I don't care about hard plaque!

I ran into a cardiology colleague this weekend. He was aware of my interest in CT heart scanning and plaque reversal.

Out of the blue, he declared "I don't care about hard plaque! I only care about soft plaque." He then proceeded to describe to me how everyone--EVERYONE--needs a CT coronary angiogram to identify "soft plaque".

Is there any truth to this view? Are we only identifying "hard plaques" by focusing on calcium and calcium scores on simple CT heart scans?

Several issues deserve clarification. First of all, CT heart scans don't identify hard plaque. They identify total plaque. Because calcium is a component of the majority of atherosclerotic plaque, comprising approximately 20% of its volume, a calcium "score" can be used to indirectly quantify total plaque, both "hard" and "soft".

Anyone cardiologist who performs a lot of the procedure, intracoronary ultrasound, knows that most human plaque is also not purely soft or hard, it is mixture of both. (I've been performing this procedure since 1995.) Quantifying only soft or only hard plaque is therefore only possible in theory, not in practice.

I believe my colleague does have a valid point in one regard, however. There is indeed a small percentage of people, probably around 5% of all people who have CT heart scans, who have scores of zero yet have a modest quantity of pure "soft" plaque. These people may be misled by having a zero score. How can these people benefit from better information?

Several ways. First, people like this tend to have very high LDL cholesterols, generally 180 mg/dl or greater. They may have a very worrisome family history, e.g., father with heart attack in his 30s or 40s. This small proportion of people with zero heart scan scores may benefit from receiving X-ray dye with their heart scan, i.e., a CT coronary angiogram. Keep in mind that we're assuming everyone is without symptoms, also. If symptoms are part of the picture, everything changes.

But should everybody get a CT coronary angiogram? I don't believe so. A CT coronary angiogram involves far more radiation exposure, greater expense (usually $1800 to $4000), and, with present day technology, does not yield quantitative (measurable) information that is useful for longitudinal use for repeated scans. You don't want to undergo yearly CT coronary angiograms, for instance.

Stay tuned for more on this issue. In the meantime, I continue to try and inform my colleagues about what is right, what is wrong, what is preferable for patient safety and yields truly empowering information, and try to impress on them that the practice of cardiology is not just about enriching their retirement accounts.

Try an experiment in a wheat-free diet

Years back, I'd heard some people argue that wheat-based products were detrimental to health. At the time, I thought they were nuts. After all, wheat is the principal ingredient in a huge number of American staples like breakfast cereals and bread.

What changed my mind was the low-fat movement of the 1980s and 1990s. Proponents of low-fat diets claim that heart disease is caused by excess fat in the diet. A diet that is severely restricted in fat therefore might cure or reverse heart disease.

But low-fat diets evolve into high-carbohydrate diets. This nearly always means an over-reliance on wheat products. People will say to me "I had a healthy breakfast: shredded wheat cereal in skim milk and two slices of whole wheat toast." Yes, it is low-fat, but is it healthy?

Absolutely not. Followers of the Track Your Plaque program know that low-fat diets ignite the formation of small LDL particles (a VERY potent trigger of coronary plaque growth), drops HDL, raises triglycerides, causes resistance to insulin and thereby diabetes, raises blood pressure. They also make you fat, with preferential accumulation of abdominal visceral (intestinal lining) fat.

Look at people with gluten enteropathy, a marked intolerance to wheat products that results in violent bowel problems, arthritis, etc. if unrecognized. These people, if the diagnosis is made early, are strikingly slender and commonly unusually healthy otherwise. There's a message here.

If you need convincing, try an experiment. Eliminate--not reduce, but eliminate wheat products from your diet, whether or not the fancy label on the package says it's healthy, high in fiber, a "healthy low-fat snack", etc. This means no bread, pasta, crackers, cookies, breads, chips, breading on chicken, rolls, bagels, cakes, breakfast cereal...Whew!

