Hope for Reversal

Hardening of the arteries is a disorder as baffling as it is widespread, and most physicians have long despaired of being able to do their patients much good. But U.S. members of the Pan American Medical Association (see above) got home last week with hope that they may soon be able to do a good deal to help patients in the earlier stages of the disease without waiting for detailed knowledge of how it develops.

Dr. Alfred Steiner, of Columbia University's College of Physicians and Surgeons, did not go into the question of what comes first, the fatty, artery-clogging cholesterol or the disease (TIME, Dec. i, 1952). Neither did he bother with the arguments as to just which abnormalities involving fatty substances in the blood are the more important. "Probably," he says, "all play a role in the development of arteriosclerosis." What Dr. Steiner was concerned with was the practical problem of checking the process by which the arteries harden and become closed by the thickening deposits of fat.

So far, Dr. Steiner reported, diet seems to be the answer. Though many drug treatments have been proposed, he and his Columbia colleagues have not found any of them useful. But among 20 patients with hardening of the coronary arteries who were kept on a lowfat, low-cholesterol diet, 13 showed a noteworthy decrease in the amount of cholesterol in their blood, and some of these have been carefully followed and lab-tested for two years or more. This diet is not extreme or hard to follow, since it may include as much as two ounces of fat a day. The doctors exclude butter, cream, fatty meat, egg yolk and cheese. However, they let the patients have skim milk.

Only recently has it been learned that in animals a cut in the amount of cholesterol in the blood results sooner or later in clearing the clogged arteries. The next step, finding out whether the same reversal occurs in man, needs a lot more study. But Dr. Steiner allowed himself some cautious optimism: "Real progress in the prevention and treatment of atherosclerosis [an early stage of arteriosclerosis] is being made, and it is hoped that in the near future the fatalistic attitude regarding it will be altered."

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