Instant heart disease reversal


What if reversal of heart disease--regression of coronary atherosclerotic plaque--were achievable instantly? Just add water and--voila!!

To my knowledge, it is not--yet. But I sometimes play with this idea in my head. I could imagine that such a program would consist of a few essential elements:

--A fast or semi-fast, or at least a very spare diet, over a period like 10 days to promote net catabolism. It is also supremely anti-inflammatory to restrict calories.

--High-dose vitamin D, e.g., 20,000 units per day of D3 to fully replenish depleted stores and achieve all the metabolism-correcting effects of D3 restoration.

--EPA + DHA at a higher than usual dose with frequent throughout-the-day dosing to encourage replacement of cellular lipid constituents with the more stable omega-3 fraction of fatty acids.

Beyond this, I'm uncertain. What role l-arginine, statins, niacin . . . conjugated linoleic acid? ApoA1 Milano infusions?

This is simply whimsical at this point. I don't know if such an approach would work. But if it did, you might imagine that it would offer an opportunity--for the properly motivated--as an alternative treatment for angina, advanced coronary disease, a means to pull someone back from the brink.

With the insights gained from our slow-but-powerful Track Your Plaque approach, perhaps we will also gain insights into how to accelerate such a process of reversal so that it is achievable in days, rather than months or years.

Comments (16) -

  • wccaguy

    10/17/2007 3:24:00 PM |

    Dr. Davis,

    You keep making posts about things this newcomer to the Track Your Plaque program is thinking about.

    I was thinking just last night that I would soon make a post at the Track Your Plaque (TYP) forum asking about what a TYP+ Supplement program might look like.

    For people like me who have already experienced cardiac events this would be a huge thing.

    I've now got my blood testing done.  I appreciate your providing feedback yesterday at the forum to my posting my blood test results there.

    I also had a heart scan done even though I know it's of more limited use given my cardiac history and that you basically don't recommend it.  Frankly, I disagree with you a bit on the usefulness of a heart scan with preexisting cardiac events.  I'll explain why later.

    So, I'm ready to go with TYP+ Supplement Program.

    I have some specific supplements in mind that aren't among the current recommended TYP Supplements.  I'll make a note of the ones you mention in this post.  I'd like your feedback on a comprehensive list to try for inclusion in a TYP+ program of supplements.

    I'll make that post to the forum soon now that I know you're thinking about this already.

  • JoeEO

    10/17/2007 11:30:00 PM |

    Dream big my friend!

    I am thinking a resort off the coast of Thailand. You take a month for the treatment. Fly in to a first class medical resort - do your fast while lounging in a tropical paradise - get lots of sun lounging by the pool (aids in Vit D absorption). While you are receiving the various medical and supplement treatments for your heart disease you might want to look into getting a little "touch-up" plastic surgery  or maybe that hip replacement you've been putting off...

    I bet your "instant Heart Disease" treatment, some plastic surgery and a hip replacement in total would still be less money than a cardiac cath and stenting back in the United States!

    I being somewhat facetious in writing this post...but I truly believe that scenario I discribed  
    will be the norm in the next 10 or 15 years - as the rest of the world becomes richer and the regulatory environment in the US and Europe slows cutting edge development i could see some fast developing nation such as Thailand assembling a team of highly skilled Doctors in order become the world leader in treat a particular disease.


    Peace

    Joe E O

  • Dr. Davis

    10/18/2007 12:27:00 AM |

    Hi, Joe--

    Interesting perspective. I hadn't thought of it in those terms. If nothing else, it would make a fascinating experience to watch.

  • vin

    10/19/2007 9:28:00 AM |

    I think that method exists since the fifties and is known as chelation therapy.

    Admittedly the mix, which is often vitamin C and other supplements plus EDTA or something similar, needs to be improved with the current knowledge about amino acids etc. But it could do the job.

    Diet on the other hand is unbeatable. One could spend two weeks in a resort and eat ideal meals to improve health.

