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CNN Larry King Weekend

A Look at Heart Disease

Aired February 10, 2002 - 21:00   ET


LARRY KING, HOST: Tonight, advice that could save your life about how to prevent America's number one killer, heart disease. From Los Angeles, actor Sly Stallone and his wife Jennifer Flavin. Their daughter was born with a hole in her heart. Also in L.A., actor Kirk Douglas, who overcame the odds after suffering a major stroke. And with him, actress Kate Jackson, who's battled back from heart surgery.

Plus, expert advice on staying heart healthy from Dr. P.K. Shah, Director of the Cardiology and Artherosclerosis (ph) Research Center at Cedars-Sinai Medical Center; Dr. Daniel Rader of the University of Pennsylvania School of Medicine; and Dr. Cheryl Healton, the President and CEO of the American Legacy Foundation. They're all next on LARRY KING LIVE.

Tonight's show on the prevention and treatment of heart disease is very personal to me. I've undergone several heart procedures, ranging from angioplasty to quintuple bypass surgery. Our guests tonight are working with the Entertainment Industry Foundation to launch a new program to increase awareness of heart disease and raise money for research to help prevent our nation's number one cause of death.

The EIF will give funding from this initiative to many research hospitals and patient outreach programs, including the Larry King Cardiac Foundation, which I started back in 1989 to help adults and children who can't afford the care they need. And we get them medication to transplants.

We begin our show tonight with the famed Dr. P.K. Shah. He is Director of Cardiology and the Artherosclerosis (ph) Research Center at Cedars-Sinai Medical Center in Los Angeles. The terrific actor Sylvester Stallone, his lovely wife Jennifer Flavin, and the Stallones were -- had a daughter who was born with a hole in her heart. How old is she now?



KING: Five? And she was your first born right?


FLAVIN: Yes. KING: What can you tell us, Sly, was -- what do you mean by a hole in the heart? And then we'll have Dr. Shah explain.

STALLONE: Well, it's called a BSD. It's a small, almost imperceptible to the naked eye, hole in the side -- I guess in one of the chambers that allows blood to either not get through or spill out. And it causes complications with her eating and it caused her to be incredibly restless. And, basically, she was sort of drowning in her own blood. It was a terrible situation that eventually could prove fatal if left unattended, at least in her situation.

KING: What's the first thing, Jennifer, you noticed? Was it right away when she was...

FLAVIN: Pretty much. It was -- she was two and a half months old when she had open heart surgery, and I noticed she wasn't sleeping. She wouldn't sleep laying down. I always had to prop her up in her car seat. That's the only way she could fall asleep, because obviously her lungs were just filling up with blood and she couldn't sleep. And she was very irritable and she wasn't eating. She was projectile vomiting all over me. As soon as I finished breast feeding her she would throw up.

And at first people told me that I was a very nervous and...

STALLONE: To spoil a child.

FLAVIN: ... neurotic mother, and said for me to come home, take my child home and just relax. And I said, "Well, you know, I've been baby sitting my entire life and I've never seen a child like this." And I didn't leave. I stayed until they told me...

STALLONE: Actually, two doctors misdiagnosed it. And it was just Jennifer's maternal instincts that, "I know something is wrong. I cannot go with..."

KING: Wow.

STALLONE: Yes, "I cannot go with their empirical statements."

KING: Is it tough to diagnose?

DR. P.K. SHAH, CEDARS-SINAI MEDICAL CENTER: Not really. I think examination of the child, followed by some very simple non-invasive tests, such as ultrasound, can give a clue as to the presence of a hole in the heart. Most holes in the heart kids are born with. Rarely, it can occur as a complication of...

KING: So this is a congenital disease?

SHAH: Yes, in most cases it is. You're born with a defect.

KING: How dangerous is it, let's say, untreated?

SHAH: Well, some of the smaller holes can actually close up on their own with passage of time. So kids have to be watched very carefully. And some that don't close are associated with other problems, they need to be fixed. And majority of the time, the fix is a surgical repair.

KING: How worried were you?

STALLONE: Very worried, because hers was rather severe. It had an extenuating flap on the side, which caused it to be impossible for it to heal itself. And it required extensive surgery and...

KING: Two and a half months?

STALLONE: Yeah, two and a half months. And I was working on the film "Copland" at the time, so basically Jennifer was on her own handling the situation. And she was -- really went through a (UNINTELLIGIBLE).

KING: But you were kind of a nervous wreck? Because I saw you during that filming and you were over here once.

STALLONE: Yes, exactly.

KING: And we talked about the movie after she had come through that successfully.

STALLONE: Yes, exactly.

KING: Were you there for the surgery?

FLAVIN: Oh, yeah. Well, Sly and I were both there. We were there the entire time. We didn't -- we slept at the hospital, we didn't leave. I was there 24 hours a day. I don't think I saw sunlight until we left the hospital with her.

KING: Now congenital means -- Dr. Shah, it means it's somewhere in either of their families?

SHAH: Not necessarily. Congenital means since birth. Some of the congenital heart defects can be transmitted to other members of the family, but not all of them.

KING: And you've had a daughter since, and have another daughter coming?


FLAVIN: On the way. And so far, we've done the ultrasound and her heart looks fine. So we're still watching it very closely.

KING: And the second daughter's fine?

FLAVIN: Yes. The second daughter is great.

KING: And now the 5-year-old, her name is?

STALLONE: Sofia (ph).

FLAVIN: Sofia (ph).

KING: Any ramifications from this at all?

STALLONE: None whatsoever. If anything, she had to be taught. She was somewhat depressed for a while after the surgery. I don't know if it's just her personality or...

FLAVIN: She never smiled, she never laughed.

STALLONE: ... the fact that she had...


KING: ... depressed? Take baby Prozac?


