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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!
  Beginning
with this issue, we’ve decided to make the Track Your Plaque Newsletter
a more personalized message from our founder. That’s me!
Every month we profile a real person who has either used heart scans
successfully or has stopped or reversed their heart scan score. I often
find that the best way to learn how to do something yourself is to
observe someone else who has done it successfully. The stories we
profile here are meant to do just that.
In this issue of the newsletter, I also discuss the Track Your Plaque
“Rule of 60”. This is our simple rule for lipid targets (LDL, HDL,
triglycerides) that heightens the chances of reducing your heart scan
score. It’s easy to remember but has a lot of thought and wisdom built
into it—it’s not just something we pulled out of thin air. The Rule of
60 is not something followed by the majority of practicing physicians,
who adhere to the lax guidelines set by the National Cholesterol
Education Panel. Like the American Heart Association’s diet, the Panel
guidelines are something that barely impacts on heart disease risk. I
find that unacceptable. The Rule of 60 is one big piece of an effort
that provides far more advantage.
And if you haven’t done so already, visit me on The Heart Scan Blog, my
free-wheeling, unrestrained commentary on issues relevant to coronary
plaque reversal. Go to Blog
with Cardiologist Dr. William Davis. You can post your own comments
and participate in the conversation.
Track in health!
Dr. Davis
Another Track Your Plaque
success story:
He overpowered his diabetes!
At age 58, Joe was the picture of poor health: a smoker
for 30 years, indulging in an unrestrained diet that caused him to be
overweight by 25 lbs, no exercise, and a high-stress, sedentary job as
vice president of a manufacturing company. Joe’s unhealthy habits left
him breathless climbing even a single flight of stairs or walking the
100 feet from his car to the office.
His job didn’t help. Even though he had risen successfully through the
ranks of his company, he didn’t enjoy the work. In fact, over the past
two or three years, he found that he went to work every day with
increasing dislike for his job.
Although there was no heart disease in his immediate family, when Joe
was diagnosed with diabetes at age 56, he began to wonder if 40 years of
unhealthy habits had stoked the beginnings of heart disease.
Retirement was just 6 months away. It struck Joe that he’d worked hard
all those years and might have created a lifestyle disaster that could
shorten the retirement he now longed for. So, 6 months from retirement,
Joe got a heart scan. His score: 278. This put Joe in the 78th
percentile (compared to other men in his age group).
Upon learning of Joe’s heart scan score, his internist prescribed a
cholesterol drug (Vytorin®) for an LDL cholesterol in the 150 mg/dl
range. Joe then came to my office for advice on a more intensive
approach. We started with a lipoprotein panel that showed a HDL of 49
mg/dl, triglycerides of 88 mg/dl—spectacular for someone with diabetes.
His LDL on the drug was 89 mg/dl. Joe also showed lipoprotein (a), or
Lp(a), and small LDL, a dangerous combination that substantially
escalates heart disease risk.
Joe added fish oil, 6000 mg per day; added niacin which he increased
gradually to 1000 mg per day (Slo-Niacin®) for the small LDL and Lp(a);
eliminated greasy fried foods, sharply cut back on his use of processed
carbohydrates like breakfast cereals and breads; and added vitamin D.
Joe also set out to lose 20 lbs. because of his diabetes and small LDL.
One year later, Joe unfortunately had failed to lose the weight he’d
hoped for and therefore remained diabetic. He did, however, manage to
achieve our targets for conventional cholesterol values and a vitamin D
level of 77 ng/ml. Another heart scan revealed a score of 264, or a 5%
reduction.
Dr. Davis: While you might not be impressed with Joe’s modest
reduction of his heart scan score, what makes his story so wonderful is
that he accomplished his regression of plaque despite the fact that he
is diabetic.
Diabetes can be among the most profound risks for heart disease. I’ve
personally seen extraordinary rates of plaque growth of 50% per year
when hidden patterns behind coronary risk remained uncorrected in
someone with diabetes. While Joe failed to achieve his weight goal, he
did correct all his conventional lipid values and raise vitamin D level
to a healthy range. The only other abnormality that was only partially
corrected was Lp(a). Joe succeeded despite this.
The message: Joe spared
himself the relentless and shocking rates of plaque growth that can
develop in someone with diabetes. He also successfully and
dramatically reduced his likelihood of heart attack. Even a
small amount of regression signals a dramatic shift from active, growing
plaque - the kind that is highly vulnerable to rupture and subsequent
heart attack - to more stable, less vulnerable plaque. A
small victory for the value of heart scanning and intensified
prevention, a big victory for Joe—and one that is likely to prolong his
healthy years of retirement.
Now, if I can only persuade him to lose the extra weight and maybe shake
the diabetes!
The Track Your Plaque “Rule of
60”
In the Track Your Plaque approach, we maximize all the
factors that trigger coronary atherosclerotic plaque growth. We’re not
content with just a reduction in heart attack risk, nor in just feeling
good. We want to stop or reverse coronary plaque growth. Remember that
your heart scan score will increase 30% per year on average without
corrective action!
Among the most important facets of the Track Your Plaque are the
recommended targets for conventional lipids: LDL 60 mg/dl, HDL 60 mg/dl,
and triglycerides 60 mg/dl: 60-60-60. We call this the Track Your Plaque
“Rule of 60”.
Not only is the Rule of 60 easy to remember—60-60-60—but is grounded in
science and results of clinical trials.
Origins of “The Rule of 60”
LDL 60 mg/dl
An LDL target of 60 mg/dl had its origins in the observation that people
who have LDL cholesterol in this range rarely have heart disease. It
gained scientific validation when experiences such as the Reversal
Trial, the PROVE-IT Trial, and the Asteroid Trial, showed that LDL
cholesterol values in the range of 60 mg/dl dramatically increased the
likelihood of stopping plaque growth or achieving regression. LDL of 60
was important in our preliminary experience and it has now been
validated in these large clinical trials.
