Even best efforts can't prevent all heart attacks

Tim Russert was a good patient, taking medications for his heart disease and exercising, his doctor said. He had no chest pains and he passed an exercise stress test weeks ago. Yet at 58, he suffered a heart attack and died.

That's not uncommon, say cardiologists. Heart disease patients can significantly reduce their chances of a heart attack, but they can't totally prevent it, said Dr. Howard Hodis of the Keck School of Medicine at the University of Southern California.

“Under the most ideal circumstances, there's still going to be individuals who succumb to the disease process. It's never going to be 100 percent,” said Hodis.

Experts say that shouldn't discourage heart patients from doing everything they can to lower their risks of a heart attack: control blood pressure and cholesterol, don't smoke, lose weight, change diet, exercise and reduce stress.

“If you have heart disease, does it mean that it's all over? No. But it really means that you have to pay attention,” said Dr. Suzanne Steinbaum, a cardiologist at Lenox Hill Hospital in New York.

For many patients, the hardest part is changing their diet and getting exercise, she said.

“It's easier to take a pill than it is to get up and do something,” said Steinbaum. “It's very difficult. It's a big commitment.”

Russert, host of NBC's “Meet the Press,” had a heart attack Friday in Washington.

His physician, Dr. Michael Newman, said in a statement that the heart attack was caused by a clot in an artery, blocking blood flow to the heart. That led to a fatal cardiac arrest – an abnormal heart rhythm that stops the heart from pumping blood to the body.

Newman said Russert had hardening of the arteries but no symptoms, and his blood pressure and cholesterol were well controlled. Russert exercised on a treadmill regularly, including the morning that he died, Newman's statement said. An autopsy showed Russert had an enlarged heart and significant blockage in the coronary artery where the clot formed.

About 920,000 Americans have a heart attack each year and 38 percent are fatal, according to the American Heart Association.