heart disease reversal

[oldtrig]

A nurse discovered that I had sugar in my urine in January 2005. The Doctor did not seem concerned about it as he had been doing the A1C on me fortwo years prior to this. I went home that day and out to walmart for a Glucose meter. What a shock I had after my first test. I eat spaghetti that night and the numbers shot up around 190. What I did after that I would not recommend to anyone but I did it. I started a low carb diet to try and get the B/S numbers normal. In six months I lost 40 pounds which was way to much for me. I looked old and wrinkled. My A1c dropped to 4.9 but my energy also dropped. I stopped the diet last year and now I have added some weight but I still do not have much muscle. I feel much better but I am not sure if I have the B/S in the normal range. I do not check much anymore. Maybe I am doing things that might harm me later but I am living a little and eating good food. oldtrig

[Alan]

Quote:

Originally Posted by oldtrig A nurse discovered that I had sugar in my urine in January 2005. The Doctor did not seem concerned about it as he had been doing the A1C on me fortwo years prior to this. I went home that day and out to walmart for a Glucose meter. What a shock I had after my first test. I eat spaghetti that night and the numbers shot up around 190. What I did after that I would not recommend to anyone but I did it. I started a low carb diet to try and get the B/S numbers normal. In six months I lost 40 pounds which was way to much for me. I looked old and wrinkled. My A1c dropped to 4.9 but my energy also dropped. I stopped the diet last year and now I have added some weight but I still do not have much muscle. I feel much better but I am not sure if I have the B/S in the normal range. I do not check much anymore. Maybe I am doing things that might harm me later but I am living a little and eating good food. oldtrig

Why was ~7lb/month over 6 months too much for you? This is what I did a few years ago over 6 months to lose 40lb and I felt great then and now. Is your new weight too low for your height and age?

Are you exercising enough? That is a good way to build muscle and increase your energy levels.

[sanjugibbs]

A high fiber diet can reduce the risk of cardiovascular diseases according to the most recent studies today. Include fiber rich foods in your every day meal.

[oldtrig]

I exercise everyday by walking two miles. I have been doing this for five years. I weight 170 now but I got down to 158. I am 5ft 11. I just looked skinny when I was at 158 and everyone was asking me if I was sick. I did not feel any better than when I weighed 198.

[Alan]

Quote:

Originally Posted by oldtrig I exercise everyday by walking two miles. I have been doing this for five years. I weight 170 now but I got down to 158. I am 5ft 11. I just looked skinny when I was at 158 and everyone was asking me if I was sick. I did not feel any better than when I weighed 198.

170 is a good weight for your height. When I lost my 40 lbs, coincidentally to get to 170, I also added a variety to my daily walk the dog exercise, including stationery bike, some strength training etc to tone up as I was concerned I'd end up with loose skin since all my weight was around the middle.

[Buckeye]

windsurf - Do you know approximately what your waist-to-hip ratio is/was? I found this interesting article about WTH ratio.

Waist-to-hip ratio a better marker of subclinical atherosclerosis than BMI and waist circumference

Aug 13, 2007Michael O'Riordan
Dallas, TX - The waist-to-hip ratio (WHR) is independently associated with prevalent atherosclerosis as measured by coronary artery calcium imaging and is a better discriminator of subclinical disease than other common measures of obesity, such as body-mass index (BMI) or waist circumference alone, a new study has shown [1]. Those with the largest WHR were almost twice as likely to have calcium deposits in the coronary arteriescompared with those with the lowest WHR, report investigators.
"These data confirm what others have shown for clinical events—that is, when you link these data to some of the large outcome studies, it really does establish a consistent message that these measures of body shape—waist and the waist-to-hip ratio—predict not just clinical events but also atherosclerotic burden," senior investigator Dr James de Lemos (University of Texas Southwestern Medical Center, Dallas, TX) told heartwire. "It also suggests that part of the mechanism in which central adiposity contributes to increased risk is through this increased atherosclerotic burden."
The results of the study are published in the August 14, 2007 issue of the Journal of the American College of Cardiology.