You won't be hungry if you replace the lost calories with plentiful raw almonds, walnuts, pecans, sunflower and pumpkin seeds; more liberal use of healthy olive oil, canola oil and flaxseed oil; adding ground flaxseed and oat bran to yogurt, cottage cheese, etc.; and more lean proteins like lean beef, chicken, turkey, and fish.

I predict that, not only will you lose weight, sometimes dramatically, but you will feel better: more energy, more alertness, sleep better, less moody. Time and again, people who try this will tell me that the daytime grogginess they've suffered and lived with for years, and would treat with loads of caffeine, is suddenly gone. They cruise through their day with extra energy.

Success at this can yield great advantage for your heart scan score control and reversal efforts. It will give you greater control over small LDL and pre-diabetic patterns, in particular.

Bigger, faster plaque reversal

Perhaps it's too early to tell whether it's true, but believe that we're seeing coronary plaque reversal--i.e., reduction of CT heart scan score--that is BIGGER and FASTER than ever before. We are now witnessing 20-30% reductions in score, even in the first year.

Early in our experience, I was thrilled with a slowing of plaque growth. Recall that coronary plaque grows at the rate of 30% per year. We would often seen slowing to 10-15% per year in the first year, then a levelling off to little or no increase in the 2nd or 3rd year. Regression, or reduction of score, was less common.

Now, with some further tweaking of our program, we are seeing these large magnitudes of coronary plaque reversal routinely. Not in everybody, of course. There are exceptions that mostly includes people who are less motivated and occasional people with more difficult to control lipoprotein patterns.

I believe that part, or perhaps most, of our recent success is from normalizing blood levels of 25-OH-vitamin D3 levels to 50-70 ng/ml. I'm unable to tell you why this occurs, but I am convinced that it has added huge advantage. Raising blood vitamin D levels to normal carries enormous implication: reduction of colon and prostate cancer risk, reduction of blood pressure, sensitization to insulin, prevention of arthritis and multiple sclerosis, and--I believe--control over coronary plaque calcification and growth.


Watch for a profile of one of our latest success stories, a physician who was experiencing 20% per year plaque growth three years in a row until he followed the Track Your Plaque approach and promptly experienced an 18% reduction in heart scan score. You'll find it in our next newsletter. To subscribe, go to the www.cureality.com homepage and click on the free book download.

I need to do more procedures!

I sat next to a cardiology colleague of mine last evening at a dinner. He was lamenting the fact that, because of changes in hospital affiliations of his several-member cardiology group, he'd seen a drop in the volume of heart catheterizations he was performing.

"I'm used to doing 5 cases a day! Now I'm down to 3 or 4 a day." He went on to tell me how he's working to increase his volume. "I'm branching out into doing carotid stents and anything I can find in the legs." He also described how he was cultivating referring physicians to send him more procedural patients.

Now, this colleague, I believe, is a hard-working, conscientious physician. But his attitude reflects the perverse logic of many physicians: I need to do more procedures, not because it benefits patients, but because that's what I want to do--to be busy, make more money, acquire more experience, build my ego, etc.

Doing more procedures has nothing to do with an altruistic goal of doing more good for society. It is purely for selfish reasons. Beware of this shockingly common, pervasive attitude. There's a proper time and place for heart procedures, or any procedure, for that matter. But feeding your doctor's ambitions is not a good reason.

Fast food and quick plaques

Such was the title of Dr. William Roberts' editorial back in 1987 discussing the health effects of fast foods.

If you need a graphic illustration of the extraordinarily damaging health effects of fast foods, take a look at trends in mainland China. A recent editorial in the American Journal of Cardiology written by Dr. Tsung Cheng of George Washington University makes several points:

--The popularity of fast food in China is booming, with Chinese now more likely than Americans to eat in a fast food restaurant. Each week, 41% of Chinese eat in a fast food restaurant at least once, compared to 35% in the U.S.

--Average total cholesterol levels have skyrocketed from 150 mg/dl in 1958 to 230 mg/dl in 2003.

