burger and everything else. He's ending up with enough saturated fatty acid in his blood vessels to kill him down the line.''

Knowledge is power

While the average American may not be paying enough attention to heart health, research certainly hasn't slowed. Scientists are studying everything from cholesterol-lowering medications to new stent procedures that doctors hope may ultimately lessen the need for bypass procedures.

Even the electron beam heart scans, which got such a boost when Winfrey got scanned in late 2000, aren't necessarily the gold standard in early detection that doctors are hoping for. The scans, which typically aren't covered by insurance, detect the presence of calcium in the coronary arteries.

``I personally think there's a lot of misunderstanding about what that test is, what it means and how it's used,'' says Patterson, ``As of right now, in practical terms, there is no good test that will be more predictive of who is likely to sustain a heart attack. The tests are more to determine whether there is significant blockage.''

Patterson, who is part of the cardiology team at Northridge Hospital Medical Center, treated Los Angeles Lakers broadcaster Chick Hearn. Just before Christmas, Hearn underwent open heart surgery to replace an aortic valve that had significant blockage. The condition, known as aortic stenosis, meant that Hearn's heart had to work harder, often leaving him fatigued.

Unlike coronary artery disease, complications from a blocked heart valve won't kill people unless it goes unchecked, according to Patterson.

``We had been following (Hearn) for quite a few years, waiting for the right time for him to have the procedure,'' said Patterson. ``Valvular disease doesn't sneak by. A physician can listen to your heart and find out if you have a valve problem. Then it's confirmed by ultrasound.''

UCLA to host 'heart day'

On the day of love, UCLA will host a free heart health fair for the public. Experts will share the latest advances in care, prevention, treatment and education. In addition, free cholesterol screenings, blood pressure and heart-risk assessment and diet counseling will be available. Refreshments and kids' entertainment are also included. The event runs from 10 a.m. to 2 p.m. Thursday at the UCLA Medical Center, 10833 LeConte Ave., Westwood, on the patio by the main entrance to the hospital. For more information, call [phone].

CAPTION(S):

7 photos, box

Photo:

(1 -- cover -- color) ON THE COVER

The pillow in the photo illustration is given to heart surgery patients at Northridge Hospital Medical Center both to comfort them and for surgeons to diagram the patients' procedures on the heart image.

Michael Owen Baker/Staff Photographer

(2) Dr. Daniel Elman, a retired anesthesiologist who suffered a heart attack and had bypass surgery at age 65, works out on a treadmill at a West Hills gym as part of his fitness rehab program.

(3) LETTERMAN

(4) WINFREY

(5) Elman works his arms as part of his thrice-weekly rehab regimen and exercises on his off days. ``I'm an evangelist about this thing,'' he says.

(6) HEARN

(7) no caption (heart structure)

American Heart Association

Box:

UCLA to host `heart day' (see text)