Data from the Dallas Heart Study

Speaking with heartwire, de Lemos said the large INTERHEART study, previously reported by heartwire, showed that the WHR and waist circumference were excellent predictors of cardiovascular events. With this in mind, the group sought to determine the underlying mechanism responsible for this increased cardiovascular risk. Some part of this risk is likely driven by atherosclerosis in the coronaries and the aorta, although high blood pressure, left ventricular hypertrophy, or inflammation and thrombosis have all been proposed as risk factors explaining the increased morbidity and mortality risk associated with obesity, explained de Lemos.
In addition, de Lemos noted, there is a complex relationship between BMI and cardiovascular risk, an almost J-shaped relationship, where those with a very low BMI having greater atherosclerotic burden than those with a higher BMI. Also, BMI doesn't reflect obesity, but rather mass, and is not a measure of central adiposity and cardiovascular risk. The purpose of this study, he said, was to evaluate the association between different measures of obesity and atherosclerosis in addition to determining whether obesity was associated with subclinical cardiovascular disease.
Investigators obtained data from the Dallas Heart Study, a large, multiethnic urban population of patients who successfully completed electron-beam computed tomography (EBCT) to detect coronary artery calcium and magnetic resonance imaging (MRI) to detect aortic plaque. They found that the likelihood of coronary calcification grew in direct proportion to increases in the WHR. In multivariate analysis, after adjustment for standard risk factors, prevalent coronary artery calcium was more frequent in the fifth vs first quintile of WHR. Those with the largest WHR were nearly twice as likely to have calcium deposits in their coronary arteries as those with the smallest WHR. There was no independent positive association observed for BMI or waist circumference.
"The finding that was most striking to me was the linear association with the waist-to-hip ratio," said de Lemos. "We don't have huge statistical power here, so this will need to be confirmed in other studies, but it is interesting that this is a linear, stepwise association across the quintiles. From a public-health perspective, this is not the sort of thing where we look only at the guy with the biggest beer belly and say this guy is the one to worry about. This may have broader implications in the sense that the average person, even though they are average by US standards, still appears to have more atherosclerosis than people with the lowest waist-to-hip ratio."
Among those who underwent MRI, the investigators also showed that the risk of atherosclerotic plaque in the aorta was three times as high in those with the largest WHR compared with those who had the smallest WHR.

The associations between obesity measurements and atherosclerosis in this study, said de Lemos, mirror those observed between obesity and cardiovascular mortality and suggest that obesity contributes to the risk via increased atherosclerotic burden. As to why WHR is a better measure of subclinical disease, de Lemos said it is an indexed value to lower body girth and provides a more precise assessment of relative central adiposity across the body sizes compared with waist circumference. In addition, there is some evidence that fat accumulated in the hips might be cardioprotective.
"That appears to be the case in this study," said de Lemos. "Large hips seemed to be protective if you had a normal or smaller waist. On the other hand, it didn't appear protective if the waist was greater than the median value. Having big hips doesn't protect you if you let your belly get too big."

Source

1. See R, Abdullah SM, McGuire DK, et al. The association of differing measures of overweight and obesity with prevalent atherosclerosis. J Am Coll Cardiol 2007; 50:752-759.

[windsurf]

Quote:

Originally Posted by Buckeye windsurf - Do you know approximately what your waist-to-hip ratio is/was? I found this interesting article about WTH ratio. Waist-to-hip ratio a better marker of subclinical atherosclerosis than BMI and waist circumference

My hips (about 40 inches) were always significantly greater than the waist which was several inches- give or take- less. I have always been very active-some belly fat from time to time- but nothing like the obesity that you see everywhere now. Despite appearances, most of the portly gents probably won't have an MI at a relatively young age. I don't know exactly what caused it, but I am sure motivated to prevent it from happening again, If I can.
Atherosclerosis develops over decades. You have heard, I am sure, that military autopsies show widespread atherosclerosis in young soldiers (Viet Nam through present). That indicates, I think, a very substantial dietary link-not cholesterol per se- also inflammation and insulin resistance, e.g.

[Buckeye]

windsurf - You may have answered this question already but what are your doctors saying to you? I don't think they really know the root cause of what happened but are any of them offering you an explanation and/or saying they "know" what it must have been?

[windsurf]

Quote:

Originally Posted by Buckeye windsurf - You may have answered this question already but what are your doctors saying to you? I don't think they really know the root cause of what happened but are any of them offering you an explanation and/or saying they "know" what it must have been?

In so many words, they've indicated that it's tough to know what caused the atherosclerosis but maybe they're just being polite and not saying something like, "You must have eaten a lot of really bad stuff for quite a few years!" I did, but I thought I was getting away with it b/c I always worked out, felt wonderful and was generally more fit looking than the average trial lawyer. And, as I have written here before, my diet for quite a few recent years was such that my lipid scores put me in the low risk class. As to what caused the MI, it was definitely a plaque rupture. These very often occur in arteries that are not substantially blocked b/c the plaques, while not substantially occluding the vessel, can less stable than heavier plaques and rupture so to speak causing a clot to form which functions to cork off the artery. p.s. It was very strange to read the diagnosis in the ER report that I obtained a couple of days ago from my hospitalization: "Sudden cardiac death with spontaneous return of circulation." When I was out on the roads on my bike yesterday, a hot, sunny day here, going up hills, getting my heart rate up, I felt that intense feeling of gratitude for just being alive that we so often suppress behind the seeming urgency of the press of business.