--50% of Chinese with normal blood pressure in 1992 are now hypertensive.

--Hospitalization for heart disease rose from the 5th most common diagnosis to #1, now constituting nearly 50% of all hospital admissions.

McDonald's and KFC dominate the fast food landscape in China, but up and coming competitors are growing at exponential rates. A media conversation that will surely be reported in the near future is the boom in obesity and diabetes in China as these trends express themselves in weight gain, as it has in the U.S.


I hope you've all seen the entertaining but frightening documentary, Supersize Me chronicling the travails of 30-something Morgan Spurlock as he eats all his meals for one month at McDonald's restaurants in 20 cities. Though focusing on McDonald's, the movie is about a lot more than that. It paints a picture of how fast food as well as food manufacturers in general have changed--distorted--our eating habits.

If you haven't yet seen it, I would urge you to do so and watch it with the rest of the family. My kids (ages 8, 12, and 14) were shocked (and entertained) and they haven't set food in a fast food restaurant since.

But fish oil is too drastic!

Ted is a 74-year old physician, still conducting a busy practice. He came to me because of some vague fatigue and breathlessness. He also got himself a CT heart scan. His score: 1277.

When he came to my office, he clearly became breathless with just minimal effort. A stress test confirmed an area of much reduced blood flow to the front of his heart muscle. A heart catheterization identified a severe blockage of 95% in the left anterior descending artery and a stent was inserted. This resulted in relief of Ted's symptoms.

When Ted returned to the office after his discharge from the hospital, I advised him that some major changes in his prevention program were overdue. "After all, Ted, you were lucky this time. You were provided some warning. It doesn't always work that way." So I advised Ted to make a number of changes in his diet (he was following an old-fashioned, and quite self-destructive, low-fat diet), have lipoproteins assessed to identify hidden causes of coronary plaque, and take fish oil.

"Fish oil? I don't think so. That's pretty drastic!" he exclaimed. He felt that all the nutrition he needed was contained in the food he ate. Even after several lipoprotein abnormalities were uncovered like small LDL and excessive after-eating (post-prandial) patterns, he still resisted any changes. "I'm going to just wait and see how I feel. But I will take aspirin."

Such is the state of mind of the older physician: procedures are okay, low-fat diets prevent heart disease, and the Beatles are touring America. But fish oil? No way!

Unfortunately, Ted's attitude encapsulates the attitudes of many of my medical colleagues who don't share the excuse of age. They still practice the woefully outdated ways of physicians like Ted, clinging to notions of "balanced diets", nitroglycerin representing a rational treatment for coronary disease, and adequate rest being curative for heart conditions.

The world is changing. We're entering an exciting age of self-empowerment. The ridiculous notions of health practiced in the last half of the 20th century are withering and dying. Poor Ted. He must view the current healthcare landscape as increasingly incomprehensible to a guy who started out delivering babies at home. Perhaps, in some respects his world was better. But, in coronary disease prevention, attitudes like this need to go the way of steam engines and racial segregation--good riddens!

A curious case of coronary plaque regression and progression

John received a coronary stent in 2003 following a small heart attack. The artery causing the heart attack was a diagonal artery, a branch of the important left anterior descending coronary artery (in the front of the heart). His cardiologist at the time advised him, "Take Lipitor and we'll do stress tests every year. Come back if you have any more chest pain." That was the full extent of John's preventive care.

He came to me for a second opinion and, naturally, we enrolled him in our program. We began by obtaining a CT heart scan score, though we had to exclude the stented diagonal artery. His score: 471. At age 51 and physically active, John had 7 additional abnormal lipoprotein patterns identified. We counseled John on better approaches to food choices, his weight target, fish oil, and correction of all lipoprotein patterns.

Two years later, John's repeat heart scan score: 511 . John was initially disappointed with the increase. But a closer look yielded something entirely different: the right coronary artery and circumflex (no stents) showed 20-30% reduction in their scores. The increase in total score was entirely due to substantial increase in score just outside the stent, in the left anterior descending artery. In other words, all of the increase in score was due to growth of a plaque at the mouth of the stent in the diagonal artery.

