THE HEART DISEASE BREAKTHROUGH

For those seriously concerned with preventing heart disease, this is your guide: detailed, current, strongly worded guidelines. Yannios, associate director of critical care and nutritional support at Ellis Hospital in Schenectady, N.Y., isn’t interested in cushioning the facts or the remedies in a feel-good framework—his horrifying case stories are successfully designed to propel readers into action, and he backs them up with the grim facts: most Americans already have well-advanced atherosclerosis by their 20s; low-fat diets “can actually raise cholesterol and increase risk in certain groups of people”; more than half the people who have heart attacks have total cholesterol levels under 200. So the remedy for those in peril, according to Yannios, takes some real work: assess your own risk; then, with the help of a physician, take advantage of the newest blood tests and make a stringent action plan—guidelines are set out here—involving diet, weight control, exercise, and medication. Yannios doesn’t let readers off easily, but that doesn’t mean he can’t offer realistic help: for instance, “practically every cardiac risk factor can be countered by exercise——it just has to be the right type of exercise. Heart disease prevention is among the fastest-advancing medical research areas, with new, often conflicting recommendations being published daily. For those at serious risk, this is an understandable, serious, and worthwhile approach.