Routine heart procedures just don’t work—and the science reveals WHY

You CAN keep your heart healthy without dangerous, invasive surgery 

Last summer, my brother on the west coast underwent heart screenings in preparation for a needed medical procedure. The tests revealed an old, partial blockage of a coronary artery. 

The story I heard, from long-distance, was that doctors immediately wanted to scour out his artery—the way you would a blocked pipe in your home—with a catheter. Then, they wanted to place a stent in the artery to help keep it open and functional.  

(I think of this arterial stent procedure as “Roto-Rootering” your heart, because it’s as invasive and unpleasant as sending a metal plumbing snake down your sewer pipe.) 

Fortunately, just like you, my brother is an Insiders’ Cures reader.  

And he’s kept track of the research I’ve reported over the years about the dangers of popular but unnecessary heart procedures like stenting. 

So, he said NO to the cardiac Roto-Rooter.  

As a result, he was forced to look for other physicians who would sign a waiver so he could get his medical procedure without first having to undergo a useless, inappropriate, and dangerous heart procedure. And, let me tell you, that was a difficult if not impossible undertaking! 

I, of course, was trying to help him through all of this medical hocus pocus with limited success. And it made me think about all of the people who don’t have a physician in the family…or easy access to research showing just how many of the heart procedures cardiologists routinely perform actually don’t work 

That’s why, in honor of American Heart Month, I’m sharing some of these studies with you here.  

And then, I’ll tell you about the many natural, nonsurgical options that can safely and effectively keep your heart healthy for years to come.  

Two common heart procedures many people don’t need 

For decades, cardiologists and heart surgeons have routinely recommended and performed two highly invasive surgical procedures for the millions of Americans with narrowed coronary arteries: Arterial stent procedures (like the one my brother refused) and coronary bypass (or open-heart surgery).   

A coronary bypass redirects blood around the blocked section of an artery. This procedure involves stopping the heart, pumping the blood back into the body through an artificial heart-lung machine, performing the bypass, and then starting the heart again.  

Clearly, both of these procedures are complicated, expensive, and dangerous. And a recent, huge study found that men and women with blocked arteries who had either of these procedures actually fared no better—and often worse—than people who had no surgical interventions. 

Let’s take a closer look… 

More evidence that stenting and coronary bypasses don’t work 

In a $100 million study, researchers followed more than 5,000 men and women from 37 countries with severe but stable heart disease.1 

The participants were given CT scans or angiograms to detect any heart blockages. Three-quarters of the people with blockages received stents. The other quarter underwent heart bypass surgery.  

Doctors then followed all of the participants to see who subsequently had heart attacks, heart failure, hospitalization, or deaths from heart disease. 

After one year, 7 percent of the people who’d undergone an invasive cardiac procedure had suffered one of these adverse outcomes, compared with only 5 percent of people who didn’t have a surgical intervention.  

That means the heart procedures actually had a significant 40 percent greater relative risk! 

Plus, after a little over three years, the researchers found that 13 percent of the people who underwent a cardiac procedure had a heart attack, hospitalization for unstable angina or heart failure, or death due to a cardiovascular event. Meanwhile, almost 16 percent of people who didn’t have a heart procedure had one of these outcomes.  

In other words, IF you survive the first year following one of these invasive procedures, your relative risk does eventually go down. But only slightly. 

In fact, the overall mortality risk at 3.3 years was virtually identical between both groups—6.4 percent in the surgery group and 6.5 in the non-surgery group.  

The placebo effect 

Overall, the researchers concluded that their study is the strongest evidence yet that tens of thousands of costly, risky stent procedures and bypass surgeries are unnecessary for people with stable heart disease. (Stable heart disease means a patient’s symptoms are generally under control.) 

In one 2018 study, people who underwent a completely bogus placebo procedure had the same modest cardiac improvements as the group that underwent a REAL coronary artery bypass!2  

That also suggests that any improvements that people have after undergoing a heart bypass are due to a placebo effect—or the healthy lifestyle changes that should be adopted post-surgery. 

(Although admittedly, stopping the heart and then bringing the patient back to life again could be considered a pretty powerful placebo effect in itself, along the lines of resurrection!) 

The real causes of heart attacks 

These studies beg the question: Why don’t these common cardiac procedures help reduce heart disease and boost longevity? 

The answer? Because the procedures are treating the wrong issue. 

The fact is, research has shown that 
cholesterol deposits in the arteries 
aren’t the real problem when it comes to heart attacks and strokes. In fact, your body uses cholesterol to repair arteries and protect their linings from damage and rupture!  

And it turns out, calcification in the arteries works in the same way. It doesn’t signal that something dangerous is going to happen…rather, it’s a sign that something already did happen,and the body is already in the process of healing.  