This is curious: profound regression of plaque with a big drop in score in the "un-instrumented" arteries, but tremendous growth of plaque and an increase in score in the "instrumented", or stented, artery, all in the same person's heart.

I don't know how controllable this specific situation in the left anterior descending and stented diagonal will be, and I'm unaware of any specific strategies to impact on this situation. The whole world of tissue growth within or around stents is littered with high hopes followed by failures. The drug-coated stents have been the only partial solution to this problem, though that's precisely the sort of stent John received.

Is there a message here? The message I take from this is that you and I should work like mad to keep from receiving a stent. Once they're implanted, we have less control over our coronary future. We can indeed regress ("reverse") coronary plaque. But we may not be able to regress the sort of tissue that grows in response to a stent implantation.

When is a heart scan score of 400 better than 200?

Imagine two people.

Tom is a 50-year old man. Tom's initial heart scan score is 500--a bad score that carries a 5% or more risk for heart attack per year.

Harry is also 50 years old. His heart scan score is 100--also a concerning score but not with the same dangers of Tom's much higher score.

Tom follows a powerful heart disease prevention program like the Track Your Plaque program. He achieves the 60:60:60 lipid targets; chooses healthy foods; takes fish oil; raises his blood vitamin D level to >50 ng/ml, etc. One year later, Tom's heart scan score is 400, a 20% reduction from his starting score.

Harry, on the other hand, doesn't understand the implications of his score. Neither does his doctor. He's casually provided a prescription for a cholesterol drug by his doctor but nothing else. One year later, Harry's heart scan score is 200, a doubling (100% increase) of the original score.

At this point, we're left with Tom having a score of 400, Harry with a score of 200. That is, Tom has twice the score, or 200 points higher, compared to Harry. Who's better off?

Tom is better off. Even though he has a significantly higher score, Tom's plaque is regressing. It is therefore quiescent with its components being extracted, inflammation subsiding, the artery is in a more relaxed state, etc.

Harry's plaque, in contrast, is active and growing: inflammatory cells are abundant and producing enzymes that degrade supportive tissue, excessive constrictive factors are constantly causing the artery to pinch partially closed, fatty materials are accumulating and triggering a cascade of abnormal responses.

This is therefore a peculiar situation in which a higher score is actually better than a lower score. It reflects the power of adhering to a preventive program. It also demonstrates how two scans are better than one because they show the rate of increase given a particular preventive approach.

Warning: Your cardiologist may be dangerous to your health!

Warren had a moderately high LDL cholesterol for years and took a statin drug sporadically over the past 7 years. Finally retired from a successful real estate investment business, he had a CT heart scan to assess his heart disease status.

Warren's score: 49. At age 59, this put him in the lowest 25%, with an estimated heart attack risk of 1% per year or less--a relatively low risk. At this heart scan score, the likelihood of an abnormal stress test was less than 3%, or a 97% likelihood of a normal stress test. Most would argue that a stress test would be unproductive, given its low probability of yielding useful information. In other words, there would be a 97% probability of normal blood flow through Warren's coronary plaque, and less than 3% likelihood that a stent or bypass surgery would be necessary.

Warren was also without symptoms. He hiked and biked without any chest discomfort or breathlessness. A prevention program like Track Your Plaque to gain control over future coronary plaque growth was all that was necessary and Warren had high hopes for a life free of heart attack and major heart procedures.

Then why did he go through a heart catheterization?

Warren did indeed undergo a heart catheterization on the advice of his cardiologist. When I met Warren for another opinion, it became immediately obvious that the heart catheterization was completely unnecessary. Then why was this invasive procedure done? There can only be a few reasons:

--The cardiologist didn't truly understand the meaning of the heart scan score. "We need to do a 'real' test."