  • Dr. Davis

    10/19/2007 2:32:00 PM |

    Sorry, but the chelation in my experience has never worked. I personally have seen several people go through it, usually provided by shady types, with huge rises in heart scan score. Until genuine evidence suggests otherwise, chelation falls in my scam file.

  • wccaguy

    11/15/2007 7:35:00 AM |

    Hi Dr. Davis,

    I have now got my intake of Niacin up to 3g a day using Slo Niacin.  I'm wondering if I shouldn't attempt to get it higher to impact my Lp(a) number.

    I'm 6' tall and at 250 pounds am a "big person".  I'm working on the weight of course.

    I understand there are potential impacts on the liver.

    I have been told and found in the past that Silibinin Plus from LEF and n-acetyl-cysteine work pretty well to keep liver numbers under control.

    What would you think about my taking my niacin dose up to 4g a day (or even potentially higher) if I could keep my liver numbers under control.

    Thanks.

  • Dr. Davis

    11/15/2007 12:07:00 PM |

    I'm a big believer in going slow with niacin. It may take a year or more for it to exert full effects, including reduction of Lp(a). I am generally not in a hurry to raise doses.

    I do favor periodic cycles off niacin, however, especially in people with Lp(a). In my many hundreds of patients with this disorder who take niacin for several years, there is a peculiar creep back up of Lp(a) levels back to the starting values. I believe that periodic "vacations" off niacin are necessary from the start, e.g., one month off every six months. Resume dose gradually and work with your doctor if/when you do this.

    Re: liver protection. I'm only superficially familiar with those agents, and I cannot say specifically whether they spare the liver from niacin effects. Interesting idea, though. Phosphatidylcholine? The liver-sparing effects of this agent are interesting, also. But I know of no specific experience with niacin, unfortunately.

  • wccaguy

    11/15/2007 3:57:00 PM |

    Thanks for the reply Dr. Davis,

    I understand that, because you're not my doctor, you can't give me specific medical advice.

    It's also true that I know of no other doctor who has more of the scientific literature and practical supplement experience than you have.

    First, however, thanks for the tip on periodic Niacin vacations.

    Let me then put another question to you this way...

    I'd like to propose to my doctor the following to get his expert insight but before I do, having your opinion would come in handy.

    Suppose I pumped up my intake of niacin to 5 grams.  After a month of that, I get a liver numbers test.  Then I begin the Silibinin Plus - N-Acetyl-Choline regimen.  Then after another month, I take another liver numbers test.

    Would a scenario like that provide me with useful information for long term Lp(a) treatment without doing permanent damage to my liver?

    Any suggestions for improving the idea?

    One last thought...

    Because Lp(a) is believed to be formed in circulation (per McCormick, Marcovina, et al), it seems to me that continuous availability of niacin in circulation is important.  So, I'm thinking 2 or 3 doses of niacin per day at 1.5g to 2.5g per dose.

    Seems to me that dosing like that would be beneficial to assessing the impact of the Silibinin Plus - N-Acetyl-Cysteine regimen.

    Does that make sense?

    Thanks for all you do!

  • Dr. Davis

    11/15/2007 5:27:00 PM |

    wccaguy--

    I think that it depends on your endpoint.

    If Lp(a)reduction alone is your endpoint, then raising niacin even to 5 g per day is reasonable.

    However, if control of plaque growth is your endpoint, then you might make do with far less, e.g., 2000-3000 mg per day. It can vary enormously. (In fact, I have even seen an occasional person reverse without Lp(a) control, though this is unusual.)

    One warning re: the frequent dosing of niacin. Far more likely to yield liver toxicity than dose is frequency. Taking niacin three times a day as SloNiacin virtually guarantees serious liver toxicity--I would strongly urge you to NOT do this. You are safest with once daily dosing of the SloNiacin preparation.

    Re: liver toxicity gauged by liver function tests. Unfortunately, these are not really good tests for quantitative assessment of liver toxicity; they are rather weak, qualitative tests. So I do not believe you can make much of shifts within the normal range.

