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Affaris of the Heart
Mending a Broken HeartRobot Heart SurgeryThe Heart FactoryHow's Your Heart?
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Reaching Out

Castelli concedes diet and exercise won't help the 5 to 10 percent of people who's heart disease is genetic. The genetic predisposition to heart disease is responsible for 85% of heart attacks suffered by people under 65. These people often have cholesterol levels of a whopping 300 or higher. Medication can save their lives, but the health care system, Castelli charges, doesn't do a good enough job of finding these patients in time.

Photo of alan being tested
Scientists test the elasticity of Alan's arteries. He passes, avoiding an early sign of heart trouble  

"Primary care doctors see maybe 40 patients a day," says Casteli. "They get fifteen, maybe twenty minutes tops with each patient."

To find potential heart disease patients before it's too late, Castelli takes the novel approach of checking the cholesterol of Framingham school kids. He surveyed the high school a few years ago, using a simple finger prick test. Family histories revealed that of the kids with dangerously high cholesterol levels, 20% of the mothers and 60% of the fathers had already had heart attacks. Worse, 20% of the fathers had already died.

"Powerful meds can prevent these attacks," says Castelli. "It was all preventable."

"I'm the first man in my family to make it to age 45. I've outlived my father and brother by 20 years."

Castelli hopes that by screening kids at Framingham Middle School, he might be able to find the high-risk parents before they have a heart attack. But this isn't a one-man crusade; Castelli also spends three days each week on the road, recruiting other physicians and health care professionals to his cause.

"The real pay off," says Castelli "will be when we get every physician to act on these numbers."

He thinks that day, however is a long time off. He notes with irony his meetings with physicians are often held at steakhouses around the country. Practicing what he preaches, Castelli routinely orders grilled salmon and salad.

"I'm the first man in my family to make it to age 45," says Castelli, in his early 60's, over the big bottle of fish-oil tablets on his desk. "I've outlived my father and brother by 20 years, my mother by 5 years."

Castelli might be just the man to make us all have a change of heart.

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