--The cardiologist was terrified of malpractice risk for underdiagnosing or undertreating any condition, no matter how mild.

--The cardiologist wanted to make more money. Talking about heart disease prevention is a money-saving, not a money-making, approach.

Regardless of which of the three motivations was at work here, they're all inexcusable. A disservice was done to this man: he had an unnecessary procedure, incurred some risk of complication in the process, and gained nothing.

An ignorant or profit-seeking cardiologist is worse than the unscrupulous car mechanic who, when presented with an unknowing car repair customer, proceeds to replace the carburetor and rebuild the engine when a simple 5-minute adjustment would have taken care of the problem.

I estimate that no more than 10% of my colleagues follow such practices, but it's often hard to know who is in that 10%. Ask pointed questions: Why is the catheterization necessary? What is the likelihood of finding information useful to my health? What are the alternatives? (By the way, the emerging CT coronary angiograms can be a useful alternative in some situations like this.)

Track Your Plaque is your source for credible information. Be well armed.

I don’t have high blood pressure!

Art undeniably had high blood pressure.

At age 53, he had all the “footprints” of high blood pressure that’d been present for at least several years: abnormal patterns by EKG, abnormally thick heart muscle, and an enlarged aorta by an echocardiogram. These sorts of changes require many years to develop. Art’s blood pressure was 140/85 sitting quietly in the office.

“That’s about what my primary care doc gets, too. Whenever it’s high, he takes it again after a few minutes and it always comes down.”

Art tried to persuade me that his blood pressure was high today only because of the traffic on the way into the office. When I dismissed this as a cause, he insisted that stress he’d been suffering because of his teenage son was the cause. “I just know I don’t have high blood pressure!”




Who’s right here? Well, Art is not here to defend himself. But one fact is crystal clear: you cannot develop complications of high blood pressure unless you truly have high blood pressure!

In other words, Art’s abnormal changes in heart structure (thickened heart muscle and enlarged aorta) are serious changes that develop only with years and years of sustained blood pressure at least as high as the one in the office. His blood pressure almost certainly ranged much higher at other times, particularly during stressful situations like waiting in the check-out line at the grocery store, watching a suspenseful TV show, petty irritations at his job, and on and on.

Blood pressure does not have to be high all the time to generate complications of high blood pressure. It can be sporadic, variable, even occasional. Clearly, sustained high blood pressure is the worst situation that creates adverse consequences more quickly. But blood pressure that wavers from low to high only some of the time can still, given sufficient time, cause the very same unwanted effects.

Control of blood pressure is crucial to your coronary plaque control program. Blood pressure may be boring: not as exotic, say, as lipoproteins, and not as fun as talking about nutritional supplements. But neglect blood pressure issues and you will not gain full control over coronary plaque growth—-your heart scan score will increase.

Watch for an upcoming Special Report on the Track Your Plaque Membership website, a full detailed discussion of how to recognize when blood pressure is an important issue, along with a full discussion of nutritional methods to reduce it, often sufficient to minimize or eliminate the need for medication.
Letter from the insurance company

Letter from the insurance company

Claudia got this letter from her health insurance company:

Dear Ms. ------,

Based on a recent review of your cholesterol panel of January 12, 2011, we feel that you should strongly consider speaking to your doctor about cholesterol treatment.

Reducing cholesterol values to healthy levels has been shown to reduce heart attack risk . . .


Okay. So the health insurer wants Claudia to take a cholesterol drug in the hopes that it will reduce their exposure to the costs for her future heart catheterization, angioplasty and stent, or bypass surgery. This is understandable, given the extraordinary costs of such hospital services, typically running from $40,000 for a several hour-long outpatient catheterization procedure, to as much as $200,000 for a several day long stay for coronary bypass surgery.

So what's the problem?

Here are Claudia's most recent lipid values:

LDL cholesterol 196 mg/dl
HDL 88 mg/dl
Triglycerides 37 mg/dl
Total cholesterol 291 mg/dl

By the criteria followed by her health insurer, both total and LDL cholesterol are much too high. Note, of course, that LDL cholesterol was a calculated value, not measured.

