Meet the Producer
Elizabeth Arledge, producer of The Hidden
Epidemic: Heart Disease in America, has a long and
distinguished record as a producer of health and
science-related documentaries. For PBS she most recently
produced, directed and wrote The Forgetting: A Portrait
of Alzheimer's, which won the National Prime Time Emmy
for Outstanding Nonfiction Special. The latest of several
documentaries she has made about the HIV/AIDS pandemic was
written and produced by her for ABC News and focuses on the
impact of the AIDS epidemic amongst Black Americans. Her
extensive credits also include numerous program's for WGBH's
FRONTLINE and NOVA television series, among them, NOVA's two
hour special on the Human Genome Project, Cracking The
Code of Life, which can now be viewed online at:
http://www.pbs.org/wgbh/nova/genome/program.html
What inspired you to do a film about heart disease?
It's the number one killer of Americans, responsible for more deaths than the next four causes of death combined, and most people don't realize that. It can strike without symptoms or warning, and yet it is also almost entirely preventable through lifestyle changes.
Why did you choose to describe heart disease as 'The Hidden Epidemic'?
Because compared to other diseases like cancer and Alzheimer's, heart disease does not get the kind of attention or strike the kind of emotional chord with the public that its toll warrants. It's a silent killer—more than half of all people who die of heart disease die suddenly without warning—and the other half have disease lurking in their body for many years before it strikes.
One of the more striking misperceptions of heart disease is in relation to women. How do you address this in the film?
Women after menopause are at equal risk for heart disease as men. Most women worry more about breast cancer but they have ten times the risk of dying of heart disease. We have several stories of women with heart disease in the film and we address the fact that women often have different symptoms from men that are easy to miss.
What are some of the new advances in heart disease research that tell us about the future of heart disease treatment and/or living with heart disease?
The field is turning away from what our main characters call the "plumbing model" of cardiology—that is, find a clog in the arteries, clear it out with surgery or angioplasty, and assume the patient will be OK—to a more complete understanding of the biological and molecular nature of the disease. Heart disease is not something that happens in one specific location in the heart. It is a systemic disease, and a blockage in one artery is a sign that the entire heart and other parts of the circulatory system are all diseased. The implications for treatment are that new drugs need to be developed that will lower cholesterol levels even more and help prevent or slow the progression of this system-wide disease process.
Will these new advances reshape the way doctors diagnose and treat heart disease? What does this mean to potential heart disease candidates?
Doctors are hopeful that they will be able to develop new tests that will reveal the disease process much earlier than it can be detected now. Through the use of protein markers that show inflammation in the bloodstream, treatment could begin earlier.
The best thing heart disease "candidates" can do is to prevent the disease through healthy life choices in diet and exercise. Once you have the disease there is no way to get rid of it. There is no cure. You will have it forever and probably die of it. The best doctors can do is delay the process so avoiding it in the first place is a far better course.
You mention the Framingham Heart Study (FHS) in the film. What about this study makes it a significant resource?
The FHS is one of the longest and most influential population studies in all of medicine. It defined the risk factors for heart disease and allowed clinical trials of drugs as well as other interventions to show what would reduce risk and what increased it. Before, the FHS people had no idea what caused heart disease and therefore no way to treat it.
What surprised you most about the people you profiled in the film?
How optimistic they all remain in the face of serious heart problems.
What are the most important messages viewers should take away from the film?
Heart disease CAN happen to you. Prevention is the best possible thing you can do, and whether or not you get heart disease is largely in your control.
You were the producer of The Forgetting, the acclaimed documentary about Alzheimer's disease. Are there similarities between the two films?
The two films both have a strong scientific story as their backbone, with compelling human stories woven into the narrative so that viewers can understand the personal implications of the medical information.
Heart disease is a topic frequently discussed on television programs such as TODAY. What makes The Hidden Epidemic different from other television discussions on the topic?
This film goes into more depth than previous programs on the subject and explores new scientific and medical advances.
There are compelling human stories in the film. Is there one that strikes you as particularly powerful?
The story of a 44 year-old seemingly healthy man who died in his sleep of a massive heart attack with no warning, leaving an infant daughter and a 10 year-old son, is a striking example of the message of the film. We are all at risk and we all have to be aware of the particular factors in our lives—cholesterol levels, blood pressure, weight, diet, exercise, family history—that may put us at risk, and do everything we can to control those factors so that we avoid heart disease.