  • wccaguy

    11/16/2007 1:47:00 AM |

    Thanks Dr. Davis for the niacin regime tips:

    To sum up.

    1   I will try to get my Slo Niacin dose to 5g per day in a single dose.

    2   I will monitor Lp(a) test scores.

    3   I will take a one month niacin vacation every six months.

    Thanks again.

  • Kiran Sawhney

    7/14/2008 9:01:00 PM |

    Your blog is very informative i must say. I like such dedicated blogs. I too write a blog on fitness and health and life. it is http://dreamfit.blogspot.com
    do stop by sometime.

  • Anonymous

    3/9/2009 10:56:00 AM |

    Dear Dr.Davis,

    I just came across your site for the first time and very much like the content and layout.

    I'm aware that you don't answer personal questions but am not quite sure with what one can post or comment on? I hope my post is considered acceptable and I hope you will take the time to comment briefly.

    I'm in a desperate need to help my mother who had a hearth attack a month ago. She's always had a low blood pressure and considered herself to be very healthy. She is 63 and never been on any medication, no pains or complaints. And all of a sudden-a heart attack! She has had two stents put in and is on several medications-Plavix 75mg, Beloc Zok 25mg, Triatec, Sortis 40mg, Aspirin 100mg and Nexium 40mg.
    I'm aware of the interactions of Plavix and Aspirin-Nexium and am terrified of the complications. She started taking a nattokinease supplement and thought that it will be better if she didn't take the Aspirin-Nexium. However after reading all your comments on natto-i feel this might not be a wise idea. I've been a regular reader of Dr.Mercola.com for many years and ordered a product called Cardioessentials from the site. I must say am not a fan of the statin drug as well but have only insisted on CoQ10 as ubiquinol of 200mg a day.
    She has become more thoughtful of her diet and exercise. I know that thing rarely happen without warnings and am sure she  could have taken a better care of herself. She did gain a bit of weight lately and I know that visceral fat does come with a price on heart health! She is following a diet rich in vegetables and fruits, lean meat and fish, nuts and seeds and low in grains. She takes fish oil, flax oil an olive oil,garlic, green tea, vit C in high doses, vit E and D, ALA, vit B complex, grape seed extract and chlorella. I'm considering L-carnitine, L-arginine, taurine, lutein and NAC.

    Please share a few wise words on this protocol and let me know if there is anything she is missing out on or should not be taking.
    I would greatly appreciate your comment. Thanks in advance,

    Lidija McLaren

  • Treatment for heart disease

    9/27/2010 12:51:28 PM |

    Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

  • Treatment for heart disease

    9/27/2010 12:52:23 PM |

    Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

  • blogblog

    10/30/2010 4:00:49 AM |

    This is a routine widely practised in Japanese hospitals for many diseases. They also use an IV glucose solution with electrolytes.

    I am doing exactly what you suggest at the moment.

    Supplements:

    1/2 teaspoon of salt and 1/2 teaspoon of salt substitute (potassium chloride) dissolved in 2L of water. This provides very roughly 2g sodium and 2g potassium/day.

    300mg magnesium and 800mg to prevent cramps.

    A single multivitamin tablet.

    A high potency B group supplement.

    500mg vitamin C.

    5g fish oil.

    After 3 days I have never felt better in my life

  • buy jeans

    11/2/2010 9:27:57 PM |

    This is simply whimsical at this point. I don't know if such an approach would work. But if it did, you might imagine that it would offer an opportunity--for the properly motivated--as an alternative treatment for angina, advanced coronary disease, a means to pull someone back from the brink.

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Being regular is dangerous to your health

Being regular is dangerous to your health

No, I'm not referring to your daily morning ritual in the bathroom. I'm talking about heart rate.

Counterintuitively, a perfectly regular heart rate is a marker of poor health. People with perfect regularity of heart rate have more heart attacks, for instance.

