Can Cheney Take the Heat?
By Christine Gorman
For a guy who had his first heart attack at age 37--and two more
before his 48th birthday--Dick Cheney has been pretty lucky.
When the first one hit in 1978, doctors were learning new ways
to treat and prevent heart attacks, which occur when the flow of
oxygen-rich blood is partially interrupted and some of the heart
tissue dies. He had his second and third in 1984 and 1988,
during a decade of extraordinary progress in the medical and
surgical treatment of heart disease. By the time he underwent
quadruple-bypass surgery in August 1988, the procedure had
become almost routine.
So much for the past. What about Cheney's future health? He
clearly did himself a big favor 22 years ago when he gave up a
three-pack-a-day cigarette habit. He supervised the planning and
execution of the 1991 Persian Gulf War with nary a complaint
from his ticker. He was also lucky that his first attack struck
the bottom wall of his heart, an area that is often associated
with minimal tissue damage.
Last week the Bush campaign released two letters from Cheney's
doctors asserting that the candidate's chosen running mate will
be able to withstand the rigors of a national campaign and
possible elected office. Most cardiologists we spoke to agreed.
But they also noted that the cautiously worded medical
statements were less than forthcoming and raised as many
questions as they answered. For example:
--IN WHAT SHAPE ARE CHENEY'S BYPASS GRAFTS? For technical
reasons, most of his grafts must have come from veins in his
legs. After about 15 years, many leg-vein grafts become blocked
as well.
--WHAT ARE CHENEY'S CURRENT CHOLESTEROL LEVELS? His doctors say
he has a long history of high cholesterol that "has been
vigorously and successfully treated with medication." But they
don't provide any figures. Dr. Roger Blumenthal of Johns Hopkins
Medical School cites a number of studies--one of which was
published just three weeks ago--showing that bypass patients who
lower their LDL (bad cholesterol) levels to 100 mg/dl or less
reduce their likelihood of needing additional invasive treatment
by 30%.
--JUST HOW STRONG IS CHENEY'S HEART? His physicians report that
stress tests have been "stable and unchanged for the past
several years." But they don't provide Cheney's so-called
ejection fraction, a measurement that tells doctors how well the
heart is pumping blood. "Stable and unchanged does not mean
normal," says Dr. David Pearle at Georgetown Medical Center.
"That is cautious wording. It could be mildly or even moderately
abnormal and still be stable and unchanged."
--WHAT KIND OF DIET DOES CHENEY FOLLOW AND HOW STRENUOUSLY IS HE
EXERCISING? "He doesn't look like the picture of health," notes
Dr. Eric Topol, chairman of cardiology at the Cleveland Clinic.
The former Secretary of Defense has gained an estimated 40 lbs.
since he left the Pentagon for corporate life. He exercises 30
minutes on a treadmill "several days a week"; many doctors
believe that a pace of 4 m.p.h. is the minimum needed to get any
cardiovascular benefit.
We may never know the answers to these questions--at least not
before the election. But this much is certain. Though Cheney's
history of heart trouble places him at a statistically higher
risk than the average 59-year-old man for another heart attack,
his odds of surviving through healthy living and proper medical
care have never been better.
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