Increased Levels of 25 Hydroxyvitamin D and 1,25-Dihydroxyvitamin D After Rosuvastatin Treatment: A Novel Pleiotropic Effect of Statins?
So statins work their magic (in some way not yet identified)by  increasing vitamin d status and thus obtaining Vitamin D3's important pleiotropic effects that lead to reduced coronary artery disease mortality.

So is this an excuse to make everyone take a statin (that inevitably will have some side effects)to achieve higher vitamin d status or is there a simpler way of increasing vitamin d3 status that doesn't have (at the normal amounts people reading this forum can be expected to require)any nasty side effects?

I think we just need to Follow the Money, to see how this piece of research will be interpreted.

So tell us. How much is too much?

This is an excellent post.

But Doctor Dean Ornish points out that the same argument is made about mono-unsaturated fats being better than saturated fats, and people therefore eat lots of mono-unsaturated fats. He claims that logic is also badly flawed.

I used to be a big fan of Ornish, and I still am, but I do try to eat lots of mono-unsaturated fats from avocados, pecans, and walnuts.

One web doctor says eat no meat. Another, no fruit. Yet another, no dairy. Still another, no grains. So much disagreement tells me that dietary results are anecdotal. Simply opinions.

Some.

No wheat is necessary for a long diabetes-free, heart disease-free life.  Also, there appears to be very little real benefit to consuming wheat, so "some" is too much.

Now that the data which establishes the protective nature of many saturated fats (including animal fats and tropical oils), and the beneficial nature of fats in general, I think that we're on the cusp of discarding Ancel Keys's bizarrely misguided leadership on fats.  Next we need to decide as a country that the FDA (Department of Agriculture) probably isn't the right place to seek dietary advice.

As for Ornish, well, I simply say that he and I start from different premises.

Anonymous,

You are correct about one thing...if you spend enough time on the web you can find a physician or nutrition 'expert' that will support any diet you want to follow.  However, find me another physician that has tested the lipid profiles of thousands of patients, both during a grain based diet and following the elimination of grains, and still tells you to eat them.  

I can save you the time and aggravation, you're not going to find it.  The unfortunate truth is that most physicians you speak to know no more about nutrition than you do.

I followed the low fat high carbohydrate diet recommended by the medical establishment for 50 years.  I put on 80 pounds, developed diabetes type 2 which led me to chronic kidney disease stage 3 along with many other ailments too numerous to mention.  10 months ago I went on an evolutionary diet, high saturated fat and low carb supplementing with high dose vitamin D3, Omega 3 wild fish oil, vitamin K2 and kelp. I have lost 54 pounds, diabetes type 2 cured, my Trig/HDL ratio is now 2.53.  

This is not an opinion it's a fact.

Courageous doctors who are not afraid of ridicule are leading the way to a medical revolution and I am sorry to say that DR. Ornish is not one of them.

It's amazing that for fifty years I was in decline and now I am reversing my health issues.

This health revolution could could cut the cost of health insurance in half if only it would become the national recommendation.  WAKE UP AMERICA!!

Hi, Ted--

Excellent point.

It's as if every aspect of health can be best served by a drug, particularly statin drugs.

While statins like rosuvastatin may increase vitamin D in its various forms by a modest quantity, it is far better to simply supplement vitamin D.

Anon-

So should we just toss up our hands and give up?

Well, that's certainly what Big Food would like us to do--succumb to the tides of marketing and eat what tastes good.

I'll stay out of that line. I'd choose instead to pick the food philosophy that makes most sense. Humans did not evolve to consume pretzels, high-fructose corn syrup, and Cheerios.

This is the best blog ever for cardiovascular, thyroid, and other medical information!  Thank you Dr. Davis!  I respectfully disagree with the idea that complete elimination of whole grains is the BEST or ONLY way to bring about the beneficial health changes (weight loss, drastic improvement in lipid profile, blood sugar, blood pressure, etc).

"Too many whole grains are bad for your health.  Therefore, you must completely elimate whole grains from your diet."...seems like a faulty logic sequence to me.

How about just consuming reasonable portion sizes within the context of a truly balanced diet?  I would bet that few people you see in your clinic actually do this.  Therefore, how would you know if it worked just as well (or even better) than completely eliminating them?  It is certainly one way, but I don't believe it is the only way, and I do not know if it is the best, because I do not understand what exactly you replace the whole grains with.  I am wondering what the "ideal" day looks like as far as macronutrient breakdown and the actual foods eaten.  Would love to see a post about this!

