Pre-diabetes: An explanation for explosive coronary plaque growth 1. June 2006 William Davis (0) Art's first CT heart scan in March, 2006 yielded a concerning score of 1336. He felt fine--no chest discomfort, no breathlessness, etc. Art agreed to take the statin cholesterol drug his primary care doctor prescribed. He also agreed to take the fish oil, niacin, and some of the nutritional supplements that we advised. But Art just couldn't bring himself to make the commitment to lose weight. At the start of his program, Art--at 5 ft. 8 inches--was 40 lbs overweight (212 lb). This was important since his blood sugar wavered in the pre-diabetic range, going as high as 130 mg. (The American Diabetes Assn. defines diabetes as a blood glucose of 126 mg or greater.) One year later, Art's lipid and lipoprotein values were corrected to perfection. But he still weighed in at a hefty 209 lbs--essentially no change. His blood sugar likewise hovered in the 120's. I felt Art need to be prodded, so I asked him to undergo another heart scan. His score: 1935--a 600 point increase, or 45%! Only now has Art begun to comprehend to power of diabetes and pre-diabetes to fan the flames of plaque growth. Recent published data, in fact, show that the majority of recently diagnosed diabetics already have well-established coronary artery disease. Don't let this happen to you. Do not dismiss diabetic patterns as they will catch up to you. If Art can lose the 30-40 lbs in the abdominal weight that is creating the diabetic pattern, he will likely succeed in stopping plaque growth. Otherwise, it's just a matter of time before his heart attack, stent, or bypass.
Who cares if you're pre-diabetic? 31. May 2006 William Davis (0) Marta is a smart lady. She's worked in hospital laboratories for the last 23 years and knows many All posts by william-davis Toggle navigation Home Blog Home Archive Join Now Log in "You've got 10 minutes" 20. May 2009 William Davis (0) There's a new trend in office healthcare in Milwaukee: Time-restricted office visits. I'm told by several physicians who are employed by a major healthcare system here in town that they are peridically watched--physically watched by an administrator--to make sure that they do not exceed the allotted 10 minutes of time. My cardiologist colleagues, I gather, were at first incredulous at such intrusions into their practices, but apparently had no choice: They were employees. Goiter, goiter everywhere 20. May 2009 William Davis (25) The results of the recent Heart Scan Blog poll are in.The question:Do you used iodized salt?The responses:Yes, I use iodized salt every day 94 (28%)Yes, I use iodized salt occasionally 56 (16%)No, I do not use any iodized salt 41 (12%)No, I use a non-iodized salt (sea salt, Kosher) 126 (37%) No, I use a non- or low-sodium substitute 15 (4%)Thanks for your responses.If only 28% of people are regular users of iodized salt, that means that the remainder--72%--are at risk for iodine deficiency if they are not getting iodine from an alternative source, such as a multivitamin or multimineral.Even the occasional users of salt can be at risk. The common perception is that occasional ="post-author">William Davis (0) I saw a patient in the office yesterday. He came to me for an opinion regarding his high heart scan score of 525, putting him in the 90th percentile (5% annual risk of heart attack). His doctor had been puzzled because his LDL cholesterols had ranged from 110 to 131 mg--actually below average. (The average LDL for the U.S. is 132 mg.) Likewise, HDL was a favorable 63 mg. Lipoprotein analysis told the story loud and clear. His LDL particle number, a far more precise measure of LDL, was 2448 nmol/l. This means that his true LDL was more like 240-250 mg! (You can get a sense for what the true LDL is from LDL particle number by dropping the last digit: 2448 becomes 244.) Conventional LDL was therefore inaccurate by over 100 mg.He also had a severe small LDL particle pattern. The cause of his coronary plaque was a large excess of small LDL particles. LDL cholesterol (and total cholesterol, likewise) didn't even hint at this pattern. Nor did his favorable HDL. Think of LDL particle number as an actual count of LDL particles per volume, e.g., number of particles per cc of blood. This makes it easier to conceptualize. LDL particle number is the measure you get when you have an NMR lipoprotein profile, our preferred method of lipoprotein testing. If this is unavailable to you, apoprotein B is a reasonable second choice, though not as accurate in my view. More info on NMR is available at their website, www.lipoprofile.com. How to make a $1 million in cardiology 26. May 2006 William Davis (0) Want to make a $1,000,000 as a cardiologist in the next year? It's easy. All you have to do is:1) Perform heart catheterizations or other procedures on anybody you can, even if it's not necessary. Perform them even if the patient has no symptoms and the stress test is normal. 2) Perform heart catheterizations if the patient is too timid or ill-informed to object. 3) Insert coronary stents in blockages, even when they're minor and it's not necessary. 4) Turn every heart procedure into a revenue-producing stream by looking for other profit opportunties, such as minor kidney artery blockages. 5) Heart disease is frightening. Scare the heck out of patients by exagerrating the dangers so they'll go through testing and procedures gratefully. Sound absurd? Well, it would be if these weren't all true.These are real examples, as awful as it sounds. I've witnessed all these behaviors. Not just occasionally, but with regularity. Just today, I encountered a colleague who performs heart catheterizations routinely (up to several per day) when any symptom is present and the stress test is entirely normal. This is grossly inappropriate.Your protection is being better-informed and avoid being sucked into the vast and frightening cardiovascular machine of revenue-yielding procedures. Part of your protection is to get a CT heart scan, then engage in a program of heart disease prevention. Doctor, do I have lipoprotein (a)? 