Here are Claudia's lipoproteins, drawn simultaneously with her lipids:

LDL particle number 898 nmol/L
Small LDL particle number less than 90 nmol/L (Values less than 90 are not reported by Liposcience)

LDL particle number is, by far and away, the best measure of LDL particles, an actual count of particles, rather than a guesstimate of LDL particles gauged by measuring cholesterol in the low-density fraction of lipoproteins (i.e., LDL cholesterol). It is also measured and is highly reproducible.

To convert LDL particle number in nmol/L to an LDL cholesterol-like value in mg/dl, divide by ten (or just drop the last digit).

Claudia's measured LDL is therefore 89 mg/dl--54% lower than the crude calculated LDL suggests.

This is because virtually all of Claudia's LDL particles are large, with little or no small. This situation throws off the crude assumptions built into the LDL calculation, making it appear that she has very high LDL cholesterol.

Do you think that Big Pharma advertises this phenomenon?

Comments (24) -

  • Anonymous

    3/18/2011 1:49:34 AM |

    Dr. Davis,

    I think total cholesterol should be 290, perhaps, and not 29?

    I have started using the lipoprofile in my practice.  Patients with relatively normal lipid profiles are startled with the results.  Getting them to make any changes is another thing, but I will keep trying.

    Teresa

  • Anne

    3/18/2011 7:42:37 AM |

    I live in the UK under the National Health Service but I also  have private medical insurance. I know that neither my private medical insurance company, nor the NHS itself, know my cholesterol numbers - they are known only to the lab, my doctors and me. How is it that patient information, which should be confidential, is given to insurance companies ? I find that a very worrisome aspect of this.

  • Kris @ Health Blog

    3/18/2011 8:08:05 AM |

    I find it kind of strange how obsessed american doctors are with cholesterol levels, in my country (Iceland) this is not such a big deal.

    It's almost as if the doctors in America are going out of their way to find something wrong with their patient so that they can treat it.

    For example high cholesterol, thyroid disorders. I pretty much never hear people talk about those things here.

  • Anonymous

    3/18/2011 11:55:23 AM |

    and when she refuses to do as ordered, her insurance company will find out about that, and will then terminate her coverage. Anybody want to make a bet? So much for privilege and confidentiality in the ole US of A.

  • Peter

    3/18/2011 1:29:41 PM |

    Seems very odd, I've had health insurance fornforty years, and they've never given me any advice or indication that they read my lab results.

  • Marg

    3/18/2011 2:22:16 PM |

    Some insurance companies routinely require physical examinations before they will write life insurance and are happy to find any reason not to write the insurance. Could this have been a life insurance company?

  • Galina L.

    3/18/2011 2:33:23 PM |

    What do you think is the best line of defense for the patient? My husband has similar calculated LDL - 181, the rest of numbers are excellent and he is in a very good health at 50 years old. Blood pressure is excellent(115/65), pulse is 45 at rest, fasting BS is 76. Our doctor admits it, but recommends Lipitor anyway. Our health insurance is about to be changed and it makes me worry about perspective pressure from insurance people on my husband to take that Lipitor.

  • Anonymous

    3/18/2011 2:37:48 PM |

    How does an individual give honest answers on health questionaires when applying for new or additional life or health insurance?  If they ask my PCP they would be told that I am low risk for heart attack.   If they look at my CT scan score they would see that I am in the 90th percentile - high risk.
    These are hypothetical questions at this point but my inclination would be to base my answer on my PCP's opinion rather than my calcium score, in part because medical insurance does not cover CT scans (apparently because they don't consider them to be a reliable predictor of risk) and in part because I have taken steps to significantly reduce my risk.

