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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!
  Attorneys
have a rough time of it.
We have many attorneys in the Track Your Plaque program: trial
attorneys, corporate attorneys, personal injury attorneys (quite a few,
curiously, of this rambunctious variety), tax attorneys, estate
attorneys, even a few judges.
I believe that they have it tougher than most when trying to reduce
their CT heart scan scores.
I suspect it’s the sort of abrasive, caustic stress they encounter that
is the nature of their work acting as advocates in tough situations,
going to battle, debating over the littlest details. We acknowledge that
optimism is a necessary ingredient in dropping your heart scan score.
It’s difficult to maintain a sense of optimism most of the time when
your life consists of confrontation.
I see the same extra difficulty in policemen, people in the security
industry, and, for less clear reason, academics. Perhaps it’s the
skepticism that is a necessary part of their jobs that spill over into
heart health.
Nonetheless, there have been notable successes among the groups. This
month’s Success Story is about an attorney who dropped his heart scan
score by a large number. Though Grady didn’t set a Track Your Plaque
record by percentage dropped, he started with a high score that
plummeted nearly 200 points that gave him the determination to go
farther.
It can be done—and we’re doing it!
.
Track in health,
Dr. Davis
Another Track Your Plaque
success story: Even a lawyer can do it!
I almost didn’t believe Grady when I met him.
Despite his heart scan score of 1151, he had a big smile on his face and
a firm handshake. He was eager to hear what I had to say. It was not
what I expected when I heard that Grady was a trial attorney.
Perhaps it helped his outlook to know that retirement was just 9 months
away at age 65.
Accompanied by his wife, who was clearly supportive of helping Grady
make any necessary change in food choices or lifestyle, we started with
lipoproteins and lab testing. Grady proved to have the usual panel of
lipoprotein suspects: small LDL with high LDL particle number, a
borderline low HDL of 42 mg/dl with lack of healthy large HDL, and
marginally elevated triglycerides accompanied by triglyceride-rich
lipoproteins.
Grady also proved to be profoundly deficient in vitamin D with a blood
level of 7 ng/ml (!!). This in particular surprised him, since he’d
spent the spring outdoors on some undeveloped land he owned, clearing it
several days per week, often working shirtless for hours in the sun.
Because Grady also showed a borderline high blood sugar of 122 mg/dl, he
set out on a weight loss program, principally focusing on reduction of
wheat products and other processed foods. He promptly lost 24 lbs.
17 months into the Track Your Plaque program, Grady’s cholesterol and
lipoprotein values were looking spectacular. Vitamin D blood level was
58 ng/ml. Repeat CT heart scan score: 944, an 18% drop! A competitive
sort of guy, Grady asked what the record drop in heart scan score was.
When I told him that the current record holder was 63% drop (though
starting with a lower score), he boldly declared, “I’m going to make it
drop to 500. You wait and see!”
Dr. Davis:
Despite his line of work, Grady had all the essential ingredients for
reduction of his heart scan score.
He achieved our 60-60-60 targets for conventional lipids, he eliminated
his pre-diabetic tendencies, he corrected all hidden lipoprotein
abnormalities, normalized his vitamin D level, and he maintained a sense
of optimism in life.
As a result, Grady overcame what was surely going to result in a major
heart attack, 2, 3, or 4 stents, or a bypass operation within the next
four years. Recall that the cardiovascular “event” rate of anyone with a
heart scan score >1000 is a deplorable 25% per year—a 1 in 4 chance of
heart attack, procedures, or death every year.
With a nearly 200 point drop in heart scan score, Grady will now enjoy
(provided he sticks to the program) a nearly zero risk of any of these
heart catastrophes. (I say nearly zero because, statistically, nobody’s
risk for heart attack is truly zero. But Grady is as close to zero risk
as anyone can humanly obtain.)
Yes, attorneys do have a tougher time of it, given the level and kind of
stress they must deal with. But it can be done and it can be done in a
big way, just as Grady showed us
.
Are heart scans dangerous?
Heart scans recently made the news again . . .but for the wrong reasons.
This time, much of the media got it wrong (again): They confused the CT
heart scans we advocate in the Track Your Plaque program to detect and
track coronary plaque that represents coronary artery disease and CT
coronary angiograms. There’s a difference.
The news was based on a report in the Journal of the American Medical
Association from Columbia University in New York (Einstein A. JAMA, July
18, 2007; 298:317–323). In this theoretical study, it was reported that,
because of the radiation exposure required for present-day CT coronary
angiograms, a young woman in her 20s would experience a lifetime risk
for cancer of 1 in 143.
Unfortunately, this triggered the usual media frenzy, eager for the next
sensational headline.
The problem is that most of the media reported that “heart scans” pose
excessive radiation risk, confusing heart scans with CT coronary
angiograms. Followers of the Track Your Plaque program know that they
are two different tests.
