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:

• Another Track Your Plaque success story !
  We prove a skeptic wrong!
• Fortune Teller
  Is your doctor passing him or herself off as a fortune teller? I’m not referring to the turban or the crystal ball, but the cholesterol panel that is being used to improperly predict your future.
• Second heart scan
  The significance of a second heart scan can only be judged by comparing it to the first. Otherwise, you’ll be misled.

Hello, everybody!

Glowing reports continue to fill the newspapers and TV reports about the wonderful pictures obtained with CT coronary angiograms. But they’re also creating a lot of confusion.

A CT heart scan is not the same as a CT angiogram. Although they are generated on the same scanning device, they are two different tests.

A CT heart scan indirectly measures the total amount of atherosclerotic plaque in your heart’s arteries by precisely measuring calcium. It is performed with a modest quantity of radiation and without a need for an IV nor x-ray dye. Its relatively low radiation exposure and precise nature make it perfect for use as a plaque tracking tool over the years of your life.

A CT angiogram does not precisely quantify the volume of plaque in your arteries. Instead, it measures the diameter reduction of your artery, the “percent blockage,” not the longitudinal or lengthwise sum of plaque. It is, nonetheless, a very easy and convenient test to determine if an area of poor blood flow is present. Thus, is it a useful adjunct to stress tests, particularly if they yield equivocal results, and may help reduce the number of unnecessary heart catheterizations. They do, however, require a substantial quantity of radiation, approximately 100 chest x-rays worth. Scan manufacturer engineers are working frantically to remedy this situation.

Some centers will routinely perform a CT heart scan and provide you with a calcium score during a routine CT angiogram. If they do not, I would recommend that you insist that they include one. After all, if you’re told that “you’ve got nothing to worry about now. You’ve got only a 20% blockage,” you do not want to undergo repeated CT angiograms to track it―too much radiation, too little precision. But the simple calcium score will prove useful for tracking. You’ll be grateful for this score in the coming years as you compare future scores―hopefully much lower!
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Track in health!

Dr. Davis

Another Track Your Plaque success story

When Ron first received the result of his heart scan, he started having pain in his chest. He became aware of pounding when he sat still. In fact, he became acutely aware of every little blip or flip of his heart. In short, it kind of made him nuts.

After all, Ron knew for years that he had several substantial abnormalities in his cholesterol panel. Ron’s triglycerides ran as high as 700 mg/dl, HDL as low as 26 mg/dl. So when he had his first heart scan at age 53 and it showed a score of 135, neither Ron nor his doctor were surprised.

Nonetheless, such concrete evidence of potential for heart attack really shook him up. Ron’s dad had experienced his first heart attack at age 52; his second proved fatal. Ron was no stranger to the dangers of heart disease.

I met Ron because of the chest pains. Although the statistical likelihood that a heart scan score of 135 was the culprit for his chest pain was rather small (5%), we had Ron undergo a stress test. It proved normal with no evidence of poor blood flow in any area of the heart. Curiously, just knowing this provided Ron with relief of his symptoms.

We proceeded to study Ron’s lipoprotein patterns more deeply. Not surprisingly, a number of important hidden factors were identified beyond the high triglycerides and low HDL, including a flagrant excess of IDL (the after-meal persistence of dietary fats), small LDL particles, zero large healthy HDL, and lipoprotein(a).

Ron initially took our advice and added high dose fish oil, sharply reduced processed carbohydrates and saturated fats, lost a few pounds, added niacin. But he progressively began to doubt that he would ever change the course of his future and became obsessed with the notion that he was destined to follow the footsteps of his father. He ended up stopping many of the strategies we started, regained the lost weight and more. I urged Ron to get another heart scan. Score: 350, representing a 159% increase over two years, a much greater rate of plaque growth than average. Now we’re starting to get worried.

But then something happened. I’m not sure what internal dialogue Ron had, but he really started to apply himself. He resumed all the changes in lifestyle we discussed, exercised, added vitamin D, took his fish oil, reduced his weight 15 of the 25 lbs we advised, etc. One year later, yet another heart scan. This time, the score: 253, a 28% decrease.

Dr. Davis Comments:

There may be a number of important lessons Ron’s experience might teach us.

One, attitude is everything. Just as we discussed in last month’s newsletter, being optimistic can spell the difference between dropping your score hugely and watching it rise while you watch helplessly. Ron’s change in attitude was undoubtedly a crucial factor.

Two, coronary disease is, for many or perhaps most of us, a very controllable process. Once you have the right tools combined with the proper attitude, dramatic results are possible. For Ron, it was the difference between an extraordinary rate of plaque growth vs. a precipitous amount of reversal.

You can’t argue with success.  

Fortune Teller

Is your doctor a fortune teller? Do you sit around a table, hands joined, to peer into the crystal ball to foresee your health future? Or perhaps decipher your fate from the layout of the Tarot cards?

I hope you said no. But that’s exactly what your doctor does when he or she tries to predict your future with the commonly accepted tea leaves called cholesterol. Whenever your doctor uses cholesterol values—total, LDL, HDL, triglycerides—to judge your heart disease risk, he/she is trying to act as your fortune teller.

