Did you see the statins article in latest issue of BW? It is a MUST read!

http://www.businessweek.com/magazine/content/08_04/b4068052092994.htm?chan=magazine+channel_top+stories

I'd make it akin to pregnancy: ya either are or ya aint... no grey areas.  
could be 9mos, could be 3mos but you're still pregnant.

Scan and Track yourself...You either have a positive CAC score, lucky dude (or dudette) it's zero. If it's positive then Obliterate that Plaque (S.T.O.P.) with TYP and DR. Davis!

And if you look 3mos pregnant (and you're male) there's a 100% chance you have plaque.
And if you're female... and NOT pregnant, ditto because central obesity typically indicates Insulin Resistance the strongest plaque builder out there. 70% of the world's population are pre-diabetic or have type 2 diabetes (T2DM) and it's growing everyday.

I can't tell you how many people have come to me and told me that a doctor told them statins were "magic" or a virtual "cure" for heart disease. Of course, they are not. They don't even come close.

Yes, statins do provide a role. In a $26 billion industry, perhaps 20% of that is truly necessary.

Well said.

Maybe I should post a piece called "Are you a pregnant male?"

A little off subject, but any comments on the latest report( I believe from the  Framingham study ) that says low vitamin D levels is a very definite cardiac risk factor ONLY in people with high blood pressure and not at all in anybody else?

As with any observational study in which no intervention (e.g., treatment with vitamin D) was made, various factors as predictors of death and heart attack emerge only when powerful effects are likely.

We see enormous effects from vit D replacement regardless of BP effects. Remember also that there is more to life and health than reduction of cardiovascular disease risk. Vit D also reduces risk of falls/fractures, osteoporosis, various cancers (esp. colon and prostate), reduces blood sugar, inflammatory responses, etc.

I know this is probably not the right place to post this message but I do not know where else to. I live in the UK and I have had 'Track Your Plaque' on order for the past two weeks with Play.com (similar to Amazon). I queried why my order is taking so long and they said that the book is printed on demand. Is this correct ? If so please can you tell me when you are next doing a printing because I really do need the book before the beginning of February when I will be seeing my cardiologist and asking him for a referral for an EBCT scan. I want to go to my appointment armed with 'Track Your Plaque' !

with kind regards,
Anne

Yes, this far out from its original printing, it is now printed only on demand.

Dear Dr Davis,

Have you any idea how long it takes to get a copy printed ? I have a bicuspid aortic valve with moderate stenosis and I think it would be a good idea for my cardiologist to refer me for a scan so that we can see why the stenosis is progressing if it is due to calcification of the valve - I don't see what else it could be - but he may take some convincing and I was hoping that if I had the book it would be helpful. If I don't get a referral it will be too expensive for me to pay for myself as an EBCT scan in the UK costs around £500 or $1000.

with best wishes,
Anne

Hi, Anne-
Unfortunately, a heart scan will not be very helpful for the question of aortic valve disease. Yes, it can quantify calcium on the valve, but this is not a factor in determining when replacement is necessary, nor does it help track progression, unlike in coronary arteries.

Be sure to take a look at vitamin D--this is crucial in aortic valve issues.

Dear Dr Davis,

Oh, I see :-( My cardiologist is doing yearly echocardiograms to determine when to replace the valve, but, from my limited knowledge, I had been thinking that if I knew the exact extent of any calcification on the valve and took all steps necessary to reverse the calcification then I could reverse the progression of the stenosis and never have to have a valve replacement. I have started to take 5000iu of D3 per day yes

with best wishes,
Anne

Hi Dr. Davis,

I have a friend whose wife has mitral valve prolapse.  Would Vitamin D3 supplementation be useful in treating this?

anne,

I bought 8 books -- and they arrived in < 1wk.  Once you read it, you'll want your best friends and family to get onboard too!   No point in being immortal... ALONE.
Also, if you're considering trackyourplaque.com membership, the TYP book is included!

g

Hi, WC--
No. Vit D will not have any specific effect on mitral valve prolapse. However, it's still worth taking for all the other benefits, however.

I received a zero score in a coronary artery calcium screening. However, the clinic mailed me a report that had some comments related to mild ectasia of the ascending aorta and subtle calcification involving the descending aorta.  Any thoughts?

Then it's likely that high blood pressure, vitamin D deficiency, and some other factors (see lipoproteins) are active issues.

Dr. Davis
Thank you for the response. I am fascinated by your blog and will follow up on your suggestions.

wccaguy,

Re mitral valve prolapse: Is magnesium a factor? Bit of an obscure ref but Mg is pretty non toxic by mouth...

Peter

Magnesium depletion seems common also in diabetes.  Could perhaps Mg depletion and it's negative consequences, including valve damage as per Peter's reference, be caused by the excessive carbohydrate consumption as the primary factor?

Stan (Heretic)

http://www.chiro.org/nutrition/magnesium.shtml#carbohydrate_metabolism

Yes, magnesium depletion can develop on high-carbohydrate diets, and it also aggravtes pre-diabetic tendencies.

However, while magnesium supplementation can reduce some of the consequences of mitral valve prolapse (such as abnormal heart rhythms), it does not actually protect the valve.

A bit confusing.

Dr. Davis wrote:  However, while magnesium supplementation can reduce some of the consequences of mitral valve prolapse (such as abnormal heart rhythms), it does not actually protect the valve.

Very interesting!  That would suggest that magnesium depletion may be a coincidental marker of something else that is the common cause of both heart damage and magnesium depletion. Much like in the serum cholesterol case, perhaps?

Dear Dr Davis,

You wrote: "Unfortunately, a heart scan will not be very helpful for the question of aortic valve disease. Yes, it can quantify calcium on the valve, but this is not a factor in determining when replacement is necessary, nor does it help track progression, unlike in coronary arteries."

