Is this because everyone, to some degree, is atherosclerotic or is
this only the beginning point for those who are atherosclerotic. If
the former, is it the acceleration and or the accumulation of
atherosclerosis that is the problem?
On Tue, 28 Oct 2003 07:42:31 -0600, "Patrick Blanchard, M.D." tag"
***remove wrote:
You are very insightful with this question!
You make me blush, lol.
Unfortunately, aging is an unmodifiable risk factor for atherosclerosis. To
some degree, yes, everyone is atherogenic (atherosclerotic). It is the
acceleration (or lack of it) that results in a wide variance of
atherosclerotic burden among individuals. However, I am concerned of your
term 'accumulation' and want to clarify something very important regarding
atherosclerosis. The process is not a deposition of gunk ON the inside
lining of arteries, but is a complex cascading set of reactions INSIDE THE
ARTERIAL WALL itself called the intima-media complex that begins in the
very young years of life. This process is also reversible with proper
therapy.
I see. Ornish called his diet "proper therapy". Would you agree on a
low to no sat fat regimen for those with serious, perhaps surgically
qualified, atherosclerosis?
It is not accumulation and obstruction, but accumulation and rupture of a
vulnerable plaque that kills and cripples more people every year than any
other cause - and has done so since 1900 (except 1918, the year of the last
great flu epidemic - did you get your flu shot yet?).
Eeeeks, should I?
Vulnerable plaques do
not give you symptoms unless you are having TIAs or Acute Coronary Syndroms
and cannot be detected by heart catherizations.
Yes, I understand that piece.
Is it the combination of fats that is issue to you? Do you see any
direct links from high sat fat intake and atherosclerosis?
On Tue, 28 Oct 2003 07:42:31 -0600, "Patrick Blanchard, M.D." tag"
***remove wrote:
This is where we leave "tierra firma", or firm grounding in clinical
science, and I don't want to debate ketogenic diets on this thread, except
to say that I believe non-diabetic ketosis is metabolically sound. It was
the introduction of agriculture many thousands of years ago that was simply
too hard for civilizations to resist. Our bodies, however, were designed to
respond favorably in chronic ketosis and was probably the main metabolic
state which our ancestors were in for millions of years before agriculture.
As you said, this is for another time and place but thank you for your
POV.
Paleolithic diets will promote atherosclerosis if you follow them
haphazardly, intermixing the standard american diet (SAD) when convienient
(known as the Atkins spousal abuse - on the Atkins site).
Didn't see it in the glossary, find it on a search of Usenet either.
This is what?
CIMT is not covered by insurance. Do not confuse insurance coverage with
cost effective and scientifically sound medicine however.
I understand managed care all too well. However, there are instances
where proactive measures can be covered by insurances.
Because the majority of heart attacks and strokes are from clinically
evident atherosclerosis, and because there are decades of preceeding
clinically silent atherosclerosis, I recommend CIMT for people age 30 and
above.
Cost?
The American Heart endorses CIMT for people identified as
'intermediate' risk by Framingham data and want to know if they are 'high
risk' (in other words, the Framingham risk profile may not have identified
high risk). Framingham data (age, smoking, cholesterol, blood-pressure,
family history, diet, exercise... is terribly inaccurate for assesing risk
and has been shown to miss over 50% of individuals at risk for heart attack
and stroke.
Or you could say it is successful 50% of the time.
CIMT takes the guesswork out of atherosclerosis management.
How often would you get a result from CIMT that you would consider to
be inaccurate? How would you now if a result is accurate or not?
Also a lesser well known problem with Framingham data is how it is often it
is improperly used to calculate risk after intervention. For example, if
you have a high risk score on the Framingham questionaires because you
smoke and have high cholesterol, and you undergo treatment, Framingham data
is no longer valid and never will be valid for you again. Framingham data
is used for initial pre-treatment assesment only, and becomes invalid the
moment you change your risk factors with therapy.
I see the point.
Therefore, if you have
taken statins a few years ago and then quit, the Framingham data is
inaccurate. CIMT however, delivers global assesment of your risk, and takes
into account all of your past risk factors and can then asses your progress
in therapy (of lack of) like no other tool!
Is there cheap stock available?
Modern therapies can reverse atherosclerosis AT ALL STAGES, and should be
initiated on individuals identified as having it. Children with
hypercholesterolemia have been shown to have increased CIMT readings that
improve with proper therapy, and I recomend the evaluation to children and
adolescents with strong risk factors (using the Framingham data). High
resolution ultrasound has 40 years of proven safety in all age groups. I
refer you to www.pubmed.gov for references. Simply search "carotid intima
media" as a starting point.
Thanks again.
http://antwrp.gsfc.nasa.gov/apod/ap030724.html
Lift well, Eat less, Walk fast, Live long.