  • Anonymous

    3/18/2011 2:41:21 PM |

    Let's name names!  I have coverage by United Health Care through an employer.  I have gotten several letters in the past couple of years telling me I NEED this test, or that that test, to maintain my good health!  [However, never anything about the value of lipoprofile testing!]

    I consider this an abhorrent practice, an invasion of my privacy, and totally reject their "advice".  Advice should be coming from my doctor, and in fact it is.  I don't need their nurse "case manager" nor this advocacy for excessive testing.

    There's nothing like a letter from an insurance company to raise blood pressure!

    madcook

  • Barbara

    3/18/2011 4:35:25 PM |

    It is very disturbing to me that 1) her health insurance has access to her medical records and 2) that a for-profit organization is getting involved in her healthcare. Having moved from Australia about five years ago, everything about American health care disturbs me. I trust no one; they all seem to be desiring a profit and therefore paperwork is their main concern, not patient care, health, or longevity.

  • Jonathan

    3/18/2011 6:31:50 PM |

    My last test showed calculate LDL at 208, however the one from three months ago was "directly measured lipid" and showed 263 LDL direct, so might the calculated version be wrong in either direction?  I have pattern A and am FH.

  • susan

    3/18/2011 6:53:21 PM |

    I'm for naming names too!  I have Aetna health insurance through my employer. I don't get letters from them, but I get emails. Just today, I told my email program to automatically delete any further emails from the "Simple Steps to a Healthier Life" program. Plus whenever I sign into the online portal, I get nagged to have all kinds of tests, fill out questionnaires, and join health improvement programs.  I got so tired of the demand that I "fill out a health assessment questionnaire" I finally gave in, hoping it would be removed from the page. It just opened a new can of worms: now I have a half dozen new "suggestions" on my "to do list". Bah humbug!

    I'm of the "live and let live" school.  Why go looking for trouble?  As long as I'm not having symptoms, I feel no need to undergo all of these tests.

    Thank God my doctor is beginning to understand that I'm not going to be taking any of those Pharma-pushed poisons just because my lab results don't meet someone's criteria. Once again, I say Bah humbug!

  • Dr. William Davis

    3/18/2011 7:15:53 PM |

    Thanks for catching that, Teresa.

    It is indeed an eye-opener, isn't it?

  • Dr. William Davis

    3/18/2011 7:17:42 PM |

    Anne and Kris--

    Fascinating non-American perspectives.

    Insurance companies have incredible info on us. I'm always surprised more is not made of this issue.

    Remember: The more they know, the better they are at denying coverage.

  • Anonymous

    3/18/2011 8:19:22 PM |

    Dr. Davis,

    I didn't want to put this here (not sure if I could post it elsewhere) , but I thought you would find this interesting if you haven't seen it yet.

    http://www.psychologytoday.com/blog/p-nu/201103/cardio-may-cause-heart-disease-part-i

    RyanH

  • Anonymous

    3/18/2011 8:25:47 PM |

    Anonymous1 said:
    "I have coverage by United Health Care through an employer"
    Ah, United. I have Oxford/United. '
    Several years ago, when everyone at Oxford (and patients) worked toward a noble goal of "salary" for their CEO of 1.6 Billion a year, they sent me several letters suggesting that I have basic check up. I followed their suggestion. Then, I started to receive letters ... refusing to pay - 100% refusal. Each time, I had to call and ask nicely and politely: "Are you nuts?" They paid.

  • Dr. William Davis

    3/18/2011 10:52:16 PM |

    Though I am not in the habit of defending health insurers, I have found that they tend to provide a benign "you should speak to your doctor about . . ." kind of approach.

    I often wonder, however, if at some point they start to be more coercive. Something like: "You should strongly consider a cholesterol-reducing drug. We anticipate that your premiums may be higher if you do not."

    That would be scary.