So, a “blocked” artery is not typically an acute danger requiring emergency, invasive, dangerous heart procedures.  

Furthermore, heart attacks (and strokes) don’t even typically occur 
because of the worst-looking 
blockages. Instead, newer research shows they’re due to sudden inflammation at the site of a smaller, minimal blockage. This inflammation can cause the thin plaque lining of an artery to suddenly burst…causing 
clotting and heart attacks or strokes.  

That means the key to prevention is calming down inflammation (as so much other research also points to) before that life-altering event happens—through diet, lifestyle changes, and supplementation…not surgery.  

Hardly “routine” surgery 

Despite the growing evidence showing the ineffectiveness of stent procedures and coronary artery bypasses, doctors still routinely perform them—as my brother recently found out.  

In fact, these procedures are performed so often that people have come to believe these surgeries are no big deal. But that couldn’t be further from the truth. 

Studies in recent years have uncovered many serious problems in people who have undergone these procedures.  

Along with the risk of infection and surgical site complications with any invasive procedure, stents can lead to blood clots…which, ironically, can lead to heart attacks, strokes, and brain damage. 

Cardiac bypass surgery can have even more complications. After all, doctors are cracking people’s chests open and basically stressing them out from stem to stern.  

So, it’s hardly a surprise that there’s a risk of infection, substantial blood loss, and blood clotting during and after this surgery. Patients can also develop pneumonia, breathing problems, and even lung or kidney failure or brain damage.  

In other words, cardiologists and heart surgeons are really the only people to clearly benefit from the millions of stent procedures and bypasses.  

Why do doctors keep persisting with heart surgeries? 

For years, I remember the leading heart surgeon at the University of Pennsylvania Hospital had his own personal helicopter for getting around quickly. Meaning the benefits of these procedures are highy profitable. 

Of course, there are other reasons as well. In a 2020 opinion piece in the Los Angeles Times, Dr. Rita Redberg, a cardiologist and professor at the UC San Francisco School of Medicine, wrote: “We asked doctors why they do these procedures, even when evidence suggests no better outcome than with medicines. Their responses included that patients expect it, that it is part of the medical culture, that doctors are afraid of getting sued if they do not insert stents (error of omission) and that they prefer the risk of harm by doing something (error of commission) to the risk of harm from doing nothing.”3 

Dr. Redberg also cited mainstream medicine as a culprit…  

“To understand the popularity of stents, despite the lack of evidence in their favor, we must also consider our medical system,” she wrote. “In it, doctors receive higher rewards for performing procedures than for talking about medications and lifestyle. Plus, we live in a culture that tends to believe high-tech solutions are always superior to old-fashioned things like medication.” (And, I would add, diet and lifestyle modifications.) 

The power of nonsurgical interventions 

Even back in the mid-1970s, as a medical student at the University of Pennsylvania, I (and a few other traditional physicians) thought these types of invasive heart procedures were dangerous—and a huge mistake.  

Of course, at that time, the mainstream assumed that heart disease was a one-way street. In other words, once you were diagnosed with it, you could never reverse the course of the disease or get any better. Rather, you could only hope to “manage” your condition.  

Then, in the 1980s, researchers in other areas of health began to show that you can, in fact, reverse heart disease with diet, lifestyle, stress reduction, and—importantly—community, emotional, and social support.  

My colleagues Dr. Dean Ornish and Dr. Lee Lipsenthal (at the original Thomas Jefferson Clinic, that I led 20 years later) even performed studies showing the reversal of heart disease due to diet and lifestyle. In fact, Dr. Ornish and former U.S. Surgeon General Dr. C. Everett Koop co-chaired my medical education conferences in the late 1990s to help bring these findings to a wide audience of health practitioners.  

So, while it may be too late for the millions of Americans who were subjected to the costs and dangers of these useless procedures for decades, it’s not too late for you—or someone you love—to improve your heart health safely, naturally, and non-surgically. 

Here’s what I recommend… 

Six simple ways to lower your risk of heart disease 

1.) Mind your peas…and other diet Qs. Study after study shows that one of the best ways to prevent heart disease is to eat a balanced diet that’s rich in whole foods. While there are diets specifically geared to cardiovascular health, I prefer the time-tested Mediterranean diet, which emphasizes heart-healthy fruits and vegetables, full-fat dairy, lean meats like lamb, nuts and seeds, olive oil, and moderate consumption of red wine.  

2.) Work out—but not too much. We all know that exercise benefits the heart. But too much exercise (or “excess-ercise”, as I call it) can have the opposite effect (think of all those marathon runners who suddenly have heart attacks and drop dead while training). Research shows that about 150 minutes of moderate exercise per week (not per day!) is most beneficial for your heart. That breaks down to around 20 minutes daily. And includes walking, swimming, housework, gardening, or other enjoyable activities. 