STALLONE: She looked like Buster Keaton. You know. She's going to be a great comic, this girl. She's like -- there was nothing there. So we would actually teach her how to smile. OK, we'd get smiling lessons, laughing lessons -- like, ha, ha.

KING: What could be the reason for that?

STALLONE: I don't know, but she literally learned by mechanical repetition on how to smile.

FLAVIN: And now she's a clown.

STALLONE: Now you can't stop her. The point is (UNINTELLIGIBLE).

KING: We'll talk about this later, but surgery on the heart at all ages causes mental things to happen to people. There's blues, there's depression, dealing a lot with the heart, right?

SHAH: I think that's especially true in the older people.

KING: Yeah.

SHAH: It's less likely to be in the youngsters.

KING: Because of the age, obviously.

SHAH: Of course.

KING: But it must have some manifestation.

SHAH: Clearly.

KING: The guys who do this surgery -- was it a man who did it?


KING: ... at UCLA? That's his specialty, right?



KING: He does pediatric -- that's so hard, isn't it?

SHAH: Well, it's one of the most delicate cardiac surgeries is to fix these congenital defects. Some are very...

STALLONE: That's the hardest (UNINTELLIGIBLE).

SHAH: ... simple, others more complex.

STALLONE: I mean it's the size of your thumbnail.

FLAVIN: But you'd be surprised. One out of every 100 children are born with a congenital heart defect.

KING: Of some kind?

FLAVIN: Of some kind. I mean think about that. We're here to raise awareness of it, because I think a lot of people don't realize it's the number one cause of birth defects.

STALLONE: Yeah, it's pretty extraordinary. One out of 100...

KING: It's the number one birth defect, Dr. Shah (UNINTELLIGIBLE)? We know heart is the number one killer in America, it's the number one disease. I didn't know it was the number one birth defect too.

SHAH: Well, one out of every 100 babies will have a congenital heart...


KING: That's a lot.

FLAVIN: That's a lot.

SHAH: That's right.

STALLONE: I would say that's right at the top of the list. Right up there.

SHAH: But the interesting thing is that now we can expect 80 to 85 percent of those kids to become adults and grownups, because of the advances in the treatment -- particularly surgical repair of congenital defects.

KING: (UNINTELLIGIBLE) 20 percent loss, then?

SHAH: Correct.

KING: ... where they don't make it?

SHAH: Correct. KING: Has the surgery been improved a lot over the years, say from 25 years ago?

SHAH: Tremendous advances in cardiac surgery.

KING: Might Sofia (ph) not have lived 25 years ago?

SHAH: Well I think this type of defect was -- the repair for this type of defect was available 25 years ago, because it's one of the -- fixing the hole in the heart in the grand scheme of the various complexities of congenital heart disease is a relatively simple one.

KING: We'll be talking in a little while for all of our guests about what mentally happens to people associated with people when it's the heart, even like a little baby. We'll be right back, and we'll be joined by Kirk Douglas, who has written, by the way, an extraordinary book called, "My Stroke Of Luck." Kirk had a stroke and stroke is associated in this area, is it not?

SHAH: Heart disease is a common reason for a stroke.

KING: But do we associate stroke with it?

SHAH: I'm sorry?

KING: Stroke, we associate under the heart complexities?

SHAH: Yes, it's considered a cardiovascular complication because stroke is like a brain attack.

KING: Kirk Douglas joins us right after this. Don't go away.


KING: If you assume this post -- and that's always a big if with the way this goes back and forth everyday -- are you fully capable of doing any duties that the president may ask you to do? Because the vice president's duties are encumbered on what the president asks him to do.

DICK CHENEY, VICE PRESIDENT OF THE UNITED STATES: Sure. Yeah -- no, there shouldn't be any problems of any kind like that. Obviously, I'd always follow my doctor's advice in that kind of situation. That's the only fair way to proceed. But we don't anticipate any trouble.

KING: Now doubt about you serving?

CHENEY: No doubt about my serving. All we have to do now is get elected.



KING: Through the EIF -- Entertainment Information Foundation, associated with many diseases -- tonight, we're focusing on heart disease. And our panel now is joined by Kirk Douglas, one of the extraordinary names in the history of American film. He suffered a stroke. He has a new book out, it's a slim book, you can read it in one sitting, it's terrific, it's called, "My Stroke of Luck." Before we even ask Kirk about the stroke, we understand from Sly he's you're hero?


KING: This man is your hero?

STALLONE: Totally. When I was watching "The Champion" and all his fantastic films like "The Vikings," that was it. I would run around the house with a wooden sword for hours on end.

KING: You wanted to be Spartacus?

STALLONE: Oh, totally.

KIRK DOUGLAS, ACTOR: Larry, he says that about all the actors.

STALLONE: No, no, no. We talked about it today, about how you can jump on a horse like no one else. So he knows.

KING: Oh he made some great films.

STALLONE: He's fantastic.

KING: Now, why do you call it, "My Stroke of Luck?"

DOUGLAS: Well, you know, I have -- my stroke has done so many things for me. It has changed my personality; it has changed my sense of value. And I always think, Larry, no matter how bad things are, they can be worse. So...

KING: That's a good way to look at it.

DOUGLAS: Yes. And during my stroke, I realized so many things that I haven't realized before. So when I wrote that book, trying to maybe help other people how to deal with a stroke or how to deal with life.

KING: Including -- including discovering more of your faith.

DOUGLAS: Well, that's the one you have -- when you almost break your back in a helicopter crash, then you have a pacemaker and then you have a (UNINTELLIGIBLE). If he's doing something -- I don't know.

KING: What's he got against me, a humble Jew?

