From the Heart

Heart specialists have been derelict in their duty to medical science and in many cases to their patients, one of their own number suggested last week at a Chicago meeting of the American Heart Association. Though he was speaking at his installation as president-elect, Dr. Irvine H. Page of the Cleveland Clinic wasted no time on the usual banalities.

Medicine, said Heart Specialist Page, is still getting nowhere in its attack on heart and artery diseases (which cause more than half of all U.S. deaths). Reason: the foundation of basic scientific knowledge has not been laid. It will take time, effort and much money to find out how and why hardening of the arteries begins and progresses among the world's best-fed peoples. Until this is done, "it is unlikely that the current shocking, death rate from [heart attacks and strokes] will be greatly altered."

Doctors are remiss too, said Dr. Page, in neglecting the early stages of the disease in their patients. As he put it: "The cardiologist [must] assume the burden of atherosclerosis, which he has so long and so successfully avoided in favor of taking care of its consequences." And on prescribing a low-fat or low-sodium diet, Dr. Page had more bitter words for the profession which sounded sweet to many a dieted layman. Dr. Page came to his conclusions the hard way: he made a drastic cut in the amount of fat he himself consumed. True, there followed a sharp drop in the amount of fat in his blood, and also in his weight, but Dr. Page saw other, less desirable effects: "An impairment of my disposition and a contraction of my circle of friends. During this period of several months, gastrointestinal disturbance was marked, but worse was the feeling of depression and irritability. Addition of vegetable fat quickly overcame both, but simultaneously raised [the level of fats in the blood] . . . The experiment ended after a year with the firm conviction that diets should be changed with the greatest caution, and that physicians should be required to try their diets before prescribing them."

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