The heart to protection

Preventing heart disease on the surface seems straightforward, but in reality the phenomenon of cumulative damage slips through the cracks. Conversations often circle back to high cholesterol, a small fish in the sea of heart disease.

What does that mean

Without violating patient confidentiality, let’s look at two patients recently treated in the hospital for heart disease. The heart disease was so bad they both needed open-heart surgery to fix the problem. While open-heart surgeries take place frequently, you need to have what we call diffuse multivessel heart disease. Basically, so many heart vessels become blocked that a fix requires sawing down the chest and cracking I open like an egg to avoid a death sentence, which by bypassing the vessels. Heart surgeons could easily pass for the plumbers of the heart.

Back to my patients. 5 years prior they both developed heart disease bad enough to need a procedure to open up the blocked vessels without surgery. A relatively simple procedure where they open up the blood vessels of the heart with tubes called stenting. Why mention this?

If you ever undergo a procedure for heart disease, you need to flip a lifestyle switch immediately. And for one of these patient the light bulb went off with a blast. Over the 5 years after the procedure, he lost 30 pounds, stopped smoking, improved his diabetes and continued to take his statin. Grade A for passing the lifestyle changes test. His cholesterol panel showed low LDL, less than 100. No longer diabetic but still pre-diabetic. He lost weight but was still over weight.

Despite the changes, he still developed worsening heart disease. Blockages of most of the larger vessels of the heart. So what gives? From the established guidelines in health and medicine, he represents a typical healthy patient. But his heart vessels tell a different story.

What is my point.

Health metrics need to change. Even though his LDL level came in below normal, his triglyceride/HDL ratio exceeded the cutoff of 2-3. Pre-diabetes while an improvement, remains a high risk for heart disease. In fact, pre-diabetics have a 37% higher risk of developing cardiovascular disease and a 36% risk of all-cause death. As we know, excessive body fat composition becomes a risk factor for many chronic health issues and diseases. He was not only overweight but carried most of the excessive body fat around his abdomen. The risk of heart disease rises to 32% with this body type. The causation or correlation train to heart disease makes a bit more sense understanding that 80% of heart disease patients overlap with obese or overweight people.

Screening for heart disease seems important

Testing for coronary artery disease has come a long way. We now have CAC (Coronary calcium scoring) or a CCTA (coronary catscan angiography). The latest in heart disease screening tools. Here’s the lowdown. This test uses less radiation than a typical heart angiography or stress test

It’s done in 5-10 minutes. Less invasive. Best-use scenario for asymptomatic patients plus self-pay, which means bypassing the hassle of insurance or doctor's. The superiority of the diagnostic accuracy for greater advantage as it images and renders the inside of the vessel wall. Sounds a bit out there and hard to believe. Funny enough, I run into the occasional highly educated patient who knows about these tests and get’s them every couple of years.

Exercise forms the basis of a protective defense against heart disease, however without dragging this newsletter out too long, I won't dig into the weeds on this one.

As for nutrition, if I had known plaques in my heart, confirmed heart attack or at the very least imaging verifying the pesky plaques, I would focus on eating very specific foods.

Pomegranate juice, extra virgin pure organic olive oil and Omega-3 fatty acids found in fatty fish like mackerel and salmon proven in evidence and data.

End

Those pestilent plaques. People everywhere walking around with tiny, dangerous health stow aways patiently waiting to hijack the heart. The underlying idea here comes from assuming minimum health guidelines and standards provide adequate guidance to prevent heart disease. The superficial nature of that assumption is akin to cotton candy dissolving in water, appearing to have a theoretical structure at first glance but failing to hold up when confronted with reality. Accountability goes both ways. Reliance on the health care system to fill the gaps in our health knowledge leaves no room for advocacy and further health problems in the future.