Small steps lead to big reduction in risk for overweight Mayo Clinic cardiologist

Moderate changes in lifestyle can lead to big reductions in risk, as reported in a feature story in the Wall Street Journal by Ron Winslow. The story opens with an anecdote from Mayo Clinic cardiologist Stephen Kopecky, who describes the case of a 240 pound, 49-year-old  man with a scary lipid profile. “He may not have been a heart attack waiting to happen, but that was the direction he was headed,” writes Winslow.

The man then started to exercise regularly and to eat a healthy diet, resulting in an 18 pound weight loss and a dramatic improvement in his lipids. Winslow quotes Kopecky, who points out that the case shows “that we can all help ourselves tremendously taking small steps and doing something that’s achievable.”

But it’s not until the very end of the story that Winslow pulls the rabbit out of the hat:

“Which brings us back to Dr. Kopecky. The 49-year-old patient whom he describes is now 55, and he is Dr. Kopecky himself. He had been an interventional cardiologist at the Mayo Clinic and says he had performed about 2,000 angioplasty procedures to open up clogged arteries of people who were unable to fend off the disease. He decided to become a preventive cardiologist.

But to do that, he felt he needed to follow his own advice. “It’s not an all-or-none phenomenon,” he says. “But any little benefit is a continuous curve. You add benefit by doing multiple things.”

Winslow ties Kopecky’s story to a much larger theme, much in evidence at last month’s ACC meeting in the ACCORD and RACE II trials, showing that more aggressive therapy doesn’t always translate into better outcomes. Winslow quotes Chris Cannon: “”Going the moderation route is what we recommend to get real change for the heart patient.”

“The overall message of the reports,” writes Winslow, “was that patients appear to do just as well aiming for treatment goals that are easier to achieve, at potentially lower cost and with fewer side effects.”

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