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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.
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| Scientists
test the elasticity of Alan's arteries. He passes, avoiding
an early sign of heart trouble |
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"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."
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"I'm the first man in my family to make it to
age 45. I've outlived my father and brother by 20 years."
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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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