|
Track Your Plaque shows how to use
CT heart scans as the 1st step in a proven program to slow, stop, even
REVERSE heart disease!
In this issue:
Hello, everybody . . .and Happy New Year!!
  Over
the past year, heart scanning has made incredible strides in being
recognized as the number one method to uncover hidden coronary heart
disease. The American Heart Association (AHA), after years of political
tap-dancing, finally endorsed the usefulness of the technology.
If CT heart scans are so great, why did it take the American Heart
Association years to back the technology? You’d think that an
organization whose mission is to educate and promote the concept of
heart disease prevention would jump on the idea of a technology that
promises to make diagnosis of the number one killer of men and women in
the U.S. a snap.
I’m not entirely certain why the delay. Personally, I find it
inexcusable. Statements published three years ago explaining why the AHA
did not yet see fit to back CT heart scans hinted of political
in-fighting and backstabbing. That may be the bright side. On the dark
side, it might be that the deeply-entrenched forces of the status quo in
heart care—hospitals, the medical device industry, and various other
entities that profit from the vast over-use of hospital
procedures—feared a drop in the use of major heart procedures. Thus, the
delays, the hems and haws, the excuses. But the truth finally won out.
Looking back over the 10 years that I’ve been involved with heart scans,
I see just how far we’ve come. But there’s more to learn. The most
fascinating and exciting area is how we can use CT heart scans not as
just tools for identification of early heart disease, but as a tool to
STOP heart disease in its tracks, a tool for tracking and for reversal.
Track in health!
Dr. Davis
Another Track Your Plaque
success story: A healthy beginning to a new retirement!
Joe fidgeted during our entire first meeting. As we
talked, I began to understand why he was so anxious.
Life had recently thrown Joe several curve-balls: First, a series of new
responsibilities were thrust on him as plant manager at his workplace,
changes that doubled his stress level which had been high to begin with.
Second, his heart scan score of 278, which shocked him, since three
stress tests over the past seven years had all been normal. Third, once
he learned of his heart scan score, he stopped smoking the pack and a
half of cigarettes he’d smoked for 30 years since age 27. He was now in
the midst of unbearable nicotine cravings.
On the bright side, the added stress at work caused Joe to consider
finally taking his retirement, something he’d been contemplating for the
past two years.
At 5 foot 8 inches and 197 lbs., Joe was by no means obese. But he did
have a prominent abdomen. His primary doctor had diagnosed adult
diabetes two years earlier and prescribed oral diabetes medication. On
learning of Joe’s heart scan score, his doctor immediately added a
cholesterol drug.
When I met Joe, he was clearly prepared for either more of the same,
i.e., several prescriptions, or a trip to the hospital. But, instead, we
began with a lipoprotein analysis (NMR). This showed (while on Vytorin,
a combination cholesterol drug):
- Small LDL―comprising 90% of all LDL particles.
- HDL 49 mg/dl―while not terrible and even above average for a male (42
mg/dl), still below the Track Your Plaque target of 60 mg/dl.
- Lipoprotein(a) 103.5 nmol/l―moderately high.
- C-reactive protein 1.7 mg/l―reflecting hidden inflammation.
Despite Joe’s diabetes, his triglycerides were just slightly above our
target (≤60 mg/dl) at 88 mg/dl, likely due to the triglyceride-reducing
effect of his diabetes medications.
Note that Joe showed the dreaded combination of lipoprotein(a), or Lp(a),
and small LDL. This is probably the highest risk combination possible.
And, of course, Joe’s a guy who smoked for 30 years, making it even
worse, and now had diabetes. That’s a really bad profile of risk.
I reassured Joe that the smartest move he could have possibly have made
was to stop smoking altogether, once and for all. We discussed some ways
to deal with the anxiety and nicotine cravings.
It was clear that, despite being just a few pounds over his ideal
weight, it was enough to generate diabetes, small LDL, and a borderline
low HDL. So I urged Joe to drop from 197 lbs to 165–170 lbs. He would
best accomplish this by reducing, even temporarily eliminating, the
amount of processed carbohydrates he ate, particularly wheat products.
He also added 45 minutes of walking every day, along with dance lessons
with his wife.
I asked Joe to add niacin, fish oil, and vitamin D sufficient to raise
his blood level to 50 ng/ml.
Twelve months later, Joe returned to the office. He was barely
recognizable: his face glowed with pride over the 22 lbs of weight loss
he’d accomplished. His enthusiasm was barely containable, stumbling over
his words as he recited all the new projects he’d undertaken in the
months since he’d taken his retirement.
His basic lipids were spectacular, all at the Track Your Plaque goal of
60:60:60. His blood sugar was normal with only one diabetes medication
remaining, and his primary doctor was considering discontinuing this, as
well. It was a perfect time for another heart scan.
Joe’s score: 264, a 5% decrease.
Dr. Davis Comments
I’ve seen it too many times: Someone works for 30 or 40
years, retires, and then the “big one” hits: a heart attack that
disrupts life just as you’re about to begin enjoying all the things
you’ve worked for. Next come hospitals stays, heart procedures, and an
uncertain future. Add the numerous medications necessary after heart
attack, the incapacity that stems from any heart damage incurred, and
the emotional trauma of a potential near-death experience. That’s no way
to begin a retirement.
