Saturday, June 14, 2008

Tim Russert and Sudden Cardiac Arrest

Tim Russert, for many years the host of NBC's Meet the Press Sunday morning show, died suddenly on June 13, 2008. Michael Newman, Tim Russert's physician, said in an interview that the 58 year old newsman had died of coronary artery disease. This was surprising because his blood pressure was well controlled and his cholesterol fractions were optimal. Dr. Newman said that Tim had shown a high level of stamina on his stress test on April 29th, worked out regularly, and had done so on the morning of his death.

According to Dr. Newman, the postmortem on Tim Russert showed that, although Tim had been asymptomatic, he had significant heart disease, particularly in the left anterior descending coronary artery. Tim had a sudden rupture of a cholesterol plaque in the wall of that coronary artery. This produced a large clot which lodged in his heart, caused ventricular arrhythmia and took his life.

Could this have been avoided? Tim Russert had the best of medical care and tried to follow good health practices. The American medical community recommends regular exercise and keeping blood cholesterol low by eating sparingly of fat- and cholesterol-containing foods and by taking cholesterol-lowering medications if dietary measures are not sufficient. Americans have, in fact, been following these recommendations, and there has not been a large decline in the incidence of heart disease. There has actually been a slight increase in the incidence of heart disease, despite the fact that more and more Americans are also giving up smoking.

We cannot know if Tim Russert's health choices were the proper ones for him. Indeed, they might have enabled him to live longer than he would have lived without them. However, it is important to consider that there is an alternative to the cholesterol-lipid hypothesis for the incidence of heart disease. We'll look at that in the next post.

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