The Unhappening of Heart Disease

Main Article Content

H. Robert Silverstein


Most of the major diseases, and atherosclerotic cardiovascular disease (ASCVD) in particular, are made to happen by patient actions.  Relevantly, it has been said that 95% of ASCVD, diabetes, hypertension and lipid disorders are curable:  made to unhappen. Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in industrialized countries including the United States. Healthcare inflicts a significant societal burden in terms of cost, and accounts for one-fifth of the gross domestic product expenditure in the United States. CVD is a disease primarily brought on by lifestyle factors, underlying genetic susceptibility becoming manifest in time (aging). Given the significant burden of health care, a major focus is now on the preventive aspects to reduce the incidence and prevalence of not only CVD, but multiple other diseases. Most diseases occur if, and ONLY if, the person with a particular genetic tendency does what is necessary to express that genetic tendency. The American public has the same genetic make-up as all other populations, but our behavioral patterns are what have activated our disease-causing genes, resulting in the major diseases and costs of our culture. By changing our behaviors, we can prevent the expression of those genetically-originated and behaviorally induced medical conditions and costs.  This includes the basic requirements:  clean air, clean water, a 90+% minimally-processed, high-fiber and ideally organic whole foods, diet with any pleasure-generating food once in a while, exercise to the point of developing abdominal clear lines of definition and demarcation, and the avoidance of unrealistic expectations.  This article provides the Preventive Medicine Center’s (PMC) philosophy and outlines guidelines that would lead to significant regression of ASCVD and reduce the disease burden in our communities as a whole. These recommendations are an invitation to consider and provide the reasonable probability of freeing the patient from the risk of disease by the “unhappening” of (heart) disease.

Article Details

How to Cite
SILVERSTEIN, H. Robert. The Unhappening of Heart Disease. Medical Research Archives, [S.l.], v. 11, n. 1, jan. 2023. ISSN 2375-1924. Available at: <>. Date accessed: 20 july 2024. doi:
Research Articles


1. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation. Jan 26 2022:CIR0000000000001052. doi:10.1161/CIR.0000000000001052
2. Cheng A, Braunstein JB, Dennison C, Nass C, Blumenthal RS. Reducing global risk for cardiovascular disease: using lifestyle changes and pharmacotherapy. Clin Cardiol. May 2002;25(5):205-12. doi:10.1002/clc.4950250503
3. Andersson C, Nayor M, Tsao CW, Levy D, Vasan RS. Framingham Heart Study: JACC Focus Seminar, 1/8. J Am Coll Cardiol. Jun 1 2021;77(21):2680-2692. doi:10.1016/j.jacc.2021.01.059
4. Farhud DD. Impact of Lifestyle on Health. Iran J Public Health. Nov 2015;44(11):1442-4.
5. Nyberg ST, Singh-Manoux A, Pentti J, et al. Association of Healthy Lifestyle With Years Lived Without Major Chronic Diseases. JAMA Intern Med. May 1 2020;180(5):760-768. doi:10.1001/jamainternmed.2020.0618
6. Thomas JA, 2nd, Gerber L, Banez LL, et al. Prostate cancer risk in men with baseline history of coronary artery disease: results from the REDUCE Study. Cancer Epidemiol Biomarkers Prev. Apr 2012;21(4):576-81. doi:10.1158/1055-9965.EPI-11-1017
7. NHE Fact Sheet.
8. Musich S, Klemes A, Kubica MA, Wang S, Hawkins K. Personalized preventive care reduces healthcare expenditures among Medicare Advantage beneficiaries. Am J Manag Care. Aug 2014;20(8):613-20.
9. Steven B. Cohen P. The Concentration and Persistence in the Level of Health Expenditures over
Time: Estimates for the U.S. Population, 2009-2010. 2012;
10. Charchar FJ, Bloomer LD, Barnes TA, et al. Inheritance of coronary artery disease in men: an analysis of the role of the Y chromosome. Lancet. Mar 10 2012;379(9819):915-922. doi:10.1016/S0140-6736(11)61453-0
11. Miller VM. Family matters: sexual dimorphism in cardiovascular disease. Lancet. Mar 10 2012;379(9819):873-875. doi:10.1016/S0140-6736(12)60200-1
12. West R. Tobacco smoking: Health impact, prevalence, correlates and interventions. Psychol Health. Aug 2017;32(8):1018-1036. doi:10.1080/08870446.2017.1325890
13. Baron JA. Beneficial effects of nicotine and cigarette smoking: the real, the possible and the spurious. Br Med Bull. Jan 1996;52(1):58-73. doi:10.1093/oxfordjournals.bmb.a011533
14. Burkitt DP. Some diseases characteristic of modern western civilization. A possible common causative factor. Clin Radiol. Jul 1973;24(3):271-80. doi:10.1016/s0009-9260(73)80037-6
15. Eaton SB, Konner M, Shostak M. Stone agers in the fast lane: chronic degenerative diseases in evolutionary perspective. Am J Med. Apr 1988;84(4):739-49. doi:10.1016/0002-9343(88)90113-1
16. Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet. Jul 21 1990;336(8708):129-33. doi:10.1016/0140-6736(90)91656-u
17. Bernard SA, Gray TW, Buist MD, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. Feb 21 2002;346(8):557-63. doi:10.1056/NEJMoa003289
18. Atherosclerosis: its cause and its prevention. Am J Cardiol. Dec 1 2006;98(11):1550-5. doi:10.1016/j.amjcard.2006.10.005
19. Silverstein HR. Preventing heart disease. The Lancet. 1990;doi:10.1016/0140-6736(90)90319-Z
20. Berry JD, Dyer A, Cai X, et al. Lifetime risks of cardiovascular disease. N Engl J Med. Jan 26 2012;366(4):321-9. doi:10.1056/NEJMoa1012848
21. Preventive Medicine Center. Hartford.
22. HR S. Maximum Healing. Berkeley, CA; North Atlantic Books 2010.
23. Silverstein H. DVD: Putting it all together.
24. Filippou CD, Tsioufis CP, Thomopoulos CG, et al. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr. Sep 1 2020;11(5):1150-1160. doi:10.1093/advances/nmaa041
25. Roberts WC. Systemic hypertension: some observations. Am J Cardiol. Dec 1 2005;96(11):1610-1. doi:10.1016/j.amjcard.2005.09.004
26. Inside The Strange Journey Of Tim Leary, From Harvard Professor To ‘The High Priest Of LSD’. 2022;
27. Isoldi KK, Aronne LJ. The challenge of treating obesity: the endocannabinoid system as a potential target. J Am Diet Assoc. May 2008;108(5):823-31. doi:10.1016/j.jada.2008.02.019
28. van Bronswijk H, Dubois EA, Pijl H, Cohen AF. [New drugs; rimonabant]. Ned Tijdschr Geneeskd. Nov 24 2007;151(47):2620-2. Nieuwe geneesmiddelen; rimonabant.
29. Million Women Study Wrong, Group Says.
30. Hamlet. SW. Act 4, Scene 3, lines 9-11.