Tim Russert's heart scan score 210. . .in 1998

Despite the media blathering over how Mr. Russert's tragic death from heart attack could not have been predicted, it turns out that he had undergone a heart scan several years ago.

A New York Times article, A Search for Answers in Russert’s Death, reported:

Given the great strides that have been made in preventing and treating heart disease, what explains Tim Russert’s sudden death last week at 58 from a heart attack?

The answer, at least in part, is that although doctors knew that Mr. Russert, the longtime moderator of “Meet the Press” on NBC, had coronary artery disease and were treating him for it, they did not realize how severe the disease was because he did not have chest pain or other telltale symptoms that would have justified the kind of invasive tests needed to make a definitive diagnosis. In that sense, his case was sadly typical: more than 50 percent of all men who die of coronary heart disease have no previous symptoms, the American Heart Association says.

It is not clear whether Mr. Russert’s death could have been prevented. He was doing nearly all he could to lower his risk. He took blood pressure pills and a statin drug to control his cholesterol, he worked out every day on an exercise bike, and he was trying to lose weight, his doctors said on Monday. And still it was not enough.

“What is surprising,” Dr. Newman said, “is that the severity of the anatomical findings would not be predicted from his clinical situation, the absence of symptoms and his performing at a very high level of exercise.”

Buried deeper in this article, the fact that Mr. Russert had a heart scan score of 210 in 1998 is revealed.

That bit of information is damning. Readers of The Heart Scan Blog know that heart scan scores are expected to grow at a rate of 30% per year. This would put Mr. Russert's heart scan score at 2895 in 2008. But the two doctors providing care for Mr. Russert were advising the conventional treatments: prescribing cholesterol drugs, blood pressure medication, managing blood sugar, and doing periodic stress tests.

Conventional efforts usually slow the progression of heart scan scores to 14-24% per year. Let's assume the rate of increase was only 14% per year. That would put Mr. Russert's 2008 score at 779.

A simple calculation from known information in 1998 clearly, obviously, and inarguably predicted his death. Recall that heart scan scores of 1000 or greater are associated with annual--ANNUAL--risk for heart attack and death of 20-25% if no preventive action is taken. The meager prevention efforts taken by Mr. Russert's doctors did indeed reduce risk modestly, but it did not eliminate risk.

We know that growing plaque is active plaque. Active plaque means rupture-prone plaque. Rupture prone plaque means continuing risk for heart attack and death. Heart attack and death means the approach used in Mr. Russert was a miserable failure.

While the press blathers on about how heart disease is a tragedy, as Mr. Russert's doctors squirm under the fear of criticism, the answers have been right here all alone. It sometimes takes a reminder like Mr. Russert's tragic passing to remind us that tracking plaque is a enormously useful, potentially lifesaving approach to coronary heart disease.

Who needs to go next? Matt Lauer, Oprah, Jay Leno, some other media personality? Someone close to you? Can this all happen right beneath the nose of your doctor, even your cardiologist?

I don't need to remind readers of The Heart Scan Blog that heart disease is 1) measurable, 2) trackable, 3) predictable. Mr. Russert's future was clear as long ago as 1998. Every year that passed, his future became clearer and clearer, yet his doctors fumbled miserably.

Copyright 2008 William Davis, MD

Comments (10) -

  • Richard A.

    6/18/2008 4:51:00 AM |

    "He also had a dangerous combination of other risk factors: high triglycerides, a type of fat in the blood, and a low level of HDL, the “good cholesterol” that can help the body get rid of the bad cholesterol that can damage arteries."

    I wonder if he was taking fish oil supplements to try to drive down his triglycerides and niacin to prop up his HDL?

  • Anonymous

    6/18/2008 5:36:00 AM |

    I had a 234 score in 2005 and a 419 score in 2007 - if it wasn't for resources like TYP - I wouldn't have pushed my Dr with questions about Vit D and CQ 10 and Fish Oil...  sit waiting for the next scan to see if things are under control (now - small LDL-P 123 nmol/L).

    Just think if Tim R had the time to do a bit of research himself and found TYP - but that is what your physicans should be doing for you.... growing... learning... but as an engineer, I know the spectrum of people calling themselves engineers is a large spectrum... so it is with MDs.

    Thanks for what you do Dr D.


