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CIMT Noninvasive testing for atherosclerosis or "hardening of the arteries"
On Tue, 28 Oct 2003 07:42:31 -0600, Patrick Blanchard, M.D. wrote:
You are very insightful with this question! 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. Many people, including some physicians, hold an antiquated view that is not correct, still believing that atherosclerosis is deposition ON the inner lining, and that once you have it, it cannot be reversed. Not so! Many web sites, including one site from the American Heart Association, reveals the antiquated view of gunk deposition ON the inner wall lining. here's my question. Where do the deposits come from? Do they come from the blood in the artery, or from outside the artery (capillaries?) going inward? Where exactly is the source of the problem whereby the LDL/HDL ratio contributes to fast or slow (or reversible?) depositions and inflammation? 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. True, but evolution of paleolithic ancestors was driven by deaths from childbirth, accidents and infectious disease, and probably not atherosclerosis. In addition the high physical activity probably made any diet reasonably OK as long as they got enough to eat. Modern therapies can reverse atherosclerosis AT ALL STAGES, and should be initiated on individuals identified as having it. what specifically can people do to reverse atherosclerosis, as opposed to slowing rate of increasing disease? Are you related to a Prof. Daniel Blanchard at UCSD? His statement of research interests is: 'My research interests include echocardiography, transesophageal echocardiography, contrast echocardiography, stress/exercise echocardiography, smoking and cardiac remodeling post-MI, and new antithrombotic agents for hypercoagulable states.' |
#12
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CIMT Noninvasive testing for atherosclerosis or "hardening of the arteries"
: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? On Tue, 28 Oct 2003 10:30:02 -0600, "Patrick Blanchard, M.D." tag" ***remove wrote: I think it is important to ask yourself just what you are attempting to accomplish with any nutrition program. Is it to boost energy, or to have ESP, or to lose weight, or to have stronger bones, or to .... you get the point. Sure do and multiple agendas are most common. Ime, if you are not focused on your health first, then you will have a major problem losing weight and a much more difficult problem than losing it, that is, maintaining ideal weight for a lifetime. My 10 years of private practice has been focused on 1 issue however, and that is to reduce death and disability caused by atherosclerosis. Good pick. Wish there were more like you.. Pseudoscience is rampant even in established medical communities (last century we were giving Mercury for hyptertension, a few decades ago smoking was "healthy" in some expert circles, the recent smallpox fiasco...), and I cannot accurately comment on no or low sat fats in general.There are simply too many variables. Personally I believe genetic phenotyping will help individuals understand where they came from and what foods they should concentrate on, but it will be decades until such testing is well validated. I'm afraid I agree with your timetable. An individual knocking on the door of a vascular surgeon or a cardiothoracic surgeon with critical levels of atherosclerosis should undergo an aggressive therapy consisting of higher dose statins, tissue ACEI like lisinopril, 81 mg asa, clopidrogel, beta-blocker, fish oil, fibrates, niacin, In what dosages and only for critical levels of atherosclerosis? no tobacco, no trans fats and moderate servings of naturally occuring saturated fats and protiens and complex carbohydrates for a minimum of 6 weeks before undergoing surgery if possible. Do you expect to see significant changes in pathology in six weeks or is this more a preparation for positive surgical results? Finding the best surgeon and technique for intervention is a completely different topic. Yes it is and thanks again. http://antwrp.gsfc.nasa.gov/apod/ap030724.html Lift well, Eat less, Walk fast, Live long. |
#13
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CIMT Noninvasive testing for atherosclerosis or "hardening of the arteries"
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? On Tue, 28 Oct 2003 11:09:57 -0600, "Patrick Blanchard, M.D." tag" ***remove wrote: This is a question about protocol. Annual CIMT evaluations will give you the earliest information about trending, or the progression or regression of global atherosclerosis (including coronary arteries), as long as the protocol is performed exactly the same way, with the same high resolution ultrasound. An accurate protocol is difficult, time consuming, and surveys 3 major flow segments of the carotid system that mimic remote arterial beds (like coronary, brain, aorta, renal, extremities) : low flow, low pressure (internal), vortex regions (bifurcation), high flow high pressure (external), medium flow medium pressure (common), each at near and far walls, and 4 different scanning angles 15 degrees apart. You can find other CIMT protocols (like Univ. of Wisconsin, Loma Linda to name 2 of them) but they are lesser quality in my opinion, and do not focus on trending. Thank you for your detailed answer. Thanks for the workout! It's one of the things I do. I am a strength and power trainer for elite athletes and counsel many individuals, privately, on their diets. Not just athletic types but diabetics, morbidly obese, thin, you get the idea. http://antwrp.gsfc.nasa.gov/apod/ap030724.html Lift well, Eat less, Walk fast, Live long. |
#14
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CIMT Noninvasive testing for atherosclerosis or "hardening ofthe arteries"
Patrick Blanchard, M.D. at tag" ***remove talked on ....
the last great flu epidemic - did you get your flu shot yet?). Eeeeks, should I? yes! ( and it won't give you the flu!) **raise hand!!! I did!! and so did my son .. I have to because I'm asthmatic and my asthma is induced by illness or stress .. -- Kitty =^..^= 168/161.6/130 Start: September 2003 |
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CIMT Noninvasive testing for atherosclerosis or "hardening of the arteries"
On Tue, 28 Oct 2003 13:31:39 -0500, Mars at the Mu_n's Edge
wrote: :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? On Tue, 28 Oct 2003 10:30:02 -0600, "Patrick Blanchard, M.D." tag" ***remove wrote: I think it is important to ask yourself just what you are attempting to accomplish with any nutrition program. Is it to boost energy, or to have ESP, or to lose weight, or to have stronger bones, or to .... you get the point. Sure do and multiple agendas are most common. Ime, if you are not focused on your health first, then you will have a major problem losing weight and a much more difficult problem than losing it, that is, maintaining ideal weight for a lifetime. My 10 years of private practice has been focused on 1 issue however, and that is to reduce death and disability caused by atherosclerosis. Good pick. Wish there were more like you.. Pseudoscience is rampant even in established medical communities (last century we were giving Mercury for hyptertension, a few decades ago smoking was "healthy" in some expert circles, the recent smallpox fiasco...), and I cannot accurately comment on no or low sat fats in general.There are simply too many variables. Personally I believe genetic phenotyping will help individuals understand where they came from and what foods they should concentrate on, but it will be decades until such testing is well validated. I'm afraid I agree with your timetable. An individual knocking on the door of a vascular surgeon or a cardiothoracic surgeon with critical levels of atherosclerosis should undergo an aggressive therapy consisting of higher dose statins, tissue ACEI like lisinopril, 81 mg asa, clopidrogel, beta-blocker, fish oil, fibrates, niacin, In what dosages and only for critical levels of atherosclerosis? you might look at Dr. Chaos's questions about statins for a discussion on hs.CRP and MPO and CIMT. no tobacco, no trans fats and moