HOFUF – The first working day of the King of Organs heart conference held in Hofuf focused heavily on the relationship between personality, lifestyle and the health and maintenance of the heart. Seemingly trespassing on the province of “New Age” alternative therapies, presentations based on solid empirical research and practical experience included the value of transcendent (other than self) involvement with the community at large and music as a modality for reducing stress and therefore the incidence of heart disease and related conditions. The conference is presenting a raft of challenging ideas to what is a majority rather conservative audience and receiving mixed reactions. The weight of research and the status of the speakers, however, demand attention to what is now a well-founded area of investigation, that of the inclusions of psychological, personality and character traits and their effects on very real cardiovascular diseases, their mitigation and prevention. Traditional chemical medicine – in the form of statins – to control the incidence of cardiovascular diseases did feature during the day in a spirited analysis of their use and effect. A slickly presented argument from Assistant Professor Khaled Othman of Cairo University supported by extensive statistics that appeared to present their benefits positively was soon under fire from the session chairman Professor Paul Rosch, Professor of Medicine and Psychiatry at New York Medical College. Rosch is widely known for his extensive work on unappreciated dangers of cholesterol-lowering measures using statin drugs based on current research and in the best spirit of debate he roundly questioned both the statistical basis and semantics of Othman's presentation. The conference buzz is that a sustained critique on the subject of statins in due later in the meeting. Professor C Robert Cloninger, Wallace Reynard Professor of Psychiatry, Psychology and Genetics established the foundations of the conference by setting out the results of his extensive research into the links between the human psychological make-up and the tendencies that derived from them to cause the adoption of lifestyles that predispose individuals to cardiovascular problems. There was, he demonstrated a very strong causal link between your personality – something that develops and can be changed during your life – and the way you act, eat and exercise. At the root of the lifestyle options is a key factor – whether one is a transcendent personality – able to think and be concerned with a world outside your ‘self' or not. It is a popular axiom in modern society that stress causes heart problems. Dr Erminia ‘Mimi' Guarneri, Cardiologist and founding member of the Scripps Centre for Integrative Medicine said that 75 to 90 percent of conditions presented to healthcare providers were stress related. “Stress is what occurs when we perceive a gap between a situation and our abilities to cope with it,” she said. “The key word here is ‘perceive'.” Echoing one of the day's threads that the individual's relationship to his environment is far more complex than simply physical, perception of the situation, the complexity of a person's biological and psychological make-up in concert with his physical condition all contribute to both perception of circumstances and reaction to them. A cardiac surgeon who was deeply involved in the development of stent technology and who has performed thousands of stent procedures, Guarneri takes a much broader approach to cardiology than simply physical intervention. Her approach to wellness involves addressing the psychological vectors of a patient that have, as the conference is demonstrating, such an important bearing on hear conditions and their rectification. Guarneri's approach incorporates techniques ranging from meditation and anger management (anger increases the risk of a heart attack by up to 230 percent) to developing resilience – the way a patient perceives and reacts to the world – to positive thinking and diet management. The holistic approach to heart medicine, several speakers have pointed out, is being openly discussed in Saudi Arabia but would probably never have been possible as a major conference in the US. There was a reluctance there to break away from the traditional diagnostic structure of identifying a malfunctioning organ and follow procedural steps to fix it while by definition ignoring the relation of the part to the whole. Perhaps the most eccentric, in the sense of off-centre- presentation of the first working day came from Professor Vera Brandes, director of the Research Programme for Music Medicine at Paracelsus University in Salzburg. Her deep knowledge of and experience in music augmented her interest in the effect it had on people and led to her developing the effect music verifiably has on health and well-being. Brandes described the research that has determined a mathematical element in music enabling the composition of a musical form that is free of cultural bias yet affects the deepest parts of the brain in repeatable yet not entirely understood ways. “Depression is not sufficiently diagnosed as a factor in heart diseases,” she said,” Yet we know the effect that music has on depressed people.” She thought that it was not quite as simple as happy music relieving depression – depressing music played to patients may have a positive effect on them by mirroring their condition and forcing them to face it in some way before turning on to the road to recovery. “What we do know is that music does directly affect the body as research on how music is recognized and remembered by new-born brains,” she said. It fell to Dr David Jones, President and Director of Medical Education of The Institute for Functional Medicine, Washington. He has practiced as a family physician with emphasis in functional and integrative medicine for over 30 years. He is a recognized expert in the areas of functional medicine and brought the conference to a point of sudden self-analysis and complete silence when dissected the structure of modern medicine and the values that underlay the whole structure of the medical profession. “We are trained to see what we want and are taught to see,” he said of the medical education that doctors undergo and suggested a whole new approach that involved thinking “outside the box” and listening very intently to patient input, history and lifestyle and not simply ticking boxes of symptoms presented. “We were surely not trained just to push pills? Now we are finally coming out of the delusion (promoted by pharmaceutical companies among others) of better living through chemistry.” Reaction to the heavily researched opinions of the speakers was not met with universal acclaim. However, the debate is under way and the balance of the conference looks to make it the most stimulating it its eight-year history. The conference continues through Wednesday. Topics mentioned above will be developed at greater length in individual features over the coming weeks.