Regularity of heart rate occurs more commonly in people with hypertension and other metabolic derangements, and it signals increased risk for both heart attack and death. A perfectly regular heart rate, i.e., no variation in the time interval from beat to beat, suggests that the parasympathetic nervous system, the component of automatic ("autonomic") nervous system control that is associated with the relaxation response, feelings of well-being, quiet, and relaxation, is weak. It also means that the opposing sympathetic nervous sytem that regulates the "fight or flight," adrenaline-like response is allowed to be dominant. Dominance of the sympathetic over the parasympathetic system generates regularity of heart rate. Heart rate also tends to be faster, e.g., 85 beats per minutes rather than 55 or 60 beats per minute. So perfect regularity, as well as increased rate, is undesirable.

What we want is irregularity of heart rate. But not irregularity that occurs chaotically with no rhyme or reason. More precisely, we want variability in heart rate. And we want variability to occur in synchrony with breathing, i.e., the respiratory cycle.

The ideal response is:

1) increase in heart rate with inspiration

2) decrease in heart rate with expiration.

Heart rate in healthy people typically varies 15-20 beats per minute within the respiratory cycle, e.g., 60 bpm at end-exhalation, 80 bpm at end-inspiration.

Restoration of increased heart rate variability is associated with reduced blood pressure, reduced blood sugars (HbA1c), reduced inflammatory markers and cortisol (associated with stress), even an increase in DHEA levels. Feelings of well-being and calm also develop.

Among the strategies to consider to restore heightened heart rate variability and slowed heart rate include:

--Omega-3 fatty acid supplementation
--Exercise
--Weight loss
--Deep breathing exercises
--Meditation, prayer, and biofeedback

For our Track Your Plaque purposes, we are folding in the HeartMath strategies, i.e., use of a heart rate monitor that calculates heart rate variability in the context of respiratory cycle. If you've not already done so, take a look at the two Special Reports devoted to this topic on the Track Your Plaque website.

Comments (21) -

  • Tim Huntley

    9/25/2011 2:06:58 PM |

    Dr. Davis,

    I have spent about 6 months taking daily HRV measurements using a Suunto t6d watch and analyzing the output with a software tool from Kubios.  From my n=1 experience, the most meaningful long-term impact to improved HRV has been regular exercise.  A lot of the research studies I looked at are in agreement with the other factors you mentioned above; however some of the factors tend to be more transitory (breathing, meditation, etc. ) and create a change during the time that you are working on them vs. the more lasting effects from exercise.

    I would be happy to share more specifics from my experience if you are interested.

    ...Tim

  • me@me.com

    9/25/2011 3:20:56 PM |

    Dear "Dr. Davis"

    i'd love to read more !

    warmly
    interested one Smile

  • Geoffrey Levens, L.Ac.

    9/25/2011 4:20:46 PM |

    The folks at Heart Math have had this mastered for years.  Books, classes, seminars, and they sell a portable and a computer based biofeedback device for training "coherence".  I am not affiliated with them in any way and do not sell their products but I do think it is a pretty good way to get into the whole arena of meditation and of very directly training HRV.

  • Diana

    9/25/2011 8:01:23 PM |

    This is really interesting, because it goes along exactly with what I learned in studying midwifery - that hearing an absolutely regular/non-variable heartbeat on a fetoscope is a sign of a seriously compromised baby. Interesting that that carries on into the adult world!