  • Dr. William Davis

    6/18/2008 11:53:00 AM |

    Yes. Fish oil alone could have cut his risk of sudden cardiac death by 45%. It would have cost him all of $3 per month.

  • Anonymous

    6/18/2008 3:09:00 PM |

    I have been wondering if the trans-Atlantic flight several days before his death could have had something to do with it...

  • Anonymous

    6/18/2008 5:08:00 PM |

    Dr Davis I just wonder what you think of this Dr. Mehmet(?) Oz who keeps popoing up on television and writing books talking about the same old stuff, low fat, high carbs blah blah blah . . . I think since Mr. Russerts death I've seen him on tv 3 times and NOT ONCE has he mentioned calcium scoring, vitamin D, fish oil . . .

  • Anonymous

    6/19/2008 3:45:00 AM |

    What a tragedy.  All week long I have been asking myself how such a smart man could be so uninformed about his own health?

    With all the resources at Mr. Russert's disposal, I would think he could have easily learned more about his condition, and the measures he might have taken to save himself.  [Then too, he might have also come across the Track Your Plaque website... or the book.]  Instead, he was apparently greatly trusting of his internist and cardiologist, and perhaps thought he was receiving optimal medical management... and nothing more could be done?

    Beyond that, I wonder about his Vitamin D status, and whether he was dehydrated from the long flight back from Europe?  I also wonder if the emotional stresses (good and bad) of a quick trip to Europe, his son's graduation from college, and having recently placed his beloved father into a care home, on top of what could only be termed a stressful and grueling work life (no matter how much he may have loved it) might have lead his body to the tipping point on that day.   I suppose we are unlikely to have these answers under the circumstances.

    R.I.P. Mr. Russert, but shame, shame, shame on your physicians, IMO they really let you down.

    Thanks for this truthful blog, an antidote to all the media nonsense and C.Y.A. I have seen in the past few days.


  • sschein

    6/23/2008 5:36:00 PM |

    My wife has been to Dr. Michael Newman the internist for Tim Russert.  I don't think she is going back.  I had Angioplasty about 10 years ago with stents put in my right and left artery.  Since then I have the thallium stress test every year, take 1500 mg's of niaspan a day, Lipitor, a blood pressure lowering drug, and aspirin.  Both my cardiologist, and my internist state that a heart scan would not do me any good, and my cardiologist stated that the heart scan would simply confuse the issues.  Are they right? Would the heart scan harm me?  If so, how?

  • Anonymous

    6/25/2008 5:18:00 PM |

    In response to the comment by sschein, I'm not sure it's such a great idea to have a thallium stress test every year.  You should probably investigate the possibility of a CT-angiogram.  

    I am not a doctor so I don't want you to think I'm defending them, but there's only so much that a doctor can do in the office visit environment.  It's really up to the patient to do the research and decide on what he believes is the best course of treatment for him or herself and then try to bring the doctor around to his point.  In my own case I refuse to have a thallium stress test and have finally decided to have a 320 slice CT-angiogram when I go to Boston next month.  My cardiologist may not agree that it's the choice he'd choose, but he's going along with it.  Quite simply they don't have the time to convince the patient one way or the other.  We really don't know all the details about Tim Russert's care.  If he had his own private physician who tended only to him or who was consulted extensively I'd probably expect better.  As just one patient (admittedly a famous one) I'm not sure how much you can expect from a doctor.  If he suggests a stress test or an angiogram and you think better of the idea, it's up to the patient to chart his own course.

    Andy (the164club) TYP member

  • Jeffrey Dach MD

    7/1/2008 11:38:00 AM |

    Tim Russert and George Carlin

    Two beloved American celebrities have succumbed to heart disease before their time.  The national response has been disappointment in a medical system that could allow this to happen.  What could have been done differently to save the lives of both Tim and George, to avoid this fatal outcome?

    To read more...Saving Tim Russert and George Carlin by Jeffrey Dach MD

    Jeffrey Dach MD
    4700 Sheridan Suite T
    Hollywood FL 33021
    my web site

  • buy jeans

    11/3/2010 6:54:38 PM |

    A simple calculation from known information in 1998 clearly, obviously, and inarguably predicted his death. Recall that heart scan scores of 1000 or greater are associated with annual--ANNUAL--risk for heart attack and death of 20-25% if no preventive action is taken. The meager prevention efforts taken by Mr. Russert's doctors did indeed reduce risk modestly, but it did not eliminate risk.