3.) Stress less. Chronic stress can lead to inflammation and high blood pressure—two of the biggest heart disease risk factors (for more about how to lower high blood pressure, see page 6). But meditation and other mindfulness exercises like breathing techniques and yoga can help you effectively manage stress, lower blood pressure, and improve your health. To find out more, consult my book, New World Mindfulness. (Order a copy for yourself or someone you know, including your doctor, from the “Books” tab of my website, www.DrMicozzi.com.) 

4.) Get your ZZZs. There’s a strong association between sleep disorders such as sleep apnea and heart disease. In fact, according to Harvard scientists, sleep apnea is found in up to 83 percent of people with cardiovascular disease, 35 percent of people with high blood pressure, and 53 percent of people with heart failure, atrial fibrillation (irregular heartbeat), and stroke. Worse yet, untreated sleep apnea may increase your risk of dying from heart disease by up to 500 percent!4 That’s why it’s important to get quality shuteye, night after night. Science shows most adults need at least seven hours of sleep each night. If you need some support, I recommend aromatherapy. The practice of aromatherapy involves applying essential oils directly to your skin and/or inhaling them through a mist diffuser. And research shows these plant oils are the most effective for supporting sleep: chamomile, lavender, limonene, orange, and peppermint. 

5.) Develop your social networks. There are plenty of studies linking loneliness and isolation to heart disease. In fact, one review of the literature found that a lack of social support can double your risk of heart disease.5 But in this time of social isolation, finding friends and social support can be difficult. One idea is to join in-person or virtual groups of people with the same hobbies or interests as you. You may also choose to get a pet for added companionship (I’ll report more on the health benefits of owning a pet in next month’s issue).  

6.) Use supplements for support. There are a several key nutrients that have been shown in numerous studies to support heart health. Here’s what I recommend: 

  • A high-quality vitamin B complex that contains at least 30 mg of B6, 800 mcg of folate, and 1,000 mcg of B12, taken daily.
  • Vitamin D3 (25 mcg [10,000 IU] per day).
  • Vitamin K2 (150 mcg per day). Note: Vitamin K may interact with anticoagulant drugs, which are often prescribed to people with heart conditions. As always, consult with your physician before adding any supplements to your diet.
  • Betaine (500 mg per day).
  • L-carnitine (500 mg per day).
  • Coenzyme Q10 (200 mg per day). For more about this essential nutrient, see page 7.

The bottom line on heart surgery 

There may be situations when a heart procedure is right for you…or a loved one. But, like my brother, you’re more likely to be the victim of an overzealous or underinformed cardiologist who can’t see beyond “routine” procedures and surgeries when it comes to heart health.  

That’s why I recommend finding a good internal medicine doctor who listens, takes time with you, and stays up–to–date with the science. These doctors are far less likely to push costly, invasive heart procedures than your typical cardiologist—who still seems to know nothing better.  

And, as always, follow the science, which clearly shows performing these dangerous procedures is often just locking the barn door after the horses have already gotten out. But thankfully, as I explained here, you don’t need to follow the herd—or be left out of the barn—when it comes to heart health.   

For additional science behind safe, effective, natural approaches to help protect your heart—without ineffective and dangerous procedures or drugs—check out myHeart Attack Prevention and Repair Protocol. To learn more about this comprehensive, online learning tool, or to enroll today, click here or call 1-866-747-9421 and ask for order code EOV3Y200.  

Know the early warning signs of a heart attack 

There are seven common signs of cardiac arrest, which can appear in the weeks and months leading up to an event. Here’s what to watch out for: 

  • Chest discomfort  
  • Shortness of breath or breathlessness  
  • Weakness or fatigue  
  • Fast-beating, fluttering, or pounding heart (palpitations)  
  • Lightheadedness, dizziness, or fainting  
  • Neck or jaw pain  
  • Nausea or vomiting  

If you experience any of these 
symptoms, seek immediate help. And always trust your instincts. If something feels off…it may well be. Don’t hesitate to call your doctor or 911 in those cases. 

Seven heart tests you should get…and two you should think twice about 

Along with routine blood-pressure readings, here’s a checklist of the tests your doctors SHOULD be performing to monitor your heart health. 

Cortisol. This hormone is produced in your adrenal glands when you’re stressed, and can be measured in your saliva. High cortisol levels can lead to heart damage, weight gain, and reductions in brain, bone, and muscle mass.  