  • LINDA

    9/25/2011 9:19:57 PM |

    (The FASEB Journal. 2011;25:971.10)
    © 2011 FASEB
    ________________________________________
    971.10
    Daily apple consumption promotes cardiovascular health in postmenopausal women
    Sheau C Chai, Shirin Hooshmand, Raz L Saadat and Bahram H Arjmandi
    Nutrition, Food & Exercise Sciences, Florida State University, Tallahassee, FL
    Animal findings suggest that apple and its components, e.g. apple pectin and polyphenols improve lipid metabolism and lower the production of proinflammatory molecules. To our knowledge, the present study is the first that evaluated the cardioprotective effects of daily consumption of apple for one year in postmenopausal women. Qualified women (160) were randomly assigned to one of the two dietary intervention groups: dried apple (75g/day) or comparative control dried fruit. Fasting blood samples were collected at baseline, 3-, 6-, and 12-month to measure various parameters. Our findings indicate that the additional daily caloric intake of ~240 from dried apple not only do not increase body weight but rather lower it by 1.5 kg without altering habitual dietary intake. In this study, apple consumption significantly reduced serum levels of TC and LDL by 14% and 23%, respectively. The daily apple consumption also profoundly improved atherogenic risk ratios in addition to lowering serum levels of lipid hydroperoxide (33%) and C-reactive protein (32%). In conclusion, incorporation of apple into regular diet is encouraged because of its highly favorable effects in reducing the risk factors for cardiovascular disease.
    Grant Funding Source: Partly supported by USDA
    Table of Contents
    This Article
    1.  FASEB J. April 2011 25 (Meeting Abstract Supplement) 971.10
    1.  Â» Meeting Abstract

  • LINDA

    9/25/2011 10:27:18 PM |

    Effects on Thyroid
    The National Institutes of Health (NIH) note that although little scientific data is available about the effects of flax on the thyroid, some experts in natural medicine advise that patients avoid flaxseed in cases of hypothyroidism. (See Resource 2) The Univeristy of Maryland Medical Center also suggests that patients with thyroid disorders stay away from flaxseed and other foods that may interfere with thyroid function. (See Reference 3)
    Goitrogens
    Thiocyanite, a substance found in flax products and other foods, such as apricots, rye, millet and broccoli, might act as a goitrogen-that is, it may block the uptake of iodine in the thyroid gland. When your diet is too rich in goitrogens and too low in iodine, it can cause the thyroid gland to swell and form a lump, or goiter. However, the typical diet in the United States contains enough iodine that problems like goiter have been practically eliminated, so goitrogens should not be a concern for the average American. (See Reference 2, pages 100-101)
    Read more: Flaxseed and Thyroid Disease | eHow.com http://www.ehow.com/facts_5629982_flaxseed-thyroid-disease.html#ixzz1Z0N1SV8j

  • Dr. William Davis

    9/26/2011 12:37:25 PM |

    I didn't know that, Diana!

    That's very interesting, a phenomenon consistent in widely variable situations.

  • Dr. William Davis

    9/26/2011 12:38:51 PM |

    Hi, Geoffrey--

    My experience with HeartMath goes back around 15 years, long ago that I still remember using Holter monitors, shipping the tape to LA, and waiting for the analysis to come back--long delay, no real-time feedback.

    The new do-it-yourself device really changes the entire equation: real-time feedback, much faster results.

  • Dr. William Davis

    9/26/2011 12:41:32 PM |

    Hi, Tim--

    I'd love to hear more! Specifically, what is the heart rate feedback like on your watch? Is it a visible signal?

    You are absolutely correct: Many effects are transitory. However, the more you do it, the more you habituate the response, the more likely it becomes "coherence" occurs spontaneously.

  • Teresa

    9/26/2011 4:14:34 PM |

    HeartMath exercises are more than regular breathing.  They advocate activating a positive feeling, such as gratitude or appreciation, during the breathing exercises.  This helps maintain the increased heart rate variability.  Here is a link to one of their techniques.  

    http://www.heartmath.com/personal-use/quick-coherence-technique.html

    This is a summary of some of the scientific concepts of HeartMath.  It is an older publication, but still interesting to read.

    http://www.heartmath.org/research/science-of-the-heart/introduction.html

    More research studies are listed here.

    http://www.heartmath.org/research/research-library/research-library.html#educational-research

    While the computer programs and gadgets are helpful, they are not essential to learning and being successful with the techniques.

    Teresa

    P.S.  I am not affiliated with HeartMath in any way except that I have a relative who works for them.  I don't make any money off of them.

  • Bill

    9/26/2011 8:03:36 PM |

    With regard to your play on "being regular", apart from being grain free with not one lapse for 4 years, I have been squatting for 5 years and believe it's natural and very beneficial. Strongly recommend!