DOUGLAS: Well, you know, I still study with a rabbi every week, but it has made me less Jewish. I have become more searching for spirituality, and I've learned that it doesn't matter what religion you are. The question is then (UNINTELLIGIBLE). There is only one thing, Larry, you have to realize, do unto others as you would have them do unto you. That's all... (CROSSTALK)

KING: What is a stroke?

SHAH: A stroke is like a brain attack, and the blood flow to a part of the brain is suddenly diminished because of a blood clot obstructing the passage of blood flow, or sometimes a rupture of a blood vessel in the brain causing hemorrhage.

KING: Usually associated with high blood pressure?

SHAH: Well, one of the major risk factors for stroke is high blood pressure.

KING: Usually it happens to older people?

SHAH: Generally more common in older people.

KING: Do you even see a stroke in a child?

SHAH: Strokes can occur in children and young adults due to specific diseases. Most of them have to do with the heart.

KING: What happened when you had your stroke?

DOUGLAS: How do you mean what happened?

KING: Where were you? What happened?

DOUGLAS: Oh, I was having a manicure in my den, because my wife likes to beautify these peasant hands.

KING: Peasant hands.

DOUGLAS: And (UNINTELLIGIBLE) manicure and (UNINTELLIGIBLE) manicure (UNINTELLIGIBLE) to me, and suddenly I felt a strange tingling line coming across my cheek, and when I tried to explain it, I couldn't talk. And the manicurist, who had been a nurse in Israel (ph) knew that I was having a stroke. So we got -- I called my wife, who was playing cards at Barbara (ph) Sinatra's house and he (ph) got a doctor who said, "If he can walk, get him to the hospital immediately, because an ambulance will take too long."

KING: The faster you get there the better.

DOUGLAS: Exactly.

KING: How quick were you there?

DOUGLAS: Within about a half an hour.

KING: Was you mind alert?


KING: So you're thinking you know everything -- I mean... DOUGLAS: Yes, I could listen to everybody. I knew what they were saying and I was surprised that they could understand me.

KING: What's the initial thing they do with a stroke victim?

SHAH: Well, for certain types of strokes, if the patient can present very early within the first couple of hours and one can prove in a CAT scan that there is no hemorrhage, that this is a blood clot, you can actually go and use a blood clot dissolving medication to actually try to open up the blocked artery and arrest the stroke in its midst to minimize the damage to the brain. But that kind of treatment is only applicable to a small number of individuals.

KING: Did you -- do you have paralysis?


KING: So your speech is the only thing affected?

DOUGLAS: That's right.

KING: And why the speech?

SHAH: Well, it depends on what part of the brain is effected by the stroke. For most right-handed people, the speech center is located in the left half of the brain. So if the stroke effects the left half of the brain and you're right-handed, you have a very high likelihood that speech will be effected.

KING: Effected by your -- and you're left-handed, what?

SHAH: Then 50-50. Half of the left-handed still have speech control in their left half of the brain. The rest have it on the right side of the brain.

KING: There's nothing you can do to (UNINTELLIGIBLE). So Stallone's not worried because...

STALLONE: No, I'm ambidextrous. I don't know what could happen.

KING: Does it happen more in men than women?

SHAH: Stroke tends to occur more commonly in men, but women also catch up when they get older. They also have an increased likelihood...


KING: Can you do something to prevent it?

SHAH: There are a number of things that one can do to prevent stroke.

KING: Really?

SHAH: Blood pressure control, cholesterol control, appropriate heart healthy diet, exercise, all of these features reduce the risk of stroke.

KING: Did you do all those things?

DOUGLAS: Well, I never checked by blood pressure, I always thought it was fine. I think, as the doctor said, if I had been checking my blood pressure, I might have noticed that it was (UNINTELLIGIBLE), but that was too late. Now I know what to do if I have a stroke. And then next time I know what to do.

KING: Give him credit for coming on a show?

FLAVIN: Absolutely, yeah.

KING: You know a lot of people would go hide. Not him.

STALLONE: Not my hero. Not my hero, no way.

KING: When we come back, Kate Jackson will join us. She has had bypass surgery. Don't go away.


ANTHONY QUINN, ACTOR: I just had difficulty walking. So somebody said I had to have -- what do they call that thing that they put...

KING: Angiogram.

QUINN: An angiogram. And that scared the heck out of me. I mean that really frightened me to have a thing going in there up to the heart. But I did it, and I saw it on television and it was a wonderful experience. So I thought, well, I'll have a heart operation. But I tell you, actually it was the happiest day of my life, because I was sure I was going to die. I was absolutely certain I was going to die.

And -- so I invited all my kids to come to New York.

KING: To say goodbye?

QUINN: And say goodbye. And we sat there -- I laid there and we all told jokes. Two of the kids knew all the jokes in the world, Franky (ph) and Larry (ph). And they were wonderful. I mean, they told me...

KING: You didn't die.



KING: Our subject tonight is heart and heart disease. With us is Dr. P.K. Shah, Director of Cardiology at the Cedars-Sinai Medical Center; Sylvester Stallone and his wife Jennifer; Kirk Douglas, the author of "My Stroke of Luck;" and we're now joined by the wonderful actress, Kate Jackson. I said bypass surgery, she had another kind -- what kind of surgery did you have?

KATE JACKSON, ACTRESS: I had surgery for an ASD (ph). I was also born with a hole in my heart. It was in the upper chambers...

KING: Like Sofia (ph)?

JACKSON: ... in stead of the lower chambers.

KING: Sofia's (ph) was lower chambers, correct?


KING: You were born with it?

JACKSON: Born with it.

KING: So how come you grew up?

JACKSON: Who knows how I got so far. No one ever -- no one detected it. I had done a television movie and went home to visit my mom and I looked at myself in the mirror and I thought, I look blue. And I was -- I knew that I couldn't walk very far on the beach. I was running (ph) at the beach without being out of breath, but I thought I was out of shape. I mean, who's going to think you have a hole in your heart out of nowhere?