I just received my latest blood test results and was delighted but not surprised to find my triglycerides down from 115 mg/dl to 66 mg/dl, because of your recommendation to supplement with high dose vitamin D3 and high dose omega 3 fish oil.  However, my other numbers have yet to improve very much. In a previous post August 9, 2007 you recommended oat bran to lower LDL to the 60 mg/dl range.  The problem is that I am hung up on the fact that oat bran is a grain product, and because I am totally wheat and grain free I hesitate to eat this.  Am I making a mountain out of a mole hill?  Also my HDL is stagnant at 42 mg/dl and will not budge.

Because of following your dietary recommendations my health has improved immensely.  Diabetes type 2 now cured and a 54 pound weight loss so far.  I will not give up until I get my HDL and LDL to mirror my excellent triglyceride numbers.

Thanks for your wonderful recommendations.  Keep up the good fight.

Dear Dr Davis,

Re the current questionnaire you have about going wheat free and what amount of weight a person lost, I  think you need another option for people who did not need to lose weight but still went wheat free. The questionnaire implies that people go wheat free to lose weight...not everyone does as not everyone is overweight to begin with.

Anne

Dr. Davis

Would you consider dedicating a post to your weekly diet (or even just a couple days)?  I hear the no grains, more mono fats, veggies and fruits thing but I have no idea how to put them together to make a meal since I'm so used to eating wheat products.  For instance, all I can think of for breakfast is eggs, eggs, and more eggs.  What other options are there?  Is dairy bad too?  Thanks!

Billye--

I ran the wheat-free poll as a reason to talk about why people fail to lose weight with wheat elimination, and a reason to talk about what grains fit well into a healthy diet. Coming soon.

DJ

I had diabetes type 2 for most of my adult life. Because of this, according to my Nephrologist, I became a chronic kidney disease stage 3 patient.  Dr. T.  "www.nephropal.com" also told me that millions of us are walking around with kidney disease and don't even know it.  He also said that if I had this program before I contracted CKD I probably would have avoided it. Ten months ago he put me on a wheat and grain free regimen and completely turned my life around.  I don't think that he would mind if I told you that he reads Dr. Davis religiously and believes they are simpatico. Because of this his practice is now based on nutrition coupled with a reduction or elimination of prescription medications including Staten's.  His plan is to be Wheat and grain free, low carb high saturated fat, supplementing with high dose vitamin D3, high dose fish oil, Super K2 and kelp caps.  These two
brave doctors along with many others who came before, are changing the face of how medicine is practiced today.  Yes, the primary offender is wheat.  Before this plan I could never report to you A1c numbers of 4.7, 4.8 and 5.0 over the last 6 months. I know no one who's life style allows them to lose weight permanently without any hunger what so ever.  The freedom of having complete control is overwhelming.  It took me fifty years to finally get it, I hope you don't waste as much time chasing fruitless diets that make you sicker and sicker. Please take advantage of the advise these great doctors provide and talk to your own physician about this plan.  By the way my kidney disease is not only under control, some of the markers are also reversing, miracle of all miracles. MY wish for you is only Good luck and great health.

I'm a zero carber and it's no big deal. You just eat meat and some eggs, maybe some cheese. Don't have to worry about anything else.

I eat about 1200 cals a day, I'm not hungry and I have no cravings. My lipids when doing low-carb were the envy of people half my age.

And I'm not going to stand around waiting for everyone to reach a consensus on what and how to eat. I've tried them all and this is what works for me. I listen to MY body. It tells me when I'm hungry and when to eat.

Dr. Davis, once again - I love your blog! I am a bit confused about the wheat and grain part. To lower cholesterol are we supposed to eliminate wheat or ALL grains?

I am now on a quest to get my nice belly down to a normal size, and eliminating all grains is on my list, including other actions off course.

Thank you again for a well written blog!

Zing!

Here's yet another take

http://www.paleonu.com/panu-weblog/2009/7/1/where-are-all-the-healthy-whole-grains.html

OK...so I'm new to all of this and have to ask what about those of us who start healthy (all the numbers look good), eat a balanced diet that included a reasonable balance of all sorts of food, and exercise regularly/aren't overweight.  On a very pragmatic level, I agree w/ Anne...suggestions for menus/meals, etc would be helpful...especially for those of us with teenage boys who eat like locusts regardless of what you fill them up with (protein, fat, grains, vegetables, fruit).  My personal opinion is that the #1 reason most folks in the US have a problem is that we simply eat TOO MUCH...there is food all around us.  Just eating less would probably solve a lot of our health problems.