  • Dr. William Davis

    9/27/2011 2:53:40 AM |

    Hi, Teresa--

    Yes, there are many ways to achieve enhanced parasympathetic tone, HeartMath coherence being one of them.

    You could meditate for months to years, you could perform thermal biofeedback. What I like about HeartMath is its immediate accessibiity.

  • Rita

    9/27/2011 10:44:58 AM |

    This is just a housekeeping issue. I used to get your posts via email but not for months now. When I try to re-subscribe, Feedburner says I am already subscribed, but still no posts come to email. Can you get this fixed? Thanks.

  • Makro

    9/28/2011 12:21:30 PM |

    Dr. Davis - OT question:

    When is WB showing up in the Kindle store? Looking forward to giving it a read.

  • MaryB

    9/28/2011 1:11:31 PM |

    This is very interesting information.  It parallels the test they do for Diabetic Neuropathy.  

    If the heartbeats are the same on inhale and exhale you have it pretty bad.  The closer they are to the same, the worse the Neuropathy is found to be.  They use an EKG test and compare the peaks... If I understand correctly.  This sounds like it relates to what you are discussing Dr. Davis... am I correct

  • MaryB

    9/28/2011 1:14:19 PM |

    hmmm did you read the article?  LOL  This is not about constipation but heartbeats.

  • Lance Strish

    9/28/2011 11:41:33 PM |

    DrGreger talked about heart rate variability in 2009 once
    http://www.youtube.com/watch?v=sK0PHQLpw4U&feature=BFa&list=PL53AA35449C7DD652&lf=PlayList#t=4m
    -
    http://tinyurl.com/drgregerPDF

  • Dr. William Davis

    9/29/2011 1:02:36 AM |

    Yes, indeed, MaryB: Absolutely correct.

    Diabetes, in particular, can lead to a marked lack of heart rate variability and its health consequences.

  • Dr. William Davis

    9/29/2011 1:03:11 AM |

    Hi, Makro--

    It should already be there. Are you outside the U.S.?

  • Dr. William Davis

    9/29/2011 1:04:56 AM |

    Hi, Rita--

    Sorry. Thought this was fixed.

    I'll have it looked into.

  • Ginger

    1/1/2013 4:16:09 AM |

    Any info on stopping PVC's? I don't do caffiene, very little sugar, i do deep breathing and meditation. I'm dairy free and don't eat gluten.

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Disease engineering

Disease engineering

Imagine you catch pneumonia.

You have a fever of 103, you’re coughing up thick, yellow sputum. Breathing is getting difficult. You hobble to the doctor, who then fails to prescribe you antibiotics. You get some kind of explanation about unnecessary exposure to antibiotics to avoid creating resistant organisms, yadda yadda. So you make do with some Tylenol®, cough syrup, and resign yourself to a few lousy days of suffering.

Five days into your illness, you’ve not shown up for work, you’re having trouble breathing, and you’re getting delirious. An emergency trip to the hospital follows, where a bronchoscopy is performed (an imaging scope threaded down your airway) and organisms recovered for diagnosis. You’re put on a ventilator through a tube in your throat to support your breathing and treated with intravenous antibiotics. Delayed treatment permits infection to escape into the fluid around your lungs, creating an “empyema,” an extension of the infection that requires insertion of a tube into your chest through an incision to drain the infection. You require feeding through a tube in your nose, since the ventilator prevents you from eating through your mouth. After 10 days, several healing incisions, and a hospital bill totaling $75,000, you’re discharged only to be face eights weeks of rehabilitation because of the extreme toll your illness extracted. Your doctor also advises you that, given the damage incurred to your lungs and airways, you will be prone to more lung infections in the future, and similar situations could recur whenever a cold or virus comes long.

A disease treatable by taking a 10-day, $20 course of oral antibiotics at home was converted into a lengthy hospital stay that generated extravagant professional fees, testing, and costly supportive care. You’ve lost several weeks of income. You’re weak and demoralized, frightened that the next flu or virus could mean another trip to the hospital. You are susceptible to repeated bouts of such episodes in future.