And Dr. Jerry Polhost, who was at University of Alabama Medical Center, he's at SC (ph) now, the chief of the cardiovascular department there. I gave him a call, he was a family friend, he had taken care of my mother when she had angioplasty. And I said, "I don't feel very good, Jerry, and I'm crying and I think I'm blue. I look blue to myself in the mirror."

And he arranged for me to be taken to the hospital and we were going to say if any of the, you know, the rag newspapers picked it up that I was dizzy or something like that. And as he was walking to the door, he stopped, he turned around and he said, "Well, I am a cardiologist. I might as well listen to your heart." And for the first time in 45 years, somebody heard this now gigantic -- not gigantic, but it was a very larger -- quite a large hole.

KING: Why had no one heard it? How do you explain this medically?

SHAH: A hole in the upper chamber of the heart is compatible with living into adulthood and even older age groups. And, generally, if a qualified (UNINTELLIGIBLE) trained cardiologist examines you and looks at the electrocardiogram, you can put two and two together and come up with a diagnosis.

KING: So she never had this?

SHAH: Obviously not.

JACKSON: Well, no, I kept -- this is -- I've had health issues before, and so I had been to the doctor and had...

KING: And it was never picked up. You had cardiograms?

JACKSON: Oh, yeah. Oh, sure. I had...

KING: Should it have been picked up?

SHAH: I think in most cases, the electrocardiogram and the examination -- careful listening to the heart -- can give you clues that there might be...

KING: But she had -- what was the difference between Kate and Sofia (ph)?

SHAH: Sofia's (ph) hole was in the bottom chamber of the heart, whereas her hole was in the top chamber of the heart. And the two tend to be somewhat different and are treated somewhat differently.

KING: When we think of heart you think of men, right?

JACKSON: Yes, you certainly do. And thank you for bringing that up.

KING: It sounds male.

JACKSON: But it's not, because statistically -- and correct me if I'm wrong -- but don't more women than men die of heart attacks or cardiovascular disease? Certainly as many...

STALLONE: I think it's up there.

JACKSON: ... as many. And most women don't know to ask their doctors, "What are my risk factors for heart disease? How does my cholesterol affect my heart? What should I be doing to prevent heart disease -- that my dad had it, or my grandfather had it. And what should I be eating? What should I stop doing?" And the number one is smoking. And women need to know that they are allowed to ask their doctors questions about their hearts.

KING: More women die of heart disease than breast cancer, right?

SHAH: I think that's absolutely true. Heart disease is an equal opportunity killer of men and women. Women tend to get it approximately 10 years later than men, but they catch up rather quickly after menopause. It is the leading cause of death in men and women in the states.

KING: Do you ever get cardiograms?

FLAVIN: Yes I have had one.

KING: You do?

FLAVIN: Yes. My dad died of a heart attack at 47.

KING: And you check your cholesterol then, too? FLAVIN: Yes.

KING: Because it is -- right? We know it's inherited. You get it from -- usually your parents.

SHAH: That's one of the risk factors, is a positive family history of (UNINTELLIGIBLE).

KING: Does this -- all this make all -- Kirk -- can all of you -- does this make you all the more health conscious?

JACKSON: Yes. It does me.

KING: Kirk?

DOUGLAS: Yes, of course. Well, Larry, I was thinking, the reason I dedicated my book to my colleagues is because here you have Sylvester, Kate, me. And I am proud of my colleagues who speak openly of their problem, and therefore help other people. That's, I think, a wonderful thing to do.

KING: Did you hesitate, Sly, about coming forward about your daughter?

STALLONE: No, not at all. Not at all. I think it's very important to realize that it doesn't single anyone out in any financial (UNINTELLIGIBLE) or whatever. It's just something we -- when we were in the intensive care unit we saw an extraordinary amount of pain and anguish from people of every social status. It was just terrible across the board.

You know, some of the children recovered, some didn't. But overall it was a very eye-opening experience about how this -- if it can be curtailed or treated because of people's awareness, then it's -- so be it then. I should come to the forefront if it will bring more awareness.

KING: Did you get any second thoughts to it, Kate?

JACKSON: Not one.

KING: Not one?

JACKSON: No, none at all.

KING: What was the procedure done on you?

JACKSON: I had open heart surgery. And I wanted to be able to still wear a nice dress, so I didn't want the big scar. So they actually did it around. They separated two...


KING: They can do that now? Mine is down the middle. But it's not. SHAH: Well, for Kate's type of defect, there is now a non- surgical alternative for certain cases, where we can actually insert...


KING: Now. What do you do?

SHAH: ... a special device and deploy it. And the tip of a catheter can be inserted through the groin, under local anesthesia, advanced right into the side of the hole, and the hole can be plugged with a device non-surgically. This procedure has become available only in the last two or three years. And people with holes in the top part of the heart, many of them would be candidates for this non- surgical procedure.

JACKSON: That's wonderful. It's really wonderful.

KING: Can we have a day, you think, where a stroke patient will not have any affect on voice or paralysis or anything? Where a stroke patient could go out of the hospital and you wouldn't know they had a stroke?

SHAH: Well, it is possible if the treatment is immediate and successful in opening up a blocked artery, it is conceivable that any brain damage could be preempted. And, therefore, any abnormality may be completely avoided. And I think that has happened in certain cases who were presented to the hospital very early and received prompt blood clot dissolving medication. The stroke consequences have been essentially completely avoided.

KING: So what are you most worried about, Kate? Do you feel that...

JACKSON: I hope that when I'm 96 or 97 I'm still really spry and have a lot of energy.

KING: How old are you, Kirk?

DOUGLAS: I'm 85 years old and...

KING: Stroke aside, are you in good health?