HDL 60 mg/dl
Achieving HDL cholesterol of 60 mg/dl is not as well grounded as LDL
targets, mostly because increasing HDL is more difficult. There’s also
no tremendously profitable way to raise HDL, as there is for reducing
LDL (statin drugs), making it less likely that you’ll hear about ways to
increase HDL. But epidemiologic observations strongly suggest that HDL
of 60 mg/dl provides maximum control over both coronary plaque growth,
as well as slashing rates of heart attack. Numerous smaller trials have
borne this phenomenon out and it has proven important in the Track Your
Plaque experience.
Triglycerides 60 mg/dl
The concept of achieving triglycerides of 60 mg/dl is based on studies
show a virtual elimination of abnormal lipoproteins, especially small
LDL, when this value is achieved. Reduction of triglycerides is an
effective means to reduce hidden lipoproteins like small LDL and VLDL.
It also means that postprandial (after-eating) dietary fats are being
effectively cleared. In contrast, triglycerides in the conventionally
accepted range of 100-150 mg/dl can be associated with dramatic
abnormalities of lipoproteins.
Thus, the Track Your Plaque Rule of 60.
How about a compromise?
What if you achieve only a single value in the Track Your Plaque “Rule
of 60”? What if, for instance, you got LDL down to 60 mg/dl, but ignored
your HDL of 41 mg/dl and triglycerides of 145 mg/dl? Can you still do
pretty well?
Probably not. In fact, this specific combination of low HDL and high
triglycerides tells me several things:
1) LDL is really much higher than suggested by the 60 mg/dl, which is a
calculated value, often much higher. Calculated LDL is prone to immense
inaccuracy. When measured, the real LDL is commonly somewhere between
120 and 160 mg/dl. However, when you raise HDL to 60 and reduce
triglycerides to 60, much of the inaccuracy is removed, i.e., calculated
LDL becomes more accurate. (LDL can be accurately measured as LDL
particle number (NMR), apoprotein B, or direct LDL.)
2) LDL particles are small. This is yet another reason why the
weight-based LDL measures can be inaccurate. Imagine you have two
identical glass jars full of marbles. One jar has small marbles, the
other has large marbles, but both jars have the same weight in marbles.
Which jar has more marbles? The jar with small marbles contains a
greater number of marbles, of course. The same phenomenon occurs with
LDL particles: at the same weight, you can have different numbers of LDL
particles. It’s the number of particles that better determine risk for
heart disease, not the weight.
3) Triglycerides of 145 mg/dl is actually in the desirable range advised
by the National Cholesterol Education Panel Adult Treatment Panel-III
guidelines, i.e., you’re okay by conventional standards. But look
beneath the surface, and you’ll find that triglycerides of 145 mg/dl are
associated with flagrant excesses of VLDL lipoprotein particles and a
greater likelihood of a postprandial (after-eating) disorder (increased
IDL or postprandial triglycerides), both of which add to coronary
plaque.
4) This pattern is also commonly associated with higher blood sugar,
higher blood pressure, increased inflammation (e.g., C-reactive
protein), increased fibrinogen—all the facets of the metabolic syndrome,
or pre-diabetes.
In fact, some of the most aggressive plaque growth—increasing heart scan
scores—will occur with this specific pattern. So just achieving one
facet of the Track Your Plaque Rule of 60 does not suffice for the
majority of people. It’s the whole package that really stacks the odds
in your favor of stopping or dropping your heart scan score.
Despite its apparent simplicity, there’s a lot of thought and wisdom
built into the Track Your Plaque Rule of 60. In our day to day
experience trying to stamp out plaque growth from its terrifyingly rapid
30% per year, or reversing it, the Rule of 60 has held up time and
again. Getting your lipids to 60 mg/dl does not guarantee that plaque
growth stops, but it appears to be a necessary requirement that tips the
scales heavily in your favor.
Those of you who’ve discussed lipid targets with your doctor will
quickly recognize that the Track Your Plaque targets appear laughably
ambitious. Keep in mind that most physicians have no idea of what
coronary plaque regression means. He/she likely conforms to the lax
targets set by the National Cholesterol Education Panel (NCEP). (These
targets depend on a number of factors such as whether you’re diabetic,
sex, risk factors, etc.)
Based on trial experiences like the few mentioned above, as well as the
Track Your Plaque experience with purposeful coronary plaque reversal,
the lipid guidelines as advocated by NCEP guarantee heart disease. Let
me emphasize that again: Follow the guidelines set by the NCEP for your
doctor to follow, and progression of heart disease is a virtual
certainty. At best, conventional cholesterol treatment may slow growth
of plaque and delay heart attack or bypass surgery, but it will not stop
it. The Track Your Plaque Rule of 60 is one big step closer to stopping
or reversing your coronary plaque.
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
Alcohol and your heart scan score
The arguments for and against alcohol for heart disease can be
dizzyingly confusing. It reduces heart attack risk, raises HDL, but also
escalates unwanted triglycerides and blood pressure. What role should
alcohol play in your plaque-control program? There’s a lot more to this
issue than the media would have you believe!
Track Your Plaque Apprentice
An update on Dave, our 2nd Track Your Plaque Apprentice. He’s struggling
but making progress in “baby steps”.
The Track Your Plaque Apprentice provides Members with an opportunity to
follow a real individual along the program from the start—their starting
heart scan score, how lipids and lipoproteins are used, how the
nutritional program unfolds, along with all the ups and downs of a
real-life person. Dave is also the first Apprentice to chronicle his
progress on his
Blog, a real log of his progress in the Track Your Plaque program.
Copyright 2006, Track Your Plaque
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