[Buckeye]

windsurf - Would you ever do one of those scans which can supposedly tell you how much stuff is buried in the walls of your arteries? I think you get some sort of score out of it. Would you want a baseline to know if what you are doing is improving your situation?

I understand your explanation about not having what people think of typically blocked arteries. I think many people still picture heart disease as a pipe with crud collecting on it over time blocking the flow of blood. Your arteries may have been completely clear of crud on the inner diameter but the deadly stuff was collecting in the walls waiting to "burst" onto the scene! I keep thinking of Tim Russert and what happened to him. He wasn't in the right place at the right time like you were.

Trial lawyer? Maybe a little stress over the years?

[windsurf]

Quote:

Originally Posted by Buckeye windsurf - Would you ever do one of those scans which can supposedly tell you how much stuff is buried in the walls of your arteries? I think you get some sort of score out of it. Would you want a baseline to know if what you are doing is improving your situation? I understand your explanation about not having what people think of typically blocked arteries. I think many people still picture heart disease as a pipe with crud collecting on it over time blocking the flow of blood. Your arteries may have been completely clear of crud on the inner diameter but the deadly stuff was collecting in the walls waiting to "burst" onto the scene! I keep thinking of Tim Russert and what happened to him. He wasn't in the right place at the right time like you were. Trial lawyer? Maybe a little stress over the years?

You're probably tlaking about a high speed CT scan looking for calcification which would require symptoms for a doc to order and the test is not benign in that it gives you a pretty good dose of ionizing radiation. I've had my share lately (the cath lab). Yup, the career included huge stress that one internalizes.

[Buckeye]

Quote:

Originally Posted by windsurf You're probably tlaking about a high speed CT scan looking for calcification which would require symptoms for a doc to order and the test is not benign in that it gives you a pretty good dose of ionizing radiation. I've had my share lately (the cath lab). Yup, the career included huge stress that one internalizes.

Major heart attack not enough to justify/trigger the test?

Is there any other test which can "see" the stuff hiding in the walls of the arteries that jumped out and bit you?

stress = inflammation?

[Rich_by_the_Bay]

Quote:

Originally Posted by Buckeye Major heart attack not enough to justify/trigger the test? Is there any other test which can "see" the stuff hiding in the walls of the arteries that jumped out and bit you?

Not really. Plaques can cause irregularities in the inner wall which can be seen on cath, though not always. More to the point, a normal cath indicates a very good prognosis for at least 5 years, regardless.

So he knows he had the heart attack, is doing everything he can to prevent another, has a good idea of his prognosis, and will be followed up closely with occasional stress tests, etc. Not sure that yet another expensive, high radiation exposure test will change a thing.

[Buckeye]

Quote:

Originally Posted by Rich_in_Tampa Not really. Plaques can cause irregularities in the inner wall which can be seen on cath, though not always. More to the point, a normal cath indicates a very good prognosis for at least 5 years, regardless. So he knows he had the heart attack, is doing everything he can to prevent another, has a good idea of his prognosis, and will be followed up closely with occasional stress tests, etc. Not sure that yet another expensive, high radiation exposure test will change a thing.

It would be torture for me if I didn't have evidence I was reducing the deadly plaque with my actions.

The additional radiation is troublesome but I would want to get the test as soon as possible so I had a baseline of the artery walls as close as possible to the time of the heart attack. If I had the test done a year later and found no plaque, is that because what I was doing was good or there was never any significant plaque there to start with?

windsurf - Did the results from other tests already tell you that you have lots of plaque in your artery walls? I know you did in at least one spot that burst. Sorry for asking again if the answer is in a previous post.

[Rich_by_the_Bay]

Just for the record, using coronary artery calcium scores, and depending on the risk background of the patient, about 10% of patients with significant stenosis (>50%) will be missed, and about 25% to 50% with positive calcium scores will be wrong (patient does not actually have important coronary stenosis). Bottom line is that if you are low risk and have a negative scan, you are very unlikely to have coronary disease. If you are at high risk (such as a history of heart attack or angina, diabetes, etc), a positive scan will likely be accurate, for what it's worth in that setting. I would add that the test involves the injection of x-ray dye into a vein, with a small risk of allergic reactions.