CT heart scans of the sort advocated for the Track Your Plaque program
do indeed involve radiation, but a relatively modest quantity. Any
screening test, like a mammogram to screen for breast cancer, needs to
be safe and not introduce risk.
If you have a heart scan on an EBT device, then your exposure is 0.5-0.6
mSv, roughly the same as a mammogram or several standard chest x-rays. (MilliSieverts,
mSv, is a common unit of radiation exposure.)
With a heart scan on a 16- or 64-slice multidetector device, your
exposure is around 1.0-2.0 mSv, about the same as 2-3 mammograms, though
dose can vary with this technology depending on how it is performed
(gated to the EKG, device settings, etc.).
But heart scans require very little time, little effort, yield
tremendous information about your coronary atherosclerotic plaque, yet
require very little radiation.
CT coronary angiography presents a different story. A greater radiation
exposure is required to create the images not just of coronary plaque,
but to generate an angiogram, or images of the x-ray dye that is
injected. The radiation exposure with CT coronary angiograms range from
5-12 mSv, the equivalent of about 100 chest x-rays or 20 mammograms.
The exposure for a CT coronary angiogram is about the same as that for a
pelvic or abdominal CT. The problem is that some centers are using CT
coronary angiograms as screening procedures and even advocating their
use annually. This is where the alarm needs to be sounded. These tests,
as wonderful as the information and image quality can be, are not
screening tests. Just like a pelvic CT, they are diagnostic tests done
for legimate medical questions. They are not screening tests to be
applied broadly and used year after year (at least with present-day
technology).
Always be mindful of your radiation exposure. However, don't be so
frightened that you are kept from obtaining truly useful information
from, for instance, a CT heart scan (not angiography) at a modest
radiation cost or other diagnostic test when the information is
important.
(Stay tuned for a full Special Report on this issue on the Track Your
Plaque website.)
How tough are the Track Your Plaque 60-60-60 targets?
Reprinted from The Heart Scan Blog.
One of the basic requirements that stack the odds in your favor of
stopping or dropping your CT heart scan score is to achieve basic lipid
targets of 60-60-60.
In other words, we generally see best results when LDL is reduced to 60
mg/dl, HDL raised to 60 mg/dl, triglycerides reduced to 60 mg/dl. Now,
these are not absolute requirements. Someone can have a spectacular drop
in heart scan score even with an HDL of 56, LDL of 71. But the "Rule of
60" provides a useful target that is easy to remember, packs real power,
and is clearly beyond that achieved with conventional approaches.
People often ask, "Just how tough is it to get to these targets?"
It's really not that tough. Interestingly, whenever I tell my
cardiologist or primary care colleagues that I advocate these 60-60-60
targets, they declare that it's tough, perhaps impossible, except for
the most highly motivated.
I agree that it requires motivation. A cigarette-smoking, TV-addicted,
70-lb overweight, chip- and pretzel-eating couch potato is not going to
achieve them.
On the other hand, you don't have to be a marathon running vegetarian to
do it, either.
Most people, in fact, engaged in the Track Your Plaque program achieve
the 60-60-60 targets—or exceed them. It's not uncommon, for instance,
for HDL to skyrocket to 80 or 90 mg/dl with many of our strategies. (Of
course, if your starting HDL is 20 or 25 mg/dl, 80 or 90 is not possible
with current technology.)
But it certainly does require more than the "Take Lipitor® and stick to
your low-fat diet" approach that is the mantra repeated in the vast
majority of medical offices across the U.S. For instance, reducing LDL
to 60 mg/dl when starting at 170 mg/dl will require addition of oat bran
and other soluble or viscous fibers; raw almonds and walnuts; perhaps
the use of Benecol butter substitute; reduction or elimination of wheat
products if small LDL comprises a substantial proportion of LDL
particles. Reducing triglycerides requires the generous use of omega-3
fatty acids from fish oil. Attention to vitamin D must be a part of the
effort.
So, no, it is not as simple as the conventional approach. But the
results are far superior in reducing or eliminating heart attack and in
dropping your heart scan score.
It can be done. We do it every day.
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 new and upcoming Special Reports on:
Calcium: The Good, the bad, and the ugly
Calcium is the stuff we use to generate your heart scan score. The
less we have, the better. But that’s not true everywhere in the
body. In bones, the less calcium, the worse
the osteoporosis and the greater the risk for dangerous fractures. All
the while, calcium in blood and other tissues remains tightly regulated.
Why this calcium disconnect in different places? Does taking
calcium have any effect? Is there anything we can do about it?
NMR Lipoproteins--The advanced user's guide
Heart scans and radiation: The Real story
Copyright 2007, Track Your Plaque
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