Such a scenario would be unimaginable with a common infection like pneumonia, or it would be grounds for filing a malpractice lawsuit. But, as horrific as it sounds in another sphere of health care, it is, in effect, analogous to how heart disease is managed in current medical practice.

First, you’re permitted to develop the condition. It may require years of ignoring telltale signs, it may require your unwitting participation in unhealthy lifestyle practices, like low-fat diets, "eat more whole grains," and "know your numbers."

It then eventuates in some catastrophe like heart attack or similar unstable heart situation, at which point you no longer have a choice but to submit to major heart procedures. That’s when you receive your heart catheterization, coronary stents, bypass, defibrillators, etc.

Of course, none of these procedural treatments cures the disease, no more than a Band Aid® heals the gash in your leg. The conditions that were present that created heart disease continue, allowing a progressive disease to worsen. At some point, you will need to return to the hospital for yet more procedures when trouble recurs, which it inevitably does.

A coronary bypass operation costs, on average $67,823. That includes the cost for the heart catheterization performed by a cardiologist to provide the surgical roadmap of your coronary arteries, the surgeon’s fees, the hospital charges. If there are any complications of your procedure, then your hospital bill may total a substantially higher figure.

$67,823 is just the upfront financial pay-off. Over the long run, your life is actually worth far more to the cardiovascular health care system because no heart procedure yields a permanent fix. In fact, repeated reliance on the system is the rule.

In fact, over 90% of people who enter the American cardiovascular health care system do so through a revolving door of multiple procedures over several years. It is truly a rare person, for instance, who undergoes a coronary bypass operation, never to be seen again the wards of the hospital because he remains healthy and free of catastrophe. A much more familiar scenario is the man or woman who undergoes two or three heart catheterizations, receives 3,4, or 6 stents, followed a few years later by a heart bypass, pacemaker, defibrillator, as well as the tests performed for catastrophe management, such as nuclear stress test, echocardiogram, laboratory blood analysis, and consultation with several specialists. The total revenue opportunity is many-fold higher than the initial 60-some thousand dollars, but instead totals hundreds of thousands of dollars per person.

A heart attack alone is a $100,000 revenue opportunity (Agency for Healthcare Research and Quality, 2004).

Of all coronary bypass procedures performed, 25% are “re-do’s”, or bypasses in people who’ve had a previous one, two, or three bypass procedures.

Perhaps it's excessively cynical to label it "disease engineering." But, whether from benign neglect or purposeful failure to diagnose, the fact remains: Heart disease is, all too often by the standard path, undiagnosed and neglected for years until the procedural payoff strikes.


Copyright 2008 William Davis, MD

Comments (10) -

  • Ketogenic Diet

    3/21/2008 2:44:00 PM |

    This is very well written.  Great perspective.

  • Anonymous

    3/21/2008 4:12:00 PM |

    And how many of these procedures are ABSOLUTELY necessary after they get you into the hospital?  

    I recently changed cardiologists.  The new doctor, after reviewing my history and talking with him (yeah, a dialog!), he made the comment that he wonders why I even had a pacemaker installed (keeps heart rate from dropping below 60)!!  Talk about being left speechless!!  

    You see, I had passed out.  It was discovered that I had severe blockage of the left descending artery.  A stent was inserted.  Then the doctor said that if a pacemaker were not installed I could experience sudden death due to low heart rate.  I can still hear his booming voice that could be heard on the entire floor stressing the words "sudden death."  What would you do?  

    Hey, is the thinking that if it is not really necessary it is at least innocuous, then cha-cling . . . $65,000?  Scary.    

    Anyway, my new doctor said that it is something that needs more study, etc.   I know the "control unit" can be changed out for new batteries but I've never heard of the wiring being removed from the heart muscles.  Geeez.

  • Anonymous

    3/21/2008 6:07:00 PM |

    Ignatius Semmelweiss had the same problem;  He railed against the conventional wisdom that 'knew' there was no reason for handwashing before surgeries.

