Tim Russert, Coronary Artery Disease, and Sleep

The news of celebrated newsman and Meet the Press moderator Tim Russert's sudden passing last Friday took many people by surprise. He was only 58 years old; even his own father, who became the basis for Tim’s last book, has outlived him.

By Monday morning, the stories about this prominent and beloved man’s life were still circulating, and talk about how or why he died so young started brewing stronger. People began asking about heart attack avoidance. Newsweek magazine featured a story about the "science of sudden cardiac arrest".

I heard Dr. Nancy Snyderman, NBC’s chief medical editor, answer general questions about Tim’s previously diagnosed health problem: coronary artery disease. He was doing everything right to manage his disease, which included occasional stress tests to check out his heart (the last of which he passed on April 29), medication, daily exercise (he had used a treadmill the morning he died), and watching his diet. His blood pressure and cholesterol were “well-controlled.” So what went wrong?

With the buzz about terrorist attacks and cancer running routinely in the media, we often forget that heart disease is the number one killer for both men and women.

That’s right: we’re all more likely to have a heart attack than be struck by a missile or get cancer.

We do have an impressive array of technology, tests, and drugs today to help detect, treat, manage, and combat heart disease. But for some, as was the case for Tim, it’s too late by the time the “big one” hits.

Sudden cardiac arrest accounts for 310,000 deaths in America every year, or 850 a day—more than those caused by breast cancer, lung cancer, stroke, and AIDS combined. According to his own personal physician, his particular heart disease resulted in hardening of his coronary arteries. A fresh clot ruptured in Tim’s left anterior descending coronary artery, causing the fatal heart attack. The autopsy also revealed that he had an enlarged heart.

The risk factors for heart disease are well-documented. They include high cholesterol, high blood pressure, diabetes, being overweight, a sedentary lifestyle, and tobacco abuse.  Russert apparently had these risk factors under control (I don’t believe he was a smoker). But he did have a very busy, over-scheduled career that had him juggling a stressful load of responsibilities. He may not have viewed his life as “stressful” because he loved what he did so much, but his body no doubt must have been crying out for a respite. Sometimes you’d see him fervently commentating into the wee hours of the night during the peak of a political campaign or election, only to see him again on television a few hours later that next morning. As if he never went to bed.

He was indeed a passionate man, dedicated to his thriving career as well as his family. He wasn’t the type to take an extended time-out because he couldn’t stand being far from his job—even if he sacrificed sleep. I hear that he flew back from Rome early, where he’d been celebrating his son’s recent graduation from college, because he wanted to prepare for Sunday’s show. He’d gotten just two hours of sleep on the plane before hitting the ground running again at work.

When you’ve already got coronary artery disease you have to consider more than the obvious risk factors. You have to think about what your body—not necessarily you—need. Otherwise, you could be setting yourself up for an unexpected, asymptomatic, and untimely health problem.

For Tim, coronary artery disease was probably his single biggest risk factor for having a fatal heart attack. Going on little sleep just compounds that—and other—problems. In fact, sleep plays directly into all of the chief risk factors for heart disease. Dr. Snynerman underscored this during her interview: “We are a sleep-deprived nation… The less sleep you get, you’re at an increased risk for heart disease.”

This is not to say that Tim’s untimely death was caused by sleep-deprivation or could have been avoided had he given his body proper rest. But it’s worth noting that adequate sleep can lower your risk for heart disease and lower some of the risk factors, such as diabetes, obesity, and high blood pressure. In addition, sleep takes the edge out of our stressful lives and helps us restore our bodies for the next busy day. 

With all this in mind, I leave you with a new list of things to do to avoid a heart attack.

• get your cholesterol and blood pressure checked and under control if high
• watch your girth (women should have a waist no larger than 25 inches around; for men it’s 40 inches)
• be active most, if not all, days of the week
• quit smoking
• eat well—a high-fiber, low fat diet
• get plenty of rest
• get plenty of rest
• get plenty of rest

While it’s true that we get to “rest in peace” after our time on earth has ended, we need to rest up for a third of that lifespan in order to make it a long one. May Tim’s death be a reminder for us all to take sleep to heart.

Comments

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[Kelly]

Blockages in the coronary arteries are still important. Most experts think that people in the high-risk category should have a stress thallium test. If this test is suggestive of a major blockage, cardiac catheterization should be considered. A stress test or cardiac catheterization should also be strongly considered in anybody who has symptoms of angina.