25. May 2006 William Davis (0) I met Joyce today for a 2nd opinion. She told me about this conversation she'd had with her cardiologist:"Doctor, do you think I could have lipoprotein (a)? I read about how it can cause heart attacks even when cholesterol is controlled.""What does it matter? Even if you have it, there's nothing we can do about it. There's no treatment for it."Joyce was understandably groping for some means to prevent her coronary disease from causing more danger. At 56, she'd already survived a heart attack that resulted in two stents to her left anterior descending. Around 9 months later, she received a 3rd stent to another artery. Her doctor had put her on Pravachol and said that was enough. "We know that cholesterol causes heart disease and the Pravachol reduces it. Why do we need to know anything more?"So Joyce came to me for another view. I explained to her that there are, in fact, several ways to deal with lipoprotein(a). It is, without a doubt, among the more difficult patterns to manage--but not impossible. In fact, we have a growing list of participants in the Track Your Plaque program who have stopped or reduced their heart scan scores. I continue to be horrified at the level of ignorance that prevails among my colleagues, the cardiologists, and the primary care community. If your doctor gives you advice like this, get a new doctor. << Older posts Newer posts >> Newer posts12...114115116117118119120121122123124Older posts
"You've got 10 minutes" 20. May 2009 William Davis (0) There's a new trend in office healthcare in Milwaukee: Time-restricted office visits. I'm told by several physicians who are employed by a major healthcare system here in town that they are peridically watched--physically watched by an administrator--to make sure that they do not exceed the allotted 10 minutes of time. My cardiologist colleagues, I gather, were at first incredulous at such intrusions into their practices, but apparently had no choice: They were employees.
Goiter, goiter everywhere 20. May 2009 William Davis (25) The results of the recent Heart Scan Blog poll are in.The question:Do you used iodized salt?The responses:Yes, I use iodized salt every day 94 (28%)Yes, I use iodized salt occasionally 56 (16%)No, I do not use any iodized salt 41 (12%)No, I use a non-iodized salt (sea salt, Kosher) 126 (37%) No, I use a non- or low-sodium substitute 15 (4%)Thanks for your responses.If only 28% of people are regular users of iodized salt, that means that the remainder--72%--are at risk for iodine deficiency if they are not getting iodine from an alternative source, such as a multivitamin or multimineral.Even the occasional users of salt can be at risk. The common perception is that occasional ="post-author">William Davis (0)
How to make a $1 million in cardiology 26. May 2006 William Davis (0) Want to make a $1,000,000 as a cardiologist in the next year? It's easy. All you have to do is:1) Perform heart catheterizations or other procedures on anybody you can, even if it's not necessary. Perform them even if the patient has no symptoms and the stress test is normal. 2) Perform heart catheterizations if the patient is too timid or ill-informed to object. 3) Insert coronary stents in blockages, even when they're minor and it's not necessary. 4) Turn every heart procedure into a revenue-producing stream by looking for other profit opportunties, such as minor kidney artery blockages. 5) Heart disease is frightening. Scare the heck out of patients by exagerrating the dangers so they'll go through testing and procedures gratefully. Sound absurd? Well, it would be if these weren't all true.These are real examples, as awful as it sounds. I've witnessed all these behaviors. Not just occasionally, but with regularity. Just today, I encountered a colleague who performs heart catheterizations routinely (up to several per day) when any symptom is present and the stress test is entirely normal. This is grossly inappropriate.Your protection is being better-informed and avoid being sucked into the vast and frightening cardiovascular machine of revenue-yielding procedures. Part of your protection is to get a CT heart scan, then engage in a program of heart disease prevention.
Doctor, do I have lipoprotein (a)? 25. May 2006 William Davis (0) I met Joyce today for a 2nd opinion. She told me about this conversation she'd had with her cardiologist:"Doctor, do you think I could have lipoprotein (a)? I read about how it can cause heart attacks even when cholesterol is controlled.""What does it matter? Even if you have it, there's nothing we can do about it. There's no treatment for it."Joyce was understandably groping for some means to prevent her coronary disease from causing more danger. At 56, she'd already survived a heart attack that resulted in two stents to her left anterior descending. Around 9 months later, she received a 3rd stent to another artery. Her doctor had put her on Pravachol and said that was enough. "We know that cholesterol causes heart disease and the Pravachol reduces it. Why do we need to know anything more?"So Joyce came to me for another view. I explained to her that there are, in fact, several ways to deal with lipoprotein(a). It is, without a doubt, among the more difficult patterns to manage--but not impossible. In fact, we have a growing list of participants in the Track Your Plaque program who have stopped or reduced their heart scan scores. I continue to be horrified at the level of ignorance that prevails among my colleagues, the cardiologists, and the primary care community. If your doctor gives you advice like this, get a new doctor.