Heart Disease Prevention + Treatment: Get the Right Tests and Know Your Options
I remember when I was first introduced to the concept of heart plaque. I thought, “Plaque, isn’t that the stuff on your teeth?” Since then I have had the pleasure of becoming acquainted with pioneering heart disease prevention and reversal like cardiologists Dr. William Davis and Dr. Bill Blanchet who boast tremendous success at reducing heart attack risk among their patients by focusing on plaque as the primary risk factor. High profile events like former President Clinton’s bypass operation and the untimely death of journalist Tim Russert punctuate the fact that even the best “traditional” medicine - with its focus on cholesterol, statins, and stress tests - falls desperately short in safeguarding the public.
The medical market place swirls with numerous claims, counterclaims, and rebuttals over what may contribute to or prevent heart disease. Traditional medicine relies on all manner of risk factors to determine how to treat it. However, risk deals only with “might” or “coulds.” Yes, if you have high LDL cholesterol, low HDL cholesterol, or any number of other risk factors you might have heart disease. But why live in the world of “maybes” when you could know exactly whether you have heart disease, how serious it is, and whether what you are doing is effective in treating it? Get a heart scan to measure your plaque and you will know for certain. As Homer Simpson would say, “DOH!”
The efficacy of heart scans is no longer in question. Recent studies, statements by the American Heart Association, the SHAPE guidelines all agree - heart scans are the best predictor of heart attack. I have always been impressed by the powerful statements issued by noted and independent heart disease experts and researchers.
Dr. Steven Nissen, Cleveland Clinic: “We now know that 95% to 99% of the heart disease occurs at sites WITHOUT artery narrowing. Thus, the old tests we perform to detect narrowing and blockages have really misled us. We miss over 95% of the heart disease that causes heart attacks.”
Dr. Harvey Hecht, The Heart and Vascular Institute: “Plaque imaging is …not to be confused with risk factors, which merely estimate a probability of developing atherosclerosis. Rather, [plaque imaging] directly measures atherosclerosis, irrespective of the presence or absence of risk factors; it provides the final common denominator and is the most powerful predictor of cardiac events.”
Dr. William R. Davis, Track Your Plaque: “Coronary imaging technology is advancing at breakneck speed. Today, we can have our coronary arteries imaged in 30 seconds and find out with 98% confidence if we have silent heart disease. Cholesterol can be 92 or 192, it makes little difference.”
These doctors understand the simple truth. Using risk factors such as the popular Framingham Risk Score can tell you if you MIGHT have heart disease. Heart scans tell you if you DO have heart disease. Yes, there is a small risk from radiation just as there is when you x-ray a bone fracture or have a chest x-ray. But just like those two examples, for me, it is worth the risk of knowing with greater certainty. Here is my simple formula. First, get a heart scan. If you have a zero score, throw a party! But, if you have a non-zero calcium score you should consider the following:
1. It is very likely YOU HAVE HEART DISEASE! It may be very mild but it is also likely to be silently growing. Deal with it!
2. Find out why YOU, specifically, have heart disease. The risk factors for MOST people are unimportant. What are YOUR specific causes? Like me, your LDL cholesterol may already be low. My doctor never mentioned my low HDL or even tested for other powerful heart disease promoting factors like lipoprotein(a).
3. You need to take measures to counteract YOUR specific causes. Starting treatments (like statins) just because they help some or most people is just plain stupid if it isn’t the best solution for your specific problem. Two different doctors prescribed Lipitor after I pleaded with them to do something. Only later did I discover that niacin is the far superior treatment for low HDL and high lipoprotein(a). Lowering my already low LDL cholesterol with a statin was not going to provide much additional benefit.
Regardless of your cholesterol levels or the drugs and supplements you may be taking, settle the question. Consider getting a heart scan and, if you have a non-zero score, dig deep into the causes. The plaque that is the root cause of heart disease can be treated - but only if you know how much you have and whether it is growing or shrinking!
Plaque, it’s not just for teeth anymore!
Chris Kliesmet, also known as HeartHawk, is a heart health activist and former patient expert writer for HealthCentral. As a heart disease sufferer with many family members lost to the disease, Chris specialized in topics within heart health, including medication, prevention, and testing. He has written for other community sites such as HeartConnect.com, and wrote for his own blog, HEARTHAWK: Your Heart Health Eye in the Sky. (Photo: University of Wisconsin)