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.

    Dave

  • 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.

    Terri
    madcook

  • 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.

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Super-carbohydrate

Super-carbohydrate

Wheat starches are composed of polymers (repeating chains) of the sugar, glucose. 75% of wheat carbohydrate is the chain of branching glucose units, amylopectin, and 25% is the linear chain of glucose units, amylose.

Both amylopectin and amylose are digested by the salivary and stomach enzyme, amylase, in the human gastrointestinal tract. Amylopectin is more efficiently digested to glucose, while amylose is less efficiently digested, some of it making its way to the colon undigested.

Amylopectin is therefore the “complex carbohydrate” in wheat that is most closely linked to its blood sugar-increasing effect. But not all amylopectin is created equal. The structure of amylopectin varies depending on its source, differing in its branching structure and thereby efficiency of amylase accessibility.

Legumes like kidney beans contain amylopectin C, the least digestible—hence the gas characteristic of beans, since undigested amylopectin fragments make their way to the colon, whereupon colonic bacteria feast on the undigested starches and generate gas, making the sugars unavailable for you to absorb.

Amylopectin B is the form found in bananas and potatoes and, while more digestible than bean amylopectin C, still resists digestion to some degree.

The most digestible is amylopectin A, the form found in wheat. Because it is the most readily digested by amylase, it is the form that most enthusiastically increases blood sugar. This explains why, gram for gram, wheat increases blood sugar to a much greater degree than, say, chickpeas.

The amylopectin A of wheat products, “complex” or no, might be regarded as a super-carbohydrate, a form of highly digestible carbohydrate that is more efficiently converted to blood sugar than nearly all other carbohydrate foods.

Comments (18) -

  • Jim Purdy

    5/22/2010 3:30:00 PM |

    QUOTE:
    "... gram for gram, wheat increases blood sugar to a much greater degree than, say, chickpeas. "

    Well, that ain't good.

  • David

    5/22/2010 4:21:52 PM |

    I've really enjoyed these last couple of posts about wheat. Very informative and accessible. Thanks for taking the time to make this kind of info available to the wider audience.

    David

  • Anonymous

    5/22/2010 5:12:17 PM |

    fascinating

  • pjnoir

    5/22/2010 8:48:14 PM |

    WOW- a classic lose-lose. 25% remains in your colon, to become a bacteria feast and the rest (75%) increases blood sugar and insulin production to store it as a fat cell.  hmmmmm, thank goodness for science, we may save ourselves.

  • Anonymous

    5/22/2010 10:15:53 PM |

    Dr. Davis,

    While not on a directly related note, do you have any general feelings on moderate consumption of buckwheat as a carbohydrate source? From what I have read, this "pseudo" grain seems to be far less problematic than true grains. It would still not give most folks a license to consume it ad libitum, but I am curious if you'd consider this a decent choice in controlled amounts (with the actual amount varying by context and the overall health of the person in question).

    -Dave Balon

  • Mike

    5/22/2010 10:37:12 PM |

    Excellent explaination, Dr Davis.

  • Anonymous

    5/23/2010 1:55:46 AM |

    I'm really enjoying your posts about wheat.  Very interesting.  Thanks

  • Apolloswabbie

    5/23/2010 3:27:45 PM |

    Thank you Dr. D

  • Jill

    5/24/2010 3:04:47 PM |

    Dear Heart Scan Blog,

    I am a student at the  University of Rochester working on an internship project in conjunction with RateADrug.com to collect primary user data about side effects and benefits from commonly used treatments for Atherosclerosis & Arterial Disease.  The goal is to build a large, public access database of unbiased, anecdotal data about Atherosclerosis & Arterial Disease treatments.

    We want to let both patients and practitioners know about how they can participate in or benefit from the project.  Users can add their experiences with a treatment and learn more about how the treatment is affecting them by taking a short, confidential survey. They can also use RateADrug to compare aggregate data for different Atherosclerosis & Arterial Disease treatments- both conventional and alternative (http://www.rateadrug.com/Atherosclerosis-and-Arterial-Disease-symptoms-feedback.aspx) - and forward the results of their own surveys to their doctors or family members.

    Rateadrug is an independent data gathering and information website that does not accept funding or advertisement from drug companies.

    Would it be possible for you to make this information available to your viewers so they can help us collect important data on Atherosclerosis & Arterial Disease treatments?

    Thank you in advance. I'd be happy to speak with you if you have any questions or comments.

    University of Rochester
    www.RateADrug.com student intern
    jillian@radpprep2.com

  • Dr. William Davis

    5/24/2010 10:28:41 PM |

    Hi, Paul--

    Yes, indeed. The data relating high-carbohydrate intake with multiple forms of cancer is getting very scary.

  • Anonymous

    5/25/2010 4:18:17 AM |

    Wow, I am a long time fan of heartscanblog, but Paul's citation is the most misleading EVER.   The authors found that carbs were associated with pancreatic cancer only in the FIRST FOUR years of follow-up, whereas fat and saturated fat were associated with pancreatic cancer during follow-up GREATER than four years.  Since pancreatic cancer takes years to develop, the authors conclude that carbohydrates are NOT CAUSAL to pancreatic cancer - fat may be.

  • DrStrange

    5/25/2010 2:43:32 PM |

    "The data relating high-carbohydrate intake with multiple forms of cancer is getting very scary."

    I would think at least in part from the higher blood sugars.  Much less problematic w/ whole, intact grains (boiled vs ground into flour and refined (and then higher temp. baked or fried)!

  • discombobulated

    5/25/2010 7:50:36 PM |

    I love your blog.  We have switched out diets to something much closer to what you recommend due to the fact that my husband's psoriasis gets so much better if he avoids wheat,potatoes, corn, refined sugars, and dairy.  We figure it's better than using steroids for the problem.  We also have one son who has been biopsied for celiac after is blood work and we were told he doesn't have the correct atrophy but does have a damaged intestine.  

    So we are committed to eating this way.  But one thing I have wondered about is if you feel that carb blockers work for blocking starch.  There are times when I would kill for a baked potato but try not to because it starts a negative cycle.  And now I know that it's not so hot for my heart either.  

    This post made me wonder if there isn't some merit in them.

  • Breast Augmentation Los Angeles

    5/26/2010 6:20:52 PM |

    Thanks for discussing this.I thought whet is sort of better than the white bread for the diabetic and the heart patients.

  • best pharmacy

    12/7/2011 11:28:22 PM |

    This is one of greatest blogs I’ve read since ever. Your site contains a lot of useful information and I’m sure many people will like it as I do. I'll keep visiting your blog very frequently.

  • best pharmacy

    12/7/2011 11:28:46 PM |

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  • Mary Wier

    7/10/2012 8:38:03 AM |

    Bill and I found our Wheatbelly book and have been off gluten for 9 months, it was hard at first but we now
    feel so different, Bill's blood sugar dropped 25 points, and we look at all our food so differently now!
    The display of wheat rolls and pastry at our buffet looks more and more like hidden poison.
    We are off sugar, too it is so tempting but our body says, Thank you Dr. Davis!

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