The nutrition counterculture

The nutrition counterculture

When we look back over our American nutritional history over the last 50 years, it's hard not to come to the conclusion that much of the innovation in nutrition did not come from official agencies like the Food and Nutrition Board of the Institute of Medicine, the National Academy of Sciences, the FDA, the USDA, or the AMA.

Instead, it came from the popular culture. It came from bold, extravagant claims made by maverick figures like Ancel Keys, Nathan Pritikin, Dean Ornish, and Robert Atkins. Of course, some ideas have now fallen by the wayside, dismissed in a broad American "experiment" as ineffective, impractical, or kooky. But it permitted experimentation on an extraordinary scale with millions of people following a particular strategy at a time.

The advice of the official agencies tended to be reactionary. When nutritional deficiencies (remember those?) of the early 1900s were prevalent, they issued advice on food choices to help alleviate deficiencies. When deficiency transformed into excess after World War II, "smart" food choices from food groups and "sensible eating" became the theme.

Unfortunately, the advice was always adulterated by the enormous influence of various special interests, anxious to protect their national franchise. Powerful groups like the meat industry, wheat producers, and the dairy industry all made sure they had a big hand in crafting and influencing what was told to the American people.

The result: the advice offered by official groups has always represented the compromise of what some agency wished to convey to the people and the very powerful input of industry. What if the government decided to advise us what automobile to buy? Imagine the uproar in the auto industry when Washington tells us to buy Toyota for fuel economy and reliability. How long would that advice last?

That's why almost no knowledgeable adult follows the advice of the USDA, the National Academy of Sciences, or the Food Pyramid. I believe that we all intuitively recognize that the advice is watered-down, sometimes silly, sometimes downright unhealthy.

Nonetheless, the national experiment in diet that has taken place since 1950 has led to a collective wisdom of what is good and what is bad. The most productive conversations on nutrition therefore take place outside of the USDA and Washington. It occurs, instead, in places like bookstores, websites, and the media. Of course, there's lots of misinformation and profiteering in these sectors, as well. But like the enormous force unleashed by the collective wisdom of those contributing to the Wikipedia phemonenon, we've zig-zagged to something closer to the truth than ever uttered by an official agency.

Comments (2) -

  • JT

    6/25/2007 2:18:00 AM |

    Nice post.  The New York Times writer Thomas Friedman said it well I thought when he titled his last book, The World is Flat.  With easier access to information - in particular due to the internet - knowledge is no longer held by just a few.  New ideas to solving problems can be distributed like never before - and I am thankful for that as it has allowed me to discover your book and ideas.      

    While this post isn't so much about nutrition maverick figures, thought to mention one figure that was left out, Dr. Barry Sears and his many best selling books titled The Zone.    
    Dr Davis, since you are an author too, thought you might enjoy this somewhat fortunate and humorous story on how Dr. Sears became an author.  

    My family and I knew Dr. Sears several years before he became a best seller author.  Originally Barry and his brother Doug were small businessmen selling health food products.  In particular Barry was known for helping begin the borage and primrose oil business.  Later I remember the two Sears brothers sold nutrition bars that were low in sugar and high in chromium for weight loss.  He would send my parents big boxes of the bars and they just loved them.    

    Barry though never was much of a businessman.  His heart seemed to be into science and research and not running a company.  

    One day the poor business practices caught up with the Sears.  They were not paying their bills and so companies stopped selling them product.  With out options left Barry wrote the book he always wanted to write, The Zone.  He did not believe his book would sell though - and if it did only a few thousand would be sold locally.  When he found a group to promote the book he asked that his 1-800 # be added to the book so that if a reader had questions he/she could call him personally.      

    Well, the rest is history.  The Zone went on to become a New York Times best seller.  And as Doug Sears told us  - when the book came out they were flat broke, were not able to pay the phone bill  - and the 1-800 phone line would not stop ringing from customers who had read the book. It took awhile before royalties came in.  For awhile the two thought they would have to declare bankruptcy even though they had the best selling book in America and were on the brink of becoming international nutrition celebrities.

  • Dr. Davis

    6/25/2007 12:35:00 PM |

    Wow! Great personal insights.

    I agree. Barry Sears has made a significant contribution to the national conversation on healthy eating. Even though a few years old now, many of the things he said still hold true and remain relevant.