C-reactive protein (CRP). This substance is naturally produced in your liver and acts as a general marker for chronic inflammation in the body. Highly sensitive CRP (Hs-CRP) tests evaluate the health of your coronary arteries, and are a much better measure of heart health than cholesterol tests.   

Homocysteine. High levels of this amino acid are a major risk factor for heart disease, stroke, and dementia. A variety of studies show that homocysteine levels lower than 9 umol/L are optimal. 

Hemoglobin A1c. An HbA1c test tracks your average blood sugar levels over three to four months. Keeping your blood sugar balanced is key to avoiding complications such as heart disease and type II diabetes. A normal, healthy HbA1C level is under 7.0, or 7.5, according to standard studies.  

Omega fatty acids. A blood test can measure the ratio of omega-3 fatty acids (from fish, seeds, and nuts) to omega-6 fatty acids (from most vegetable oils and shortening) in your cell membranes. You want your blood to be higher in omega-3s, which have been shown in many studies to help prevent heart disease. For an omega-3 boost, I often recommend supplementation based on diet. Refer to the sidebar in the April 2021 newsletter for more direct guidance. 

Vitamin B12. There are varying opinions on what constitutes “normal” levels of this heart-healthy vitamin—anywhere from 200 to 400 ng/L or higher—so you’ll need to discuss your blood test results with your doctor. 

Vitamin D. A 25(OH)D test measures the amount of vitamin D in your blood. Your levels should be in the 50-75 ng/ml range, and up to 90 ng/ml looks fine according to the latest science. It’s best to get tested at the end of winter (when your D levels are likely the lowest) and the end of summer (when they’re at their height, due to sun exposure). Then, vitamin D supplementation can help reach—and maintain—optimal levels. 

Now, let’s move on to two heart tests that are commonly prescribed, but often unnecessary. 

EKG. Routine EKGs are mostly a waste of time—unless you’re being monitored for a known heart condition. 

Lipid panel. This overblown blood cholesterol test is most often used as a reason to prescribe dangerous and useless statins. Not to mention, numerous studies tell us that cholesterol is not a major risk factor for heart disease. 

Urgent CPR warning (especially for women) 

According to the American Heart Association (AHA), nearly 400,000 Americans die each year from sudden cardiac arrest.6 Death from a heart attack can occur within minutes unless the heart is restored back to a normal beat—meaning there are a few precious, “golden” moments to react and perform cardiopulmonary resuscitation (CPR).  

That’s why I encourage every able adult to learn CPR. (Check your local Red Cross for classes.) 

Of course, even when bystanders are trained in CPR, a recent study revealed that women having a heart attack are less likely than men to get help from people witnessing their collapse.7 The researchers found that 74 percent of men were given assistance, compared with 69 percent of women.  

Men were also more likely to survive the “golden moments” after a heart attack and get to the hospital for needed care. In fact, 37 percent of men made it to the hospital alive, while only 34 percent of women did.  

Overall, men who suffered cardiac arrest outside the hospital had a 20 percent chance of getting to the hospital, recovering, and being discharged. By comparison, only 12 percent of women achieved this outcome. (That’s almost 50 percent worse!) 

Why the large disparity? 

Well, for one, bystanders are probably less likely to recognize when females suffer a cardiac arrest. And women themselves may not recognize the urgency of their symptoms.   

Men who have a cardiac arrest tend to experience classic heart attack symptoms such as chest pain. But women may experience vague, “masked” symptoms, such as fatigue, fainting, nausea, vomiting, and neck or jaw pain. Delay in recognizing symptoms can lead to delays in calling emergency services, and in providing CPR on the spot. 

In addition, in this era, men are more reluctant to touch women, anywhere, for any reason. And they’re particularly reluctant to touch their chests and mouths, as required for CPR.  

If you see someone in distress, however, please don’t hesitate. Learn CPR and use it… you just might save a life.

Sources: 

1“International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial: Rationale and design.” Am Heart J. 2018 Jul;201:124-135. 

2“Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomized controlled trial,” Lancet, January, 2018. 391(10115): 31-40. 

3https://www.latimes.com/opinion/story/2020-01-24/op-ed-blocked-artery-its-unlikely-you-need-a-stent-but-your-doctor-may-not-tell-you-that 

4health.harvard.edu/heart-health/how-sleep-apnea-affects-the-heart 

5“Social support and coronary heart disease: epidemiologic evidence and implications for treatment.” Psychosom Med. 2005 Nov-Dec;67(6):869-78. 

6https://professional.heart.org/en/science-news/-/media/bfb89c6f202a4ec4b756a7f738ac3b02.ash

7“Women have lower chances than men to be resuscitated and survive out-of-hospital cardiac arrest.” European Heart Journal, 2019. 40(47): 3824–3834.