DOUGLAS: Yes. Yes.

KING: Your heart's good?

DOUGLAS: I play -- I play golf. And, you know, when I first had my stroke I had an optimistic point of view (UNINTELLIGIBLE). So I said, Mrs. Kirk, silent pictures will come back and I will be (UNINTELLIGIBLE).

KING: Do you worry about your forthcoming daughter?

STALLONE: Yeah, you do. I mean there's always a little bit of a shadow thought in there. But, you know, again, we remain optimistic. Because I worry more about my daughter when she has her children, because in five percent it can be transferred. So we don't know. You know, it's five in 100, I believe.

KING: So it's one in 100 and then becomes five in 100?

SHAH: Yeah, anyone who has had a birth defect of the heart has a somewhat highly than normal likelihood of transmitting it to their children.

KING: Do you have children, Kate?

JACKSON: Yes, I do.

KING: And do they have any birth -- any heart defects?


KING: No? Your kids are OK? Your grown kids are OK with blood pressure and the like?

DOUGLAS: I assume so. I have never taken their blood pressure.

KING: But do you think they take their blood pressure?

DOUGLAS: I think so. I hope so.

KING: Do you get regular checkups?

STALLONE: I do. I do. But I was just about to ask the doctor if there is a quote, you know, sort of a magic bullet or anything that can be preventative? Is there credence to the aspirin theory or the glass of wine or...

KING: Yeah...


SHAH: Certainly, people who are at high risk of heart attacks, because they smoke or have high cholesterol or a positive family history of high blood pressure or diabetes, they do benefit from taking a small dose of aspirin on a regular basis. There's no question about the benefits of aspirin.

JACKSON: Baby aspirin, doctor?

SHAH: Baby aspirin.

STALLONE: And, wine, is that true?

SHAH: Now in terms of wine, I think it is true that cardiovascular deaths are fewer among wine drinkers who drink modest amounts at home.

STALLONE: I love this guy.

FLAVIN: You got your answer, honey. KING: Let me get a break in and we'll pick right up, because we're going to have two other -- two other doctors are going to join us on this panel. The entertainment industry gets behind a lot of things, and when it hits home, it hits home. We'll be right back. Don't go away.


SID CAESAR, ACTOR: Sure, you have to think about that, because that's (UNINTELLIGIBLE). When you listen to it beating and you wake up in the morning, that's it.

UNIDENTIFIED FEMALE: That's right. You got it.

KING: You did an amazing job, though, Sid. I mean, look how you look. You lost all that weight. You exercise.

CAESAR: Well I tell you, it was a miracle for me, it really was, because I was slowly starting to slow down on a lot of things and slow down on this. And because I was afraid -- and I was afraid to go out of town because, if, you know, you're in the hotel room by yourself and you're out of town, you don't know anybody, it's kind of scary, you know. If you get a little angina, you go, "Whoop de do." You know, you start (UNINTELLIGIBLE).



KING: Our subject tonight on this special edition of LARRY KING LIVE is heart disease, in cooperation with the Entertainment Industry Foundation, which gets involved in many diseases by using figures in the entertainment world to help raise money for various causes. And, as we said earlier, one of the beneficiaries in EIF's fund drive this year is the Larry King Cardiac Foundation.

Our guests are Dr. P.K. Shah, Director of Cardiology at the Cedars-Sinai Medical Center; Sylvester Stallone, the famed actor and his beautiful wife Jennifer, who is seen regularly on QVC...


KING: And out -- made more money than him last year.


KING: On HSN, I'm sorry. The other one in Tampa you go to.

FLAVIN: That's right. I go to Tampa, right.

KING: You don't have to go to Philadelphia in the winter.


KING: Sylvester and Jennifer's baby Sofia (ph) had that hole in the heart. Kirk Douglas, who suffered a stroke. He is 84 years young. His new book, "My Stroke of Luck" is brilliant. Kate Jackson, the wonderful actress, who had heart surgery, also had a hole in her heart, not discovered until later on. And now joining us here in Los Angeles, Dr. Daniel Rader, Director of Preventive Cardiovascular Medicine at the Lipid (ph) Clinic at the University of Pennsylvania. And Dr.Cheryl Healton, President and CEO of the American Legacy Foundation.

What is cardio-preventive cardiovascular medicine, Dr. Rader?

DR. DANIEL RADER, UNIVERSITY OF PENNSYLVANIA: Well, when it comes to heart disease, preventing is really where it's at. You know 2,300 Americans die of heart disease everyday. About one every 30 seconds. And at least a quarter of those are people who had no idea they had heart disease. They died suddenly of their first heart attack.

So really, the message is, we've got to get people to understand they could be at risk for heart disease, even though they feel fine. To understand what their risk is and to then do something about it. To try to prevent the disease from ever occurring in the first place.

KING: And who are high risks?

RADER: Well, people who have high blood pressure, high cholesterol, who smoke, who are overweight, who have a family history for early heart disease, who have diabetes. All of these are risk factors, and especially when together, they form very high risk individuals who really need to do something before they have their first heart attack.

KING: Jennifer Flavin, your father died at what age?

FLAVIN: Forty-seven.

KING: Her father died at 47. Should she be on guard?

RADER: Absolutely. I see lots of patients who have family histories of early heart disease, like she does. And I always tell them, "You are at risk, because you have a family member who has early heart disease." There are many tests that can be done. Everyone should know what their cholesterol is, should know their (UNINTELLIGIBLE) or their good cholesterol, and should really talk to their doctor about what their risk is of developing heart disease.

KING: Since it is so prevalent and it's the number one killer, why doesn't everybody just act as if they're a candidate? Why doesn't everybody do the preventative things?