I've just found this article which suggests that the stenosis associated with bicuspid aortic valve can be reversed, and likens the progression of the calcification on the valve to that in atherosclerosis in arterial walls: http://content.onlinejacc.org/cgi/content/full/42/4/593

Can you comment on this please because if it were true then the strategies employed in Track Your Plaque would work for valves too wouldn't they ?

with best wishes,
Anne

Anne--

The review you cite preceded publication of two studies that attempted to affect progression of aortic valve disease using high-dose Lipitor or Crestor. Lipitor had no effect; Crestor, 40 mg per day, did have a small effect.

Because the Track Your Plaque program does not track aortic valve disease, I cannot say whether or not it has any effects. However, it is probably small to none--with the exception of vitamin D. I have great hopes for vitamin D's effect on slowing or reversing aortic valve disease. We are accumulating an experience with vit D, but it's too preliminary to publish.

I saw my cardiologist today for my yearly echocardiogram. The pressure gradient across my bicuspid aortic valve has increased from 35mmHg to 38mmHg since last year which my cardiologist said was good....but he's going to refer me for an EBCT scan !  And because I have private health insurance I should be covered.....they don't do EBCT scans under the NHS here in the UK so I'm really lucky

all the best,
Anne

Dear Dr Davis,

I had the results of my scan today. There's no calcification in the coronary arteries But calcification showed up on the bicuspid aortic valve. My cardiologist said there's nothing I can do about that because of the turbulent blood flow, but I'm determined that I will be able to halt the calcification or reverse it and I will be watching your blog for anything you write about aortic valve disease, especially when you write about your work with vitamin D and aortic valves. I'm currently taking 4000iu D3.

with best wishes,
Anne

Coronary atherosclerosis is a diffuse process that involves much of the length of the artery. It is therefore folly to believe that a 15 mm long stent has addressed the disease. This is no more a solution than to replace the faucet in your kitchen in a house with rotting pipes from the basement up.

Any particular types of snacks helpful when taking niacin? I sometimes eat a handful of nuts, or an apple,  when taking niacin, hoping it will reduce the possibilty of flush -- just curious if some foods are better than others.

Also, since niacin can raise histamine, has any studies been done on taking an anti-histamine along with high dose niacin? Or how about some vitamin C (natural histamine reducer) at the same time as niacin?

And finally, any real differences between Niaspan, Slo-Niacin and Enduracin (besides cost)? The only difference I can find is that Slo-Niacin might tax the liver a bit more, since it takes longer to fully absorb. The others are absorbed within 6-8 hrs, I believe.

What about the use of Quercetin. There is a recent article showing it may inhibit the niacin flush. At least that was the result in rats. The study was published in the British Journal of Pharmocology Jan 2008
Anne

Dr Davis, the flush of Niacin has been of little bother to me. However each winter when I go to Florida from my cold north home, the Niacin itchy rash appears on my chest. This year I finaly found that Benadryl extra strength eliminated it after three applications. It has to be the increased sunshine that kicks it in. I hope others may find this helpful...Niacin is a life saver and still vastly under rated. Thanks for your informative blogs. Over&Out

I've noticed what seems to be a correlation between flushing and eating spicy foods -- foods that contain peppers containing capsaicin.  Has anyone else noticed this?

It seems that I can pretty much count on getting a flush response 30-60 minutes after eating spicy food.  

Dr. Davis, any thoughts?

Nice post - and I swear I don't know how doctors do it, repeating your self over and over.  I forward your blog wittings to family and friends.  And because of that I'm the one they naturally come to when looking for TYP advice.  

For what ever reason, no matter how many times I repeat myself, people forget two items with niacin:  1)hydrate to limit flush 2) avoid time release niacin as that can dangerously poison your liver - along with telling your doctor you are taking niacin. Grrrrr.........

Sorry, as a long-time niacin user I have to say the advice to increase hydration is good in general, but inadequate in itself to quickly eliminate a niacin flush. You can test this yourself. The next time you experience a big flush, go consume a large quantity of water...see if your flush quickly reduces.  It won't.

On those rare occasions when water by itself is insufficient, then an adult (325 mg), uncoated aspirin or 200 mg ibuprofen can also be used to accelerate relief.

"Sorry, as a long-time niacin user I have to say the advice to increase hydration is good in general, but inadequate in itself to quickly eliminate a niacin flush. You can test this yourself. The next time you experience a big flush, go consume a large quantity of water...see if your flush quickly reduces. It won't."

Okay. And as a long-term niacain user, myself, who just read this earlier tonight and who just tried drinking water when experiencing a flush, I will say that it does work. For me, at least.

Great factors…I would note that as someone who actually doesn’t comment to blogs a lot (in actual fact, this can be my first submit), I don’t suppose the time period “lurker” is very flattering to a non-posting reader. It’s not your fault at all, but maybe the blogosphere could give you a better, non-creepy name for the 90% of us that get pleasure from reading the posts.

Great factors…I would note that as someone who actually doesn’t comment to blogs a lot (in actual fact, this can be my first submit), I don’t suppose the time period “lurker” is very flattering to a non-posting reader. It’s not your fault at all, but maybe the blogosphere could give you a better, non-creepy name for the 90% of us that get pleasure from reading the posts.

Hey - good blog, simply wanting round some blogs, appears a fairly nice platform you're using. I’m currently using WordPress for a few of my websites however seeking to change considered one of them over to a platform just like yours as a trial run. Anything specifically you would recommend about it?

Wonderful put up from professional additionally it can probably be an exquisite know-easy methods to us and thank you a large number for posting this precious info with us all.