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Heart Disease Awareness May Create Anxiety

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LITTLE ROCK, Ark. (AP) _ The attention that former President Clinton's heart surgery has drawn to problems of the circulatory system could have a negative side, experts say.

Some Americans may be inspired to take more preventive steps, but it could also lead to anxiety or an additional burden on an already overloaded health care system, they speculate.

Sharon Arnold, a specialist in medical sociology at Lebanon Valley College in Annville, Pa., said the constant media coverage of Clinton's heart trouble is sure to draw Americans into their doctors' offices, at least for now.

``It's called a cue: People think they're invincible until they get a cue that makes them think, 'This could happen to me,''' Arnold said. ``This is something that frightened everyone, but when people get away from it, it will lessen. In the long-term, though, it may result in better medical care.''

The American Heart Association said Wednesday it was too early to tell if Clinton's surgery Monday, which followed a sudden trip to the hospital with chest pains Thursday, had led to an rise in heart screenings and checkups.

In 2000, a survey by the Universities of Michigan and Iowa found that appointments for colonoscopies increased 20 percent nationwide after ``Today'' show host Katie Couric televised her procedure on the NBC morning show.

Dr. Anjan Sinha, a cardiologist at the University of Arkansas for Medical Sciences in Little Rock, said that, after working through the holiday weekend, he senses that Clinton's ordeal has had an effect on patients in Clinton's old home town.

``I had several patients who had symptoms before Friday and didn't do anything, but came in after that,'' Sinha said. ``I could tell President Clinton's situation had something to do with it.''

Clinton's situation has called attention to the importance of diet and exercise in preventing coronary heart disease. But there could be some negative byproducts of the closer attention to heart problems.

Arnold warned that an overreaction _ like calling for more and earlier screenings _ could strain a managed health care system that already discourages testing without established cause.

She worried that only the most affluent will be able to take advantage of the latest preventive measures, like statins _ expensive drugs that are increasingly popular to guard against clogged arteries. That could also lead people to look for a magic cure.

``We are a magic-bullet society; we like a pill to fix everything,'' she said. ``It's likely people on statins will think, 'We're safe, we can gain a little weight, we can have that burger.'''

That kind of undisciplined or simplistic response to a celebrity's health issues also concerns Nate Williams, a professor of psychology at the University of Arkansas. He said the medical misfortunes of the rich and powerful can cause anxiety among ordinary people who might feel even more powerless to prevent disease.

``The potential concern is that if you consider that President Clinton had the best health care team available, and yet still required heart bypass surgery, an individual may feel like heart disease is beyond their control,'' said Williams, who specializes in the relationship between psychology and vulnerability to illness.

``It may lead, perhaps, to increased anxiety and a potential decrease in preventive efforts,'' he said.

Williams said it's important for the public to realize there are several factors that can cause coronary heart disease, and psychology is one of them. He said Clinton's experience can be a positive model if people keep in mind that his stressful lifestyle may have contributed as much to his condition as his genetics or his diet.

He said it reminds him of a phenomenon he saw with Viagra's rise in popularity: ``When the pill came out, people made assumptions that it must just be a physical phenomenon and downplayed their emotional or behavioral problems.''

Clinton's story will have a positive impact, he said, only if people are educated about all of the warning signs.

``People need to remember it's a combination of biology, psychology and environment that results in illness,'' he said.
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