RADER: You know, Larry, that's one of the really uncertain things. Heart disease is so common, and yet many people seem to think that heart disease is solved. And if they don't have any symptoms or chest pain, that they're not at risk. Nothing could be further from the truth. And, really, part of this whole campaign is to get people to understand that it's so important and that everyone is potentially at risk, despite how they feel and despite whether they don't think they have any heart disease currently. KING: Sly, do you ever think that you're going to get a heart attack or you fear heart ever?

STALLONE: Actually, every now and then you think that perhaps you could push it too far. And at times I have pushed it to the point where I actually did have chest pains during one of the boxing scenes. And they had to put me on a watch for about -- oh, eight days because of an actual -- actually, I was punched in the heart, so -- but it made me very aware of how delicate an instrument it is.

KING: Can you be punched in the heart, doctor?

SHAH: Yes, there is something called...

KING: Rupture?

SHAH: (UNINTELLIGIBLE). That is, you hit somebody too hard on the chest, you can actually trigger either a heart attack or sudden cardiac death.

STALLONE: That's like the kind of symptom that you get when you have a car accident and the wheel hits you in the chest and the (UNINTELLIGIBLE) begins to swell.

KING: I didn't know that. In your life, Kirk, did you ever worry about heart problems?

DOUGLAS: Not at all. I thought nothing would touch me.

KING: Nothing was going to bother Kirk Douglas, right? Spartacus didn't get -- the champion doesn't get heart problems.

DOUGLAS: Exactly.

KING: Did you ever worry, Kate?

JACKSON: No. I never even thought about it.

KING: What, Dr. Healton, is the American Legacy Foundation?

DR. CHERYL HEALTON, PRESIDENT, AMERICAN LEGACY FOUNDATION: The American Legacy Foundation was created to -- as the largest public health foundation in the United States to combat smoking. First, by helping young people to never start. And we know that 90 percent of people who ultimately smoke started as young people. And, second, to help people who are smoking to successfully quit, if that's what they choose to do.

KING: Do you do all those crazy -- not crazy -- those tough commercials?

HEALTON: We do those tough commercials, and they're working, according to the University of Michigan and the federal government. They are primarily very much responsible for a steep decline in youth smoking. They're tough, but they're working.

KING: A lot of people were very critical of them, you know.

HEALTON: I know that.

KING: (UNINTELLIGIBLE) too strong. Have you seen them?


KING: What do you think of them, Jennifer? Commercials against smoking?

FLAVIN: I think they're extremely important. I grew up in an age where they were already saying, "Say no to drugs. Don't smoke." I've never smoked a cigarette in my life.

KING: Really?


STALLONE: I think you can't (UNINTELLIGIBLE). You really have to hit it hard.

FLAVIN: You have to hit it hard.

STALLONE: Really hit it hard.

FLAVIN: And I think the more you educate children and teenagers on how foolish it is and how stupid it is and how uncool it is to smoke -- I'm totally against it. My father was a smoker and...

KING: I smoked (UNINTELLIGIBLE) heart attacks.

STALLONE: I know. I mean, literally, until school, when they brought up a burnt, shriveled lung in a bottle of formaldehyde did it come crashing down.

KING: That worked on you?

STALLONE: Yeah -- no. But it was -- you never want to see formaldehyde again. It did work. It had an effect.

KING: Yeah, they used to make us smell nicotine (UNINTELLIGIBLE). Kirk, did you smoke?

DOUGLAS: I never smoked until I came to Hollywood. And for my first picture, the director said, "You have to learn to smoke." And then I smoked all the time. And suddenly I said, "This is stupid." So about 30 years ago I gave it up.

KING: Your industry, Kate, contributed a lot to smoking.


KING: Because all of our actors smoked and all of our heroes smoked. All of the old movies, everybody smoked.

JACKSON: Yeah, they certainly did. Yeah. KING: Can you tell us, Dr. Shah, what's the connection between the smoking and heart disease? How do -- what do we know?

SHAH: It's the number one preventable cause of cardiovascular deaths throughout the world is cigarette smoking.

KING: All kinds of smoking? Cigarettes?

SHAH: Cigarette smoking, particularly, but also -- although to a slightly lower extent -- other forms of smoking. Cigarette smoking is lethal.

KING: What does it do?

SHAH: Well, it triggers a heart attack. It can cause a blood vessel to close up, either through a blood clot or due to a spasm that can happen in the arteries of the heart, triggering a heart attack or a sudden death. It can happen in the brain arteries and trigger a stroke. Not to mention, other hazards of smoking related to cancer, lungs, bladder, colon, mouth, tongue, everything. You name it.

KING: It is insane.

SHAH: It is absolutely insane, but it's an addicting drug.

KING: Some people -- Governor Richards, Ann Richards on this show last week, an alcoholic, said it was much harder to stop smoking than to stop drinking.

SHAH: It's a serious addiction. And many people who are addicted do need help. Even though they want to quit, they have a hard time quitting.

KING: And your emphasis more, Dr. Healton, is on stopping smoking in the first place, right?

HEALTON: Well, starting people -- you know, stopping people from ever starting. But also really addressing the fact that just as was pointed out by Dr. Shah and by yourself the story of Ann Richards. No question, quitting smoking is a highly -- it's a highly addictive drug. Most people who quite have 11 attempts before they succeed. Many observers believe that it's much harder to kick than alcohol or even heroin.

As a former smoker myself, I can tell you, it's hard to quit. I just quite 10 years ago. My mother died with a cigarette in her hand at age 62. This is a subject that needs to matter to more Americans, because as was pointed out by P.K. Shah a moment ago, it's 100 percent preventable if we can succeed in stopping some of the 50 million Americans who currently smoke.

KING: And I think we're the lowest percentage country in the world, aren't we?

HEALTON: Unfortunately, that's not the case.



KING: I thought we were.