Instead, Joe seized control of his heart disease and diabetes. He
transformed a disastrous profile of risk for heart attack to a benign
pattern essentially devoid of risk. By reducing his heart scan score and
minimizing, even eliminating, his diabetic patterns, Joe’s prognosis for
future health is immeasurably better than it might have been.
Men and women aren’t equal
Men and women are not the same—referring of course to
their heart scan scores. Let me explain.
.
Say we have a 55-year old male with a heart scan score of 100 and a
55-year old female with a score of 100. Both have the same amount of
scorable calcium in their coronary arteries, and thereby the same amount
of atherosclerotic coronary plaque. However, by “percentile rank,” i.e.,
how each person’s score compares to other people of the same age and
sex, the man is in the 50th percentile, the woman in the 90th
percentile.
Experience has shown that the man’s risk of heart attack is 2–3% per
year (roughly 20–30% over 10 years), the woman’s 4–5% per year (roughly
40–50% over 10 years). These risk measures are based on the percentile
rank. (If you would like to know your percentile rank and heart attack
risk, refer to the tables in chapter 2 of What Does My Heart Scan Show?
If you don’t have a copy, you can download a free copy from
www.trackyourplaque.com by
clicking on the upper right-hand corner of the homepage.)
How could this be? How can the very same quantity of atherosclerotic
plaque yield two different likelihoods of plaque “rupture”, or heart
attack?
It could be that atherosclerosis begins at a younger age (about 10 years
earlier) in males. While both have the same amount of plaque, the
woman’s developed in a shorter amount of time. Faster growing plaque may
be more prone to rupture. Of course, there are also differences between
men and women in risk profiles (e.g., men have lower HDL cholesterols by
about 10 mg/dl, on average), hormonal differences, etc.
So, if Mr. and Mrs. Jones, both 55 years old and both with the same
heart scan score, it’s Mrs. Jones that I’d worry about more, since she’s
in a higher percentile rank and is exposed to greater risk of heart
attack.
Unless, of course, she follows the Track Your Plaque program!
Suffocating from overweight
(Reprinted from the December 2006 Heart Scan Blog)
This is a sample image from the heart scan of a 54-year
old, 212 lb, 5 ft 2 inch woman. The heart is the whitish-gray in the
center; lungs are the dark (air-filled) areas on either side of the
heart.
Note the massive amount of surrounding gray tissues that encircles the
heart and lungs. This is fat. At this weight, the diameter of total fat
exceeds the combined diameter of the heart and lungs. If we were to show
the abdomen, there would be even more fat. (The image shows the body not
well centered because the technologist centers the heart, since this is,
after all, a heart scan.)
This is a 55-year old, 151 lb, 5 ft 4 inch woman. Note the contrast in
the quantity of fat tissue surrounding the chest, a much more normal
appearance. Note that this woman is still around 25 lb over ideal
weight, but not to the extreme degree of the woman above.
Another curious observation: Note the whitish streaking and cloudiness
of the heavier woman's lungs. Heart scans are performed while holding a
deep inspiration (a deep breath inwards) to eliminate lung respiratory
motion during image acquisition. Nonetheless, the heavier woman's lungs
are not as fully expanded as the more slender woman. In other words, the
heavier woman cannot inflate her lungs as effectively as the thinner
woman.
Ever notice how breathless heavy people are? Some of this effect is just
being out of shape. But there's also the added effect of the abdominal
fat exerting upwards compression on the lung tissues, and the
constrictive effect of the encircling fat mass surrounding the chest. At
the beginning of inspiration, the chest fat exerts resistance of inertia
to inspiration. With each breath, the heavy woman must move 50 lbs or so
of surrounding fat mass just to inhale.
The heavier woman is, in effect, suffocating herself in fat.
The distortions to the human body incurred by extreme weight gain are
both fascinating and shocking. I hope you're breathing easily..
Interested in becoming a Track Your Plaque Member?
If you’re interested in finding out more about becoming
a Member of Track Your Plaque, go to the
Track Your
Plaque Member Benefits page. See why more and more people are
finding out that there are alternatives to the conventional answers (or
lack of answers!) for heart disease.
Track Your Plaque Members: Watch for our upcoming
Special Reports
Watch for our upcoming Special Reports on:
The Cuisine of Well-being: Healthful recipes from chef Michel Nischan
Author of the hit James Beard Award-winning cookbook, Taste: Pure and
Simple—irresistible recipes for good food and good health, Nischan is
credited with creating a “cuisine of well-being.” His creations focus on
a respect for pure, local, organic ingredients and their intense
flavors, without the use of highly processed ingredients. Chef Nischan
has generously chosen 11 dishes for Track Your Plaque Members, a bounty
of wonderful recipes for breakfast, lunch, and dinner. All are healthy
and all are delicious!
Double the horsepower of your statin drug
Good or bad, the statins have assumed a prominent role in many people’s
heart disease prevention program. If you’ve committed to including a
statin drug in your program, here are ways to double or even triple the
benefits.
Heart Hawk editorial and blog
What’s the hidden message in the recent drug-coated stent controversy?
Our very own Heart Hawk goes on the offensive against the status quo and
argues for a side of the argument you won’t hear in the media.
Also, see his new blog at
www.hearthawk.blogspot.com
Checklist: Small LDL
People sometimes complain that specific efforts to correct lipid and
lipoprotein patterns are often complex and confusing. We’ve assembled
several checklists for quick reference in your efforts to gain control
over your patterns. This month: small LDL.
Copyright 2007, Track Your Plaque
|