I was watching the news last week and I realized that there's many markers that sell products with cyanide and of course this report made that his popularity get low because people are worry about it. Generic Viagra  Buy Viagra

For better absorption of your body nutrients & better balance of essential nutrients, eat whole plant foods, which will slow digestive processes. This results in better cell growth management, and better maintenance and cell division. In addition, it will cause better regulation of your appetite & of your body's blood sugar levels. Its better to eat regularly scheduled meals instead of infrequent meals.

It seems like everything medical is profit driven!!  One of my biggest irritants with insurance companies is the unwillingness to act pro-actively and approve preventative procedures, treatments, etc.

They spend a fortune each year on statins, but won't cover heart scans. They spend millions on coronary bypass, PTCA, etc but they won't pay for inpatient smoking cessation programs, and many still have no coverage for lifestyle change programs!!

Nice post this one. Just keep telling yourself; there is no conspiracy. The depth of complexity generated by billions of often quite small acts of personal greed, when combined together, does behave like a coherent plan. Eventually there may be studies looking at this as a phenomenon in its own right. The further out of the mainstream that you live, the more interesting it becomes to consider the hows and whys. No conspiracy, just human greed. Some small quanta of greed, some enormous. You even get personal greed combined with the will to do general good. Very complex.

Peter

Years ago, my baby was in NICU with a condition that seriously affected his immune system; the drs wanted him on breast milk to help boost the immune system, and since I wasn't always at the hospital anymore (I had returned to work by then), the drs wrote an order for a breast pump.

Since I worked in that field, I asked the lactation specialist for a catalog of pumps from the same company the insurance company used, and found out the pump I *wanted* cost $300, but the pump the insurance comp wanted me to have cost $1000. I asked the lacto nurse about the pumps, and the cheaper one (shaped like a large purse with a shoulder strap) worked just as good as the more expensive pump (a boxy machine attached to a wheeled pole, like a short IV pole) was better if there were going to be many women pumping.

Since it was just going to be me pumping, and the cheaper pump was so much easier to transport to work, I asked the insurance company if I could have the $300 version. They denied it, and I had to contest it with my lacto-specialist coworker's written letter that the cheaper one would work just as well.

The insurance company's nurse told me she was glad I contested it with a letter from a lacto-specialist, because now the company would save money on pumps.

WOW! It took somebody that had experience in that field with access to a specialist just to get an insurance company to change to a much cheaper, but just-as-effective, medical device. So your story doesn't surprise me at all. Insurance companies are either getting kickbacks, have too many layers of bureaucracy to approve anything different, or might just be dumb sometimes.

S

How did we get to this point that revenue generation overrides the care of patients?  Can we blame Hollywood for creating a myth of the health care provider that knows it all and worries endlessly over the health of patients, government and insurance companies not giving enough oversight over hospital practices, and/or patients not questioning enough the motives of health care providers?  What ever the answer, I imagine future generations will read about these times and cringe over the health care practices of today.

I asked my cardiologist to order a scan for me in a big boston hospital. My insurance wouldn't cover it until enough "risk factors" were documented on the claim form. The test was $270, money very well spent.

What is sad is that most people believe patients' health is the medical community's primary concern. Also, interestingly, those with marginal insurance are forced to advocate for themselves and as such can, perversely, end up with better care.

keith

I truly get the sense that there are factors present that we are not privy to: behind-the-scenes maneuvering, closed-door politics, etc. It's surely not always in a health insurer's best interests to follow the policies often in place. So we can only conclude that something fishy is going on.

You could be right.

An inadvertent, collective evil?

Yes, Keith. You make a crucial point.

Caveat emptor, whether it's in the doctor's office, hospital, or used car lot. Watch your wallet and recognize that they all share one thing: they are profit-seeking operations with your welfare second.

This is NOT a defense of insurance cos, just an attempt to explain their possible thinking. One reason for an objection to CT heart scans is because there could be potentially very many ordered, relative to CT/angiograms. It is like a pyramid, with a much greater number of lower cost procedures resulting in a higher amount of claims submitted, and higher overall cost experience. So, they say no.

I don't think insurance cos. engage in collusion with equipment makers or doctors. They just use a logic that isn't necessarily in my or your best interests.