HEALTON: If you take the entire world, that would not be the case. In the industrialized world, we are having a significant decline. But needless to say, the industry is working hard to get new customers in parts of the world where, at this point, few people smoke.

KING: We'll be right back with more on this important issue right after this.


KING: You jump, though, at pain, right? We all do.

CHENEY: Yeah. And I never -- I'm sure the same is true for you, Larry. You become very sensitive to what's (UNINTELLIGIBLE).

KING: Oh, do you. And you think sometimes you get false feelings.

CHENEY: Occasionally you get false feelings, but it's never been intense pain. But it doesn't take much to trigger it and say, "Well, I better go have it checked." And that's the...

KING: And you do a smart thing.

CHENEY: Absolutely.



KING: Dr. Rader, are you, in your opinion, successful? Are more Americans getting into preventative areas?

RADER: I do think that more people are recognizing the fact that heart disease is common and that it can be prevented. There's been a lot of press about ways to prevent heart disease, like Staten (ph) therapy, to lower cholesterol. On the other hand, some of the major risk factors -- not just smoking, but overweight and obesity, for example -- are getting much worse in this country. So I think that the message is starting to get out, but we still have a long way to go.

KING: Does it make us all a little, do you think Kate, hypochondriac? That we get -- you can get so worry preventative that you become obsessed?

JACKSON: Well, if it's about smoking, I don't think you can get too worried. There's no such thing as too worried.

KING: But, generally, about -- you know, do you run in every time you get a pain?

JACKSON: You don't run in every time you get a pain, but you watch your lifestyle and you watch your diet and you take care of yourself and you do everything in moderation and you don't get crazy doing...

KING: Did you ever think, Kirk, you could have prevented your stroke?

DOUGLAS: I don't know how. But I think that if people check themselves regularly, they will not become hypochondriacs, it will reassure them. And in my case, I didn't smoke, I exercised. But maybe I had high blood pressure and I didn't know it.

KING: Yeah. Does it drive you a little nuts to know how you sound?


KING: You know what a voice you had -- he was one of the great voices in American movies. You, too. Your voices are -- no, the actors...


KING: ... their voice is a big part of it.

DOUGLAS: The most frustrating thing about a stroke is your (UNINTELLIGIBLE) is here and your speech is coiling around. You know, it's frustrating because we take speech for granted. You think a thought and you say it. Suddenly, you have to learn speech all over again. How to make each sound. That's very (UNINTELLIGIBLE).

KING: A lot of rehab with stroke patients, right?

SHAH: Absolutely. That is really critical for recovery. And there are some amazing examples of recovery, both of speech and...

KING: Paralysis too?

SHAH: Absolutely. Rehab is really absolutely important after the initial phase of treatment. It can restore people to a functional state.

KING: Are you going to make Sofia (ph) aware of what happened to her?

FLAVIN: She is aware. She has a scar right across her chest.

STALLONE: Yeah, we made her aware already. She has -- she understands exactly pretty much what is -- as much as a five-year-old can understand what happened to her. But I still -- I'm very aware of it, which makes me...

KING: Doting? STALLONE: Yeah, very doting and on guard. And I know, I talk to the doctors who say, "Oh, it's OK. She's normal." And she is. But, you know, you've been traumatized, and it's really hard to get over that -- that vision that we went through with that scenario.

KING: What's it done to you, Jennifer?

FLAVIN: It just made me just so appreciate to have her still here. And thank God we have doctors that can perform this surgery. Because 50 years ago, who knows if she would have lived. I'm just -- I'm so blessed with my children.

KING: And are you saying, Dr. Healton, that the cigarette companies want Sofia (ph) to smoke?

HEALTON: Well, I think that there's no question, that if all young people in this country didn't start, that there would be a major business problem for tobacco in the United States.

KING: So quid pro quo, they want her to smoke?

HEALTON: Well, I think that their ad campaigns are a little disingenuous, to say the least. And obviously in magazines they're still an enormous presence of advertising. And you see it, you know, in the films and everywhere. So I'm not saying that this is something that you can legislate necessarily. But no question, it's hard to grow up in America without being constantly bombarded by images of -- of people you admire with a cigarette in their hand. Whether it's your parent or a movie star.

KING: But you don't see many movie stars smoking anymore do you on screen? Or do you?

HEALTON: Well I actually think it's -- I hate to say it -- on the rise.

KING: Really?

HEALTON: I think something like 90 percent of films have someone smoking in them. And I think it's a personal responsibility issue. I think every actor and actress has to search their own soul and say, you know, "Do I want to be a walking billboard for this particular industry?"

KING: OK, we have three actors here. An actor -- director says to you, "This character must smoke."

STALLONE: Usually, you go along with it. And, yeah, if you're trying to be true to the character, but -- so you're very conflicted. I know, because I've been in that position a few times, and Rocky smoked. He was an athlete. And so that's a hard one -- that's a tough one to call. But I think -- eventually, I think intelligence has to win out and maybe the director can say, "How important is it really to smoke?" I mean, is it going to break the character down and destroy the performance? Usually not.

KING: Kate, would you smoke?

JACKSON: I choose not to smoke on screen if it's at all possible. As Sly said, sometimes -- if it's an absolute -- if you can't find another...


JACKSON: ... another way to express whatever the character is feeling...


JACKSON: Yeah. Surely you can find another way.

KING: Would you, Kirk?

DOUGLAS: I (UNINTELLIGIBLE) not to smoke in pictures. But as Sly said, if I had to, I might smoke. But I disagree, I think that nowadays in pictures there's smoking very often. Too much.

KING: Do you see a lot of smoking?

DOUGLAS: Yeah. Especially in independent films. You know, where it deals in its gritty realism. And it's -- I guess it's a reflection of life. It's not like they're trying to sell cigarettes. You know the irony about cigarettes is, if there had never been tobacco in this country, in other words, tobacco was just being brought to this country today for the first time, it wouldn't even get past -- it wouldn't get over the dock. The FDA would say, "We're not going to...