  • Anonymous

    3/19/2011 12:50:53 AM |

    Ah, I should have continued.
    In a way, Oxford achieved their goal. What they paid was minimal, but they avoided bigger cost at that time.
    They scared me to death - if they don't pay for what they send to ( with letters firmly printed) which is basic, stated officially in some book as my right, they probably won't pay for anything else. I neglected all symptoms and asked for medical attention when I really didn't have any choice (and in a slightly new climate)
    I was diagnosed with two quite serious conditions - neither curable, but one was preventable and the other was at this time preventable to a degree. I mean the condition would be one only (the result of "bad" accumulation +genes?), less serious and correctable.

  • Contemplationist

    3/19/2011 3:16:40 AM |

    An insurance company has a tremendous incentive to reduce its costs and hence a great incentive to find out the truth. If they are not, it means that something is fishy. Why are insurers not commissioning their own studies? Are they not allowed to? Is it the regulators who are holding them back? Or are they actually stupid?

  • Anonymous

    3/19/2011 3:59:39 AM |

    I have not had any insurers say they know what a patient's lipid numbers are, but they can pretty well tell from claims data what tests have been done, and what medications are prescribed.

    We get faxes all the time recommending that meds be changed or weaned or made as needed rather than routine.  Yes, I know Mrs. Jones has been on an ulcer medicine for 6 months, and we should try to wean it.  What they don't know is that she won't change her diet and lose some weight, so maybe her symptoms would stop, and her symptoms get horribly worse without her ulcer medication.

    Teresa

  • jkim

    3/19/2011 2:57:41 PM |

    Dr. Davis,

    Based on Claudia's numbers, I guess I should expect a letter from my insurance company and a prescription from my doc for a statin. I won't fill the scrip.

    I'm 65, slim, eat VLC, and haven't been afraid of  saturated fat. But I just got my labs and TC was 476, HDL 146, Triglycerides 79 (I'd had wine with dinner--they're usually in the 30s), and LDL 314!!!

    How worried should I be about these numbers?

  • susan

    3/21/2011 1:57:39 AM |

    Hey Dr. Davis,

    At my last visit, my doctor mentioned my lipid numbers; but even he had to admit that my LDL (157) and TC (234) had improved (from 177 and 255), and the rest of my labs were all WNL. I generally eat low carb -- other than my recent indulgence in mini PB cups -- so I suspect that, as you indicated, the actual numbers are better than the official calculated numbers.

    My doc didn’t try to prescribe any meds this time. But at other visits he’s tried to guilt me into following the accepted guidelines by telling me his “performance score” is determined by how well he adheres to those guidelines, including prescribing all the meds and tests recommended by the so-called experts for a patient of my age with my lab results.

    I also fear that things are changing in this regard – and not for the better. Our government has now decided that we all must have insurance or pay a fine. If I refuse to follow the recommended guidelines, either my insurance company or my doctor, or both, may “fire” me. The truth is, I really don’t give a fig which entity it is (doctor, insurance company, or government panel) that tries to hector me into following guidelines promulgated by “experts” who believe in the lipid hypothesis. I simply choose to believe that I’m in charge of my body and that I get to determine whether to take a recommended med or have a recommended test.

    As for insurance companies getting lab results, I don’t know whether the doctor’s office or Quest Labs has been feeding my results to my insurance company, but when I look at my online health info on the insurance company’s web site, all my lab results are listed. And I’m sure the company is basing at least some of its many recommendations on those results.

    I must admit, having the results online makes it easy for me to keep track of them; but given the ease with which records can be hacked, I fear for my health privacy. And I resent the big brother attitude of the insurance company. I'm a well-informed, healthy adult. Treat me like one.

  • ShottleBop

    3/21/2011 4:50:53 AM |

    Just this past week, my insurance company (Aetna), which has paying for my test strips for the past year and a half, sent me a letter suggesting that I might have diabetes, and should talk to my doctor.

  • jkim

    3/21/2011 1:39:31 PM |

    Hi Dr. Davis,

    I spent the weekend reading your older posts about LDL. I guess I need to get a test done to determine my LDL particle number before my doc and I have a discussion. Thanks for posting that info in such detail on your blog.

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