That is one reason that I am against mandatory medical insurance. The patient and doctor should decide what medical care is appropriate, not an insurance company.

It may indeed be as simple as that. And, in fact, that is what I told many people who were frustrated by their insurer's failure to reimburse heart scans. However, more recently, I have begun to wonder if there is more to this question. I've just witnessed this phenomenon too often: When big money is involved, things happen. Heart scans do not make big money for anybody. CT angiograms provide potential for lots of big money.

Out of curiosity, do insurance companies ever pay for heart scans, if they are considered high risk? That is, have had a heart attack, extremely high lipids, or some other heart disorder?

The only rationale I can imagine for declining calcium scans, while paying for full CT scans, is what Thomas suggested -- it's a numbers game. Since generally speaking, only high risk people get CT scans, the numbers are relatively low. If everyone got calcium tests (although in the long run it'd pay off for them), insurance companies would have to pay a lot out of pocket now.

But... if insurance companies paid for calcium scans for high risk people, it'd make sense both in the short and long term for them, I'd think. Then again, in my own experience, I find the behavior of my health insurance company bizarre. They'll gladly pay for physician visits/testing even when I tell them the doctor never actually did those things... yet decline certain tests I need just because less reliable (and cheaper) alternatives exist.

The evolution of the marketing and ins. coverage will be interesting to watch. For example, a hospital in the Chicago suburbs markets a 64 slice CT scan direct to the public for $99. No doctor referral needed. You can bet they figure stress tests and angios will follow. Nonetheless, you can get the scan about as cheap as possible.

In my town far away, cardiologists won a turf war with radiologists to be the exclusive readers of these tests, and they aren't being marketed. And, the tests aren't on sale either. Local politics, and the ability to control patient flow, is probably the most important driver, but if you live in a large metro area, you may find what you're looking for at a decent cost.

Some insurers do try and distinguish who is "high risk" or not, depending on conventional risk factors.

Of course, the difficulty is that conventional risk factors fail to identify many people truly at high risk for heart disease and heart attack. In effect, health insurers have legislated who can or cannot obtain reimbursement for a heart scan.

I have heard it expressed that insurance companies have no interest in preventative medicine. The benefits are too long term for them to see the results. People change jobs, change insurance carriers, etc.

Yes, I believe that is true. From their perspective, better to pay lots for the occasional catastrophe rather than pay for the many more who would use preventive services. Insurance is not in our best interests, but of the collective financial good.

Three years ago I had a stress test done due to chest pains and triglycerides as a risk factor.  I ended having an area of concern and my doctor wanted to do a CTA.  The insurance company approved it and I was all set up to go when I mentioned the test to my allergist.  She was concerned that I may have a reaction to the contrast dye, so the CTA was canceled and they sent me for a calcium score test.  The insurance company wouldn't pay the $195 for the test even though they were ready to pay a few thousand for the CTA!  Anyhow I came back with a big fat 0 for the test so the money was worth the piece of mind.

What a great example of how useful cheap, simple heart scans can be. You also spared yourself over 90 chest x-rays of radiation.

The latest Oprah mag Jan 2008 has this article about the first sign of heart disease/obstruction is 'fatigue' and reports that the MD may order a heart 'CT scan'... (this health writer is on TOP OF HER GAME -- unlike DR. Oz!!)

Don't read the proposed 'treatment' -- the writer is not apparently informed on TYP yet!

http://www.oprah.com/health/omag/health_omag_200801_fatigue_102.jhtml
Most Often Overlooked Causes of Fatigue (2 or 4)

Heart Trouble

Fatigue is a distinct characteristic of cardiovascular disease in women, according to recent research. In one study of 515 female heart attack survivors, 70 percent reported unusual fatigue in the weeks before; just 57 percent had acute chest pain. In another study, fatigue was a symptom for women with dangerously clogged arteries that escaped notice on heart scans.

Why it's overlooked: Only one in ten women realizes that heart disease is her biggest health threat. And emergency room doctors are six times more likely to give women with serious heart problems (as opposed to men) a clean bill of health.

Other Symptoms: Shortness of breath. Indigestion. Pain in your shoulder, arm, or jaw. But for many women, nothing at all.

Tests: Your doctor will order an exercise stress test or angiogram if she suspects clogged arteries in your heart. Because that test isn't always accurate in women, she may order a CT scan or echocardiogram as well. She'll also test your cholesterol, blood pressure, and blood sugar—diabetes can quadruple a woman's heart risk.