Many believe that technologic advances will overcome many of these imperfections but at an exposure comparable to perhaps 20 chest x-rays every time, the risks are there, too.

[Nords]

Quote:

Originally Posted by Buckeye It would be torture for me if I didn't have evidence I was reducing the deadly plaque with my actions. The additional radiation is troublesome but I would want to get the test as soon as possible so I had a baseline of the artery walls as close as possible to the time of the heart attack.

Quote:

Originally Posted by Rich_in_Tampa Many believe that technologic advances will overcome many of these imperfections but at an exposure comparable to perhaps 20 chest x-rays every time, the risks are there, too.

To add to Rich's comments, the only direct evidence would be a post-mortem. You could spend big bucks on a boutique spa physical, but would those guys have any credibility?

Speaking from the perspective of 311 mrem of lifetime documented exposure to ionizing radiation, I thought I knew all about radiation and its hazards. I knew that most of the physiology was based on Hiroshima & Nagasaki as well as various American accidents over the years, but i was still very taken aback in the 1990s when the radiation medical experts said "Uh, this is all about three times more dangerous than we previously believed."

The rules of the game can change without warning. You don't want to absorb the rads just to see if you can find some plaque.

[Buckeye]

Quote:

Originally Posted by Nords To add to Rich's comments, the only direct evidence would be a post-mortem. You could spend big bucks on a boutique spa physical, but would those guys have any credibility? Speaking from the perspective of 311 mrem of lifetime documented exposure to ionizing radiation, I thought I knew all about radiation and its hazards. I knew that most of the physiology was based on Hiroshima & Nagasaki as well as various American accidents over the years, but i was still very taken aback in the 1990s when the radiation medical experts said "Uh, this is all about three times more dangerous than we previously believed." The rules of the game can change without warning. You don't want to absorb the rads just to see if you can find some plaque.

If I had windsurf's history, I would accept the radiation risk to "see" what was going on inside. I agree it might not be considered the appropriate choice for everyone but with his history I would have to take a peek.

[Rich_by_the_Bay]

Quote:

Originally Posted by Buckeye If I had windsurf's history, I would accept the radiation risk to "see" what was going on inside. I agree it might not be considered the appropriate choice for everyone but with his history I would have to take a peek.

I'll let this be after one last comment to be sure you (and other interested folks) understand the role of these tests in this setting: Windsurf just had coronary catheterization which is the gold standard for the presence and severity of coronary disease. It detects narrowing, plaque, and prognosis as well as or better than any currently available test. To subject yourself to any additional imaging study now is of no prognostic, diagnostic, or therapeutic benefit acutely.

For surveillance down the road (say a couple to 5 years), CT imaging might prove better than stress testing in some ways, and could avoid a repeat cath (though this question is unstudied).

I do think this is an area where noninvasive options will be forthcoming in the next couple of years, perhaps in the form of improvements of the coronary CT techniques. .

[windsurf]

Quote:

Originally Posted by Buckeye If I had windsurf's history, I would accept the radiation risk to "see" what was going on inside. I agree it might not be considered the appropriate choice for everyone but with his history I would have to take a peek.

Buckeye, your point is well-taken as to the unaware, but my case is different. I know my status b/c of my "event" and the consequent angiography which showed several areas of stenosis (three vessel disease) I'm not sure sure you read both posts about what happened. I had a CABG x6 and the diagnosis on my ER report is, "Sudden cardiac death with spontaneous return of circulation." Per your suggestion, I would be very interested in taking a "peek inside" in about 5 years to see if the vein grafts are patent in consideration of statin therapy and a plant-based diet. actually, that is why I started this second thread. to see if anyone on the list has undertaken a cardiac disease reversal strategy? The research indicates it can be done.

[Buckeye]

Quote:

Originally Posted by windsurf Buckeye, your point is well-taken as to the unaware, but my case is different. I know my status b/c of my "event" and the consequent angiography which showed several areas of stenosis (three vessel disease) I'm not sure sure you read both posts about what happened. I had a CABG x6 and the diagnosis on my ER report is, "Sudden cardiac death with spontaneous return of circulation." Per your suggestion, I would be very interested in taking a "peek inside" in about 5 years to see if the vein grafts are patent in consideration of statin therapy and a plant-based diet. actually, that is why I started this second thread. to see if anyone on the list has undertaken a cardiac disease reversal strategy? The research indicates it can be done.

That's right. I forgot about all the new plumbing! I probably wouldn't wait 5 years but a "peek" right now wouldn't provide any new information.