KING: That's right, Dr. Rader. Who would approve tobacco?

STALLONE: No one today. Are you kidding?

RADER: No one. Obviously, that's something...


KING: OK, gentlemen. Here's this thing. What do we do? You inhale.

STALLONE: It's fertilizer, right? It just goes in the backyard. This can't go in your mouth.

KING: So, Dr. Rader, don't -- doesn't that make us look a little silly?

RADER: It does. I mean, a lot of things that are not very good for us sort of have a long history. But certainly smoking is one example of something that we wouldn't approve today.

KING: We'll be back with our remaining moments with our outstanding panel right after this.

(COMMERCIAL BREAK) KING: We're back with our remaining moments. We salute the Entertainment Information Foundation for getting involved in helping fight things like this. Do you think we'll ever cure it, Dr. Shah? Do you think we'll ever cure heart disease?

SHAH: Well, that's obviously a dream that we all have. And I think we can do a hell of a lot now. And with research that this particular National Cardiovascular Research Initiative of the Entertainment Industry Foundation that they're launching will help in the future to eliminate the rest of the heart disease that we're not able to cure or prevent with available treatment right now.

KING: Dr. Rader, do you think it will ever be cured?

RADER: I do. I do.

KING: You do?

RADER: Heart disease is a lot lifestyle. But when you look at the success we've had with cholesterol lowering medications, the Statens (ph), the incredible success in terms of reducing heart disease risk, even in people whose cholesterol levels are not that high to begin with, and we think about using these appropriately in people at high risk -- even when cholesterols are not too high -- that could be something that could really make a major impact on heart disease risk down the road in another 10 or 20 years.

KING: In fact, they're doing studies, Lipator (ph) and others, where they're recommending it now to a wider range of people, right?

RADER: Absolutely. One big recent study suggested that if you're at high risk, it doesn't matter what your cholesterol is. Taking one of these medications further reduces your risk. This really will open up using these medications to a much larger number of people.

KING: Well I'm glad you brought that up, because we talk about not having kids start smoking. But nutrition and diet and prevention of obesity really starts in childhood. I think it's incredibly important to teach our children good eating habits and to realize that most obese adults started gaining weight and becoming overweight as children. A very important issue in terms of preventing heart disease.

KING: Isn't it hard, Jennifer, to keep the French fry away from the child?

FLAVIN: Almost impossible. My daughter loves French fries and ketchup and...

KING: And whole milk?

FLAVIN: Whole milk. I still have their own bottles, still.

STALLONE: But if you cook it in olive oil, it's not too bad.

FLAVIN: Well we don't, honey, unfortunately.

KING: Don't you find it hard, Sly? What do you say to a kid, "Don't eat that?"

FLAVIN: Well I think there's -- in moderation. I mean, you know, you can't grow up without ice-cream, giving your kids ice-cream.

STALLONE: No, we're pretty strict. Really strict.

KING: You are?


FLAVIN: Because -- I mean, they have oatmeal in the morning.

STALLONE: I mean, they have a pretty Spartan (UNINTELLIGIBLE).

KING: Would we all be healthier, Dr. Rader, if we were all vegetarians.

STALLONE: Well, when my back is turned.

RADER: Well, I think that answer is yes. Animal products have a lot of saturated fat, which really is not good, not only for heart disease, but for certain types of cancer. So I think so. It's unrealistic to expect that everyone is going to be a vegetarian, but avoiding saturated fats and particularly avoiding calories and avoiding gaining weight. Weight gain is not something that is inevitable with age, and I think we've got to have people understand they have to limit what they take in and avoid gaining weight with age.

JACKSON: Don't they also have to read labels? Because you would be astonished if you read the label of a cracker and found out it had animal lard in it.

STALLONE: Yeah, that's right.

KING: How about stress?

SHAH: I think mental stress certainly has a role to play in bringing on heart disease. It doesn't actually cause the disease itself, but it can unmask disease that's been latent. And there's no question, negative emotions like anger, hostility, frustration, can actually trigger heart attacks in someone who's at risk.

KING: And how about depressing news?

SHAH: Yes. Depression is both contributing to an increased risk of cardiovascular disease and depression is also a common manifestation of cardiovascular disease. So it's on a viscous cycle.

KING: You have it, you get depressed.

SHAH: Absolutely.

KING: Or you get depressed and you can trigger it.

SHAH: Exactly. Right. It's a viscous cycle. And I think there's some very intriguing evidence that controlling depression after a heart attack -- either with psychotherapy or with certain medications prescribed by an appropriate professional -- may actually have a favorable effect.

KING: Because the type A personality is hard to...

SHAH: Well not just simply a type A, but also how do you react to stress. I think negative emotions tend to be generally much more conducive as a risk factor.

KING: Does stress play a part in stroke?

SHAH: Yes, it's the same thing for stroke as well, as it is with heart disease. But, again, it's important to point out, stress by itself is not a factor.

KING: Because Kirk is a very intense person. As long as I've known him he's...

DOUGLAS: Listen, I have discovered a way to deal with depression with a (UNINTELLIGIBLE). And you are free to use my formula.

KING: Quickly, what is it?

DOUGLAS: I think depression is caused by too much thinking about yourself. If you decide to think about other things and other people, it releases depression.

KING: That's a good idea, Sly.

STALLONE: It makes me even more depressed. What happened to all the vanity, Kirk?

KING: Thank you all very much. Just ruined an entire acting profession. Thank you all very much for participating and thanks to the Entertainment Information Foundation for the work they do. And I hope that we can make some strong strides in this. I'm Larry King, from our studios in Los Angeles, good night.