Treatment: You may get a cholesterol-lowering statin and medicines to treat blood pressure, such as diuretics. You'll also be advised to follow a heart-healthy diet and get regular exercise.

From Why Am I So Tired? in the January 2008 issue of O, The Oprah Magazine.

THANK YOU! g

FYI... Recent pubs -- 12/1/2007 and 12/15/2007 respectively

Merry Xmas Dr. Davis! You have many buddies in more progressive countries! Regards, g

(1) Non-invasive screening for coronary artery disease: calcium scoring
Raimund Erbel1, Stefan Möhlenkamp1, Gert Kerkhoff2, Thomas Budde2, Axel Schmermund3
http://heart.bmj.com/cgi/content/
extract/93/12/1620

Despite the decrease in overall mortality from coronary artery disease, the number of out-of-hospital deaths from myocardial infarction is in the range of 60% of all infarct related case fatalities.1 In patients with known risk of sudden cardiac death (SCD), such as survived resuscitation, left ventricular aneurysm or low left ventricular ejection fraction, the incidence of SCD is in the region of 30% per year. In the general population, it is only 0.5% per year.2 However, the absolute number in this group is 10 times higher than in the patient population with known SCD risk, reaching more than 300 000 case fatalities per year in the USA.2 Even renowned cardiologists such as Ronald W Campbellw1 and Jeffry M Isnerw2, who were experts on the topic of arrhythmias and myocardial infarction, suffered SCD. The MONICA (Monitoring trends and determinants in Cardiovascular disease) study reported that of all coronary . . . [Full text of this article]

(2) Cardiac computed tomography: indications, applications, limitations, and training requirements

Report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology
http://eurheartj.oxfordjournals.org
/cgi/content/abstract/ehm544v1

As a consequence of improved technology, there is growing clinical interest in the use of multi-detector row computed tomography (MDCT) for non-invasive coronary angiography. Indeed, the accuracy of MDCT to detect or exclude coronary artery stenoses has been high in many published studies. This report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT (WG 5) of the European Society of Cardiology and the European Council of Nuclear Cardiology summarizes the present state of cardiac CT technology, as well as the currently available data concerning its accuracy and applicability in certain clinical situations. Besides coronary CT angiography, the use of CT for the assessment of cardiac morphology and function, evaluation of perfusion and viability, and analysis of heart valves is discussed. In addition, recommendations for clinical applications of cardiac CT imaging are given and limitations of the technique are described.

Another FYI...  HOLY MOLY This is why the lame Framingham misses the entire picture --- failure to take into acct that 70-80% of the population are on the Metabolic spectrum is like trying to see thru gauze blindfolds. very holey... (I guess it's good I can't access TYP right now... I'm spending my time otherwise well spent *ha*).  I LOVE the first line...'Coronary artery calcification is pathognomonic of coronary atherosclerosis.'  Hope you and your familia have a great holiday season -- full of wishes fulfilled and hope re-ignited!  Thanks for letting me loose *ha ha* Take care, g

http://content.onlinejacc.org/cgi/
content/abstract/50/23/2218

J Am Coll Cardiol, 2007; 50:2218-2225(Published online 14 November 2007).

CLINICAL RESEARCH: CORONARY ARTERY DISEASE
Determinants of Progression of Coronary Artery Calcification in Type 2 Diabetes
Role of Glycemic Control and Inflammatory/Vascular Calcification Markers
Dhakshinamurthy Vijay Anand, MBBS, MRCP*,,*, Eric Lim, MBChB, MA, MRCP*, Daniel Darko, MD, MRCP, Paul Bassett, MSc, David Hopkins, BSc, MBChB, FRCP||, David Lipkin, BSc, MD, FRCP*,¶, Roger Corder, PhD, MRPharmS and Avijit Lahiri, MBBS, MSc, MRCP, FACC, FESC*
* Cardiac Imaging and Research Centre, Wellington Hospital, London, United Kingdom

Objectives: This study prospectively evaluated the relationship between cardiovascular risk factors, selected biomarkers (high-sensitivity C-reactive protein [hs-CRP], interleukin [IL]-6, and osteoprotegerin [OPG]), and the progression of coronary artery calcification (CAC) in type 2 diabetic subjects.