In some states, fortune telling is illegal, a misdemeanor. The New York State law books say:

A person is guilty of fortune telling when, for a fee or compensation which he directly or indirectly solicits or receives, he claims or pretends to tell fortunes, or holds himself out as being able, by claimed or pretended use of occult powers, to answer questions or give advice on personal matters or to exorcise, influence or affect evil spirits or curses; except that this section does not apply to a person who engages in the aforementioned conduct as part of a show or exhibition solely for the purpose of entertainment or amusement.

Rather than occult powers, your physician claims to use "medical judgment" to tell your fortune. Except for that distinction, it might be construed as a misdemeanor.

Why all the “know your numbers” urgings from the media? Whenever there’s a question of why, look for who gains from the outcome. You got it: drug manufacturers. The tens of billions of dollars of statin drug opportunity is driving it. Your poor hapless doctor, used to the days when drug companies provided educational information without all the marketing, helplessly goes along.

Let's take three typical examples. None of the three is taking any cholesterol drugs.

1) 58-year old Laura has a high LDL of 195 mg/dl. Her HDL is 52 mg/dl, triglycerides 197 mg/dl, and she has high blood pressure. Does Laura have heart disease?

2) 51-year old Jonathan has an LDL of 174 mg/dl, HDL 34 mg/dl, triglycerides 156 mg/dl. He is 30 lbs overweight. Does Jonathan have heart disease?

3) 71-year old Marian has LDL cholesterol of 135 mg/dl, HDL 84 mg/dl, triglycerides of 67 mg/dl. Does Marian have heart disease?

None of the three have symptoms. They all feel well. None has an impressive family history of heart disease and none are smokers or have diabetes.

Can you tell who has heart disease and who doesn't? If you can, you're smarter than I am, because I certainly can't tell.

But your doctor tries to divine your future by looking at these numbers.

Do they know something that we don't know? No. It's a crude odds game, a guessing game—a guessing game that frequently comes up on the losing end for people either treated needlessly or treated inadequately, since your doctor never knew in the first place who truly had heart disease and who did not. The winner? Not the patient, of course, but the one who profits from the over-prescription of drugs—the drug manufacturer.

These are three real people. Laura, despite her high LDL, has no identifiable coronary heart disease. Jonathan has advanced coronary disease. These were his numbers just prior to his stent. Marian has a moderate quantity revealed by a CT heart scan score of 419.

Don't even try predicting your future from your cholesterol numbers. It simply can't be done. Every day, I see patients and physicians beating their heads over this dilemma. Telling your fortune using pretended occult powers is illegal. Telling your fortune using cholesterol numbers should be, too.

If you want to know if you have the atherosclerotic plaque that constitutes coronary disease, that's the role of the CT heart scan. Plain and simple.

Second heart scan and heart attack risk

 At first, Joe felt disappointed, defeated, and frightened. After his heart scan, a radiologist at the center told him that his score of 264 was moderately high. He told Joe that he was at elevated risk for heart attack and that a nuclear stress test was going to be required.

This left Joe feeling confused. After all he'd had a heart scan 18 months earlier and his score had been 278—5% higher.

I reassured Joe that the radiologist had not been aware that Joe had a prior heart scan. The radiologist didn't know that Joe's heart scan score had actually been reduced.

In fact, his risk for heart attack is not moderate, it is now very low, since Joe’s score had been reduced. While growing plaque is active plaque, shrinking plaque is inactive plaque. Inactive plaque poses far less risk for heart attack.

When you've had more than one scan, the risk for heart attack suggested by the score takes a back seat to the rate of change of your score. In other words, even though Joe's score of 264 represented moderate risk for heart attack (of 3% per year, roughly 30% over 10 years), this level of risk no longer held true, since it represented a 5% decrease over a previous score.

Joe's risk for heart attack is probably close to zero, provided he remains on the program that allowed him to reduce his plaque score. ALWAYS view your second (or any subsequent) heart scan score in the context of your previous score, not in isolation.

Interested in becoming a Track Your Plaque Member?

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Track Your Plaque Members: Watch for our upcoming Special Reports

Watch for our upcoming Special Reports on:

C-Reactive Protein: The Track Your Plaque Perspective
Useful test or just another useless piece of data? When you know the right answers, CRP can help in your plaque control program.

Matrix Metalloproteinase—What is it and why is it important?
There’s Matrix metalloproteinase is increasingly being blamed for the process of plaque rupture that triggers heart attack. Here’s the Track Your Plaque Special Report on how this important factor may provide advantage in further reducing your risk for heart attack.

Vitamin K2—Newest addition to your Track Your Plaque program?
Vitamin K2 has proven to be a predictor of future heart attack. But what should we do about it? Is there enough information to justify adding it to your program?

Aspirin: How it works, how much to take
Conventional practice dictates that aspirin benefits some people, fails to benefit others. Here we cut through the clutter and discuss whether or not aspirin holds any benefit for us in the Track Your Plaque approach.

Copyright 2007, Track Your Plaque