An epidemic of heart disease reversal

10. January 2007 William Davis (3)
Heart disease reversal is nothing new in my office. However, I have to admit that it's not something that generally happens each and every day.

As our approach is refined, we are witnessing an unprecedented frequency of plaque reversal. Since Monday (today is Tuesday), I've seen four people who have regressed their coronary plaque and dropped their heart scan score.

Pat was the most recent addition to this list. At age 53, I was honestly surprised at the ease of dropping her heart scan score from 128 to 42 in the space of a year. I was surprised because among her lipoprotein patterns was the dreaded combination of lipoprotein(a) and small LDL, probably the most aggressive risk for heart disease I know of and also among the most difficult to gain control over. She also suffered a deep personal tragedy in her family, an emotional convulsion that can sometimes wipe out any hope of plaque reversal.

I'm hopeful that this virtual epidemic of heart disease reversal continues. And I hope that you participate in it.
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  • Bill, the songwriter

    1/30/2008 12:58:00 AM |

    Dr. Davis, I have been reading your site off and on for months. I guess only a doc can answer this.

    I am confused about the options a "reasonable person" would have upon learning that he has coronary heart disease (CHD). By that, I mean blockage in a major artery.

    Take me for example. (First, I'm doing fine now.) Two years ago, I had the "felt like a band tightening around my chest." 911 ambulance ride to the hospital. Bummer. My family history is terrible, all the men died of heart disease. I'm 54 now. I was disappointed and a bit apprehensive, although not "scared." I just figured they'd fix it. It usually works out that you don't die. (Although I lost a good friend on the bypass table who was seemingly healthy as could be the day before... routine physical and a stress test and they recommended bypass right away. He died on the table from the surgery!)

    Back to me... over the next few days, CHD confirmed. LAD had 99% blockage and a branch had 90%.

    I assume that my options at that time were...

    1. Get angioplasty and that's it
    2. Get angioplasty and a stent(s)
    3. Get bypass surgery
    4. Treat the heart disease with aggressive therapy. Which if you buy into the mainstream medicine way, it's drugs, low-fat diet, exercise, stress reduction. If you buy into alternative methods, it can include low-carb diet and powerful supplements.

    Confusion revolves around #4. My question is...

    >>>
    Do you think #4 is apropos for a person in this situation? (99% blockage in LAD)
    >>>

    I am confused because I'm thinking, okay, confirmed blockage. But it was the first sign I had ever had that I had heart problems.

    I realize that the percentage is a guess on the cardiologist's part, they don't measure it. But if it's 99% I tend to think... what is the risk of walking away to treat it without #1, 2 or 3? A blood clot that occurs for whatever reason hits that blockage and I could die. Could happen at any moment. Hours, days, weeks, months, years later.

    I also realize that there is risk in angioplasty, stents and bypass. Even discounting risk (of complication or dying on the table), restenosis is a common problem. And of course, you can have other blockages manifest themselves.

    But you could take the aggressive alternative therapy route and hope to stop the growth of plaque. At that time, I was not convinced that the blockages could be "reversed." Now, it appears that this can occur.

    I'll assume that you can reverse the situation and actually clean up your arteries. Is it a reasonable risk to opt for #4 or is this only for people who have less severe blockage? You're risking that you DON'T have a blood clot hit a blockage and kill you before you can achieve the artery-cleaning effect by your therapy, whatever it is.

    Seems I have read that stats are showing that #1, 2 or 3 do not necessarily beat #4 ... that #4 does just as well (lifespan) after the diagnosis.

    If quality of life was an issue, such as a person who has angina so severe or such difficulty breathing that a normal life was not possible, maybe that person is a definite candidate for #1, #2 or #3. But I wasn't there. I felt fine before AND after the event.

    As mentioned, I'm doing fine now. I love my low-carb diet, my lipids are great, I've lost weight, I exercise. This is just something that I would like to clear up for my own education. And who knows, a friend might ask me about this if s/he is diagnosed.

  • Dr. Davis

    1/30/2008 1:12:00 AM |

    You've made great changes in your lifestyle that will likely translate into much reduced risk for more struggles with heart disease. However, it is highly unlikely that you've put a stop to it, let alone reversing it.

    I would refer you to the website that this blog accompanies, www.trackyourplaque.com. Please keep in mind that I nor any other responsible physician can diagnose or offer individualized medical information over the net.

  • Bill, the songwriter

    1/30/2008 2:03:00 PM |

    Thanks for answering. I didn't mean to infer I am asking about me in particular for a present situation, I just used me as an example because that's what I know. I was asking about a hypothetical person.

    I've read much on your site but I'll go back again.

    IMO, 99% (at least) of all people who get a recommendation from a cardiologist to undergo an invasive procedure... they do it. And I'm curious about one taking another approach.

    Oh well, thanks again, Doc.

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A second chance

A second chance

29. September 2006 William Davis (1)
Stewart had a CT heart scan in 2004. Score: 475.

As always in the Track Your Plaque program, Stewart had his lipoproteins assessed. Among his patterns were LDL 157 mg/dl, severe small LDL, and the (post-prandial, or after-eating) IDL. Stewart was also "pre-diabetic" with a blood sugar of 123 mg/dl. Blood pressure was also a major issue. Although initially concerned, life and distractions got in the way, and Stewart's attentions drifted away.