Background: Coronary artery calcification is pathognomonic of coronary atherosclerosis. Osteoprotegerin is a signaling molecule involved in bone remodeling that has been implicated in the regulation of vascular calcification and atherogenesis.

Methods: Three hundred ninety-eight type 2 diabetic subjects without prior coronary disease or symptoms (age 52 ± 8 years, 61% male, glycated hemoglobin [HbA1c] 8 ± 1.5) were evaluated serially by CAC imaging (mean follow-up 2.5 ± 0.4 years). Progression/regression of CAC was defined as a change 2.5 between the square root transformed values of baseline and follow-up volumetric CAC scores. Demographic data, risk factors, glycemic control, medication use, serum hs-CRP, IL-6, and plasma OPG levels were measured at baseline and follow-up.

Results: Two hundred eleven patients (53%) had CAC at baseline. One hundred eighteen patients (29.6%) had CAC progression, whereas 3 patients (0.8%) had regression. Age, male gender, hypertension, baseline CAC, HbA1c >7, waist-hip ratio, IL-6, OPG, use of beta-blockers, calcium channel antagonists, angiotensin-converting enzyme (ACE) inhibitors, statins, and Framingham/UKPDS (United Kingdom Prospective Diabetes Study) risk scores were univariable predictors of CAC progression. In the multivariate model, baseline CAC (odds ratio [OR] for CAC >400 = 6.38, 95% confidence interval [CI] 2.63 to 15.5, p < 0.001), HbA1c >7 (OR 1.95, CI 1.08 to 3.52, p = 0.03), and statin use (OR 2.27, CI 1.38 to 3.73, p = 0.001) were independent predictors of CAC progression.

Conclusions: Baseline CAC severity and suboptimal glycemic control are strong risk factors for CAC progression in type 2 diabetic subjects.

Why did they NOT look at 25(OH)D when they were looking at the osteo- whatever thingy. *uurrgghh*

I like this guy... he proposes heart CTs for all T2DM to screen for silent MIs. just like colon CA screening... and breast CA screening... wow ya think?

CAD in most people esp T2DM is diffuse and systemic (maybe someday we can CAC someone's wrist like we do for Bone Mineral Density testing for osteopenia/porosis screening at the local drugstore?)... and very accelerated when glucose and insulin are elevated (without a good mod/high healthy MUFA PUFA diet and systemic TYP strategies).
http://content.onlinejacc.org/cgi/
content/abstract/49/19/1918

Noninvasive Screening for Coronary Atherosclerosis and Silent Ischemia in Asymptomatic Type 2 Diabetic Patients
Is it Appropriate and Cost-Effective?
George A. Beller, MD, MACC*
Cardiovascular Division, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia.

Coronary artery disease (CAD) accounts for 65% to 80% of deaths in diabetic patients. The merits of screening asymptomatic type 2 diabetic patients for either the presence of coronary atherosclerosis by imaging of coronary calcification using cardiac computed tomography or (B) silent ischemia by stress myocardial perfusion imaging (MPI) remain controversial. Some observers have advocated for such noninvasive screening in at least the subset of the diabetic population who have significant clinical CAD risk factors, so that the highest risk patients for future cardiac events can be identified and offered more aggressive intensive medical therapy or coronary revascularization and optimum medical therapy. Computed tomography coronary calcium scanning could be the first noninvasive screening test in these clinically high-risk diabetic patients, followed by stress MPI to detect silent ischemia in those who exhibit high coronary calcium scores.

Hi, G-

As you see, some people in the medical community are waking up to the great usefulness of heart scans to detect hidden coronary plaque.

However, it's going to be another five or more years before they also wake up to the idea of using it to TRACK the disease.

Not unless you win global recognition for your achievements and TYP ...  

Can u imagine a world where the failure to offer TYP would be malpractice...for someone with diabetes? pre-diabetic? with Lp(a) or Homocysteinemia?  I do... and  who knows sooner than u might think.

I think behind every genius-man, there stands a genius-woman. Once when I couldn't log on, couldn't access 'chat' and couldn't find reports when they were right in front of my *darn* NOSE... a wise woman told me 'you can't know everything.'  *ha ha* give her a hug for me
g

Just a note to g regarding screening for osteoporosis at the wrist.  These are very ineffectual tests.  It is best to use the spine +/or hip as osteoporosis starts at the center of the body.  By the time it is detected in the distal extremities, you would already have significant bone loss. At least this is my understanding as a technologist. Could this also apply to artery disease?