  • Anne

    3/22/2008 1:33:00 AM |

    "A much more familiar scenario is the man or woman who undergoes two or three heart catheterizations, receives 3,4, or 6 stents, followed a few years later by a heart bypass, pacemaker, defibrillator, as well as the tests performed for catastrophe management, such as nuclear stress test, echocardiogram, laboratory blood analysis, and consultation with several specialists. "

    I think you have been following me around. I am glad to say that I did not go on to pacemaker/defibrillator, but I had all the rest. The day I got my first stent, my doctor told my husband "I fixed her" and proudly handed us a before and after picture. Funny, I did not get any pictures when I had more angioplasies.

    I am so tired of band-aid medicine. Finally, I think that I am on the right track of lifestyle changes, thanks to information here and other forward thinking websites.

  • LJ

    3/22/2008 2:08:00 PM |

    Agreed, great perspective... but my goodness! Pardon this slightly off topic comment, but you just described word for word what a good friend of mine is going through with pneumonia -  except she was sent home from a doctor's office twice. By the time she was admitted to hospital, her blood pressure was about 60/40 and she was in agony from a collapsed lung.

  • Rich

    3/24/2008 5:12:00 AM |

    Brilliant. Where is your monthly column in the Wall Street Journal?

  • Carrie Tucker

    9/15/2008 2:44:00 AM |

    "Perhaps it's excessively cynical to label it "disease engineering." But, whether from benign neglect or purposeful failure to diagnose, the fact remains: Heart disease is, all too often by the standard path, undiagnosed and neglected for years until the procedural payoff strikes."

    What an incredibly ballsy statement!  My hat is off to you.  

    I have been a Respiratory Therapist for 23 years.  To hear a cardiologist make such a statement is the most validating thing I have heard in all these years.

    I have almost been fired more times than I can count, for trying to address a low oxygen level.

    Shoot some docs take everything personally!  I'm not trying to save anyone, just make them feel better while they're on the planet.

    You and I both know that they can save themselves.  It is just a matter of education.

    Many blessings

  • Jenny

    10/20/2008 2:58:00 PM |

    Dr. Davis,

    What makes you think that people who show up with all the symptoms of serious infection get antibiotics?

    One of my kids is permanently deaf in one ear because the pediatrician gave us that speech about how antibiotics just cause bacterial resistance and refused treatment.

    And there have been quite a few stories in the press recently of young people dying of pulmonary MRSA because their initial symptoms were ignored.

    You're a cardiologist so you see this problem in the context of heart disease. But the problem of only treating complications is widespread through all medical specialties.

    Years ago when my blood sugars were routinely going into the 200s after every meal I visited the guy who was supposed to be the "best" endo in our area, who offered me no treatment and told not to come back to see him until I'd spent a year with an A1c over 8%--an A1c high enough to guarantee complications. He told me he didn't bother treating people whose blood sugar wasn't that bad.

    My guess is that this attitude grows out of the way physicians are trained with hospital-based residencies that concentrate on heroic medicine.

    This makes people who are not in the throes of a massive complication look "fine" and keeps them from getting proper preventative treatment.

  • Anna

    10/20/2008 5:02:00 PM |

    Your post and Jenny's comment make the point that people can't be lax about their own care; they need to be willing to learn, be informed, get second and third (or even 4th) opinions sometimes, and to be assertive when the recommended care doesn't seem to match with their intuition or condition.

    There's a continuum between throwing all the available treatments at a condition and waiting to let nature take care of it, and there are cases to be made for approaches on either end and those in between, but it takes good judgement to know when and how to apply the appropriate approach.  Too many people have abdicated their own responsibility in the decision and judgement process.

  • Anonymous

    10/20/2008 5:43:00 PM |

    You could also include thyroid disease in there as a problem that doctors routinely ignore, until it gets to the state where the patient has major problems (full blown hypo/nodules, etc).

    And prevention, for many health problems, seems to be a dirty word to doctors. The system is very flawed across all specialties.

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