Two years of a lackadaisical effort and Stewart's heart scan score was 600, a 26% increase. Not as bad as it could have been doing nothing (i.e., 30% per year), but still far from great. But, even with the increase in score, we still really didn't get Stewart's attention. He went about his business with a very lax dietary program, overindulging in breads, crackers, goodies, hot dogs, etc., and following a virtually non-existent exercise program except for playing golf once or twice a week.

Unfortunately, Stewart started having pains in his chest with very minimal efforts like climbing a single flight of stairs. His stress test proved abnormal. Stewart then received a stent in his left anterior descending coronary and another in his circumflex. His right coronary artery had a 40-50% blockage, close to requiring a stent.

I stressed to Stewart that this had been preventable. Should motivation remain unchanged, the next step would be bypass surgery.

I think I finally succeeded in getting Stewart's attention. He found the prospect of a bypass operation a lot more concrete than the idea of progression or regression of coronary plaque. So Stewart is being given a second chance. Unfortunately, we will no longer be able to track Stewart's plaque very effectively, since two of three arteries now contain stents, and only the right coronary remains scorable.

I hope Stewart succeeds. But I sure wish he had done this earlier. He had realistic hopes of never requiring stents or bypass surgery.

Learn from Stewart's mistakes. Attention to your program requires vigilance. You can't ignore the causes of your coronary plaque for any length of time without it catching up to you. But seize your first and best chance.
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  • Rick

    1/27/2009 4:56:00 AM |

    I hadn't realised that a stent prevented calcium scoring. Why is that?

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Heart health consultation with Dr. Joe D. Goldstrich

Heart health consultation with Dr. Joe D. Goldstrich

20. June 2010 William Davis (3)
Cardiologist, nutritionist, and lipidologist, Dr. Joe D. Goldstrich, is a frequent contributor to the Track Your Plaque Forum, where we discuss the full range of issues relevant to coronary health and coronary plaque reversal.

I have come to value Dr. Goldstrich's unique insights, especially in nutrition. Formerly National Director of Education and Community Programs for the American Heart Association and a physician at the Pritikin Center, his dietary philosophy has evolved away from low-fat and towards a low-carbohydrate focus, much as we use in Track Your Plaque. Like TYP, Dr. Goldstrich is always searching for better answers to gain control over coronary health. His unique blend of ideas and background has helped us craft new ideas and strategies. Dr. Goldstrich has proven especially adept at understanding how to incorporate new findings from clinical studies in our framework of coronary atherosclerotic plaque management strategies.

Dr. Goldstrich is offering to share his expertise with our online community. If you would like a one-on-one phone consultation with Dr. Goldstrich, you can arrange to speak with him at his HealthyHeartConsultant.com website.
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Light the fuse of heart disease

Light the fuse of heart disease

26. October 2006 William Davis (1)
Father Bob, despite his calling as a priest and counselor, led a stressful life. His average day was packed tightly with commitments: counseling members of his congregation, visiting the hospital, more official priest and church duties.

At age 53, his heart scan score of 799 came as a complete surprise. Even more of a surprise, his stress test was dramatically abnormal showing poor flow in the front of his heart at a level of exercise that wouldn't challenge most 75 year olds. His blood pressure with exericse: 230/100. Bob was shocked.

A few stents to the LDL later, Bob was trying to turn a new leaf on lifestyle. His life prior to the diagnosis of heart disease was driven by convenience. Because his day was so filled with commitments, he simply grabbed what he could from hospital cafeterias, fast foods, etc.

But after his procedure, Bob committed to choosing healthier foods, walk every day, and resist the food temptations presented by convenience.

However, temptation defeated him twice in the first few weeks after his stents. On the first occasion, Bob gave into eating a cheeseburger. On the second, Bob was at a fish fry (this is Wisconsin, after all) and ate a large serving of deep-fried fish.

On both occasions, Bob started feeling awful within minutes after eating: foggy, bloated, gassy, and fatigued. He took his blood pressure after each incident: 210/90, even though his blood pressure had more recently been trending down towards 130/80.

What happened? Grotesquely unhealthy foods like the deep-fried fish and cheeseburger provoke an abnormal constrictive process body wide. Some call this "endothelial dysfunction". Regardless, it is a graphic and frightening demonstration of the power of these sorts of unhealthy foods to wreak immediate and dangerous effects. Father Bob's response was more exagerrated than most, but it happens to all of us.

Eat badly and your body will pay the price. Even that occasional hot chocolate sundae or Egg McMuffin will yield cumulative injury, among which will be a rise in your heart scan score.
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  • madcook

    10/27/2006 4:22:00 AM |

    Okay, I'm feeling sufficiently guilty just reading this.  Yes, I know intellectually about postprandial lipid surges and such... but given that in the real world sometimes we are caught in situations where there isn't a lot of healthy foods available:  By way of instruction, how could the Good Father have salvaged these situations from disaster?  What choices could he have made in these situations which would have been better, healthier (yes, I know about the lunch pail and packing good, healthy foods to take from home, and do it all the time).  But WHAT IF he didn't have the option of bringing his own food to a restaurant or social "fish fry" situation?  What to do then, constructively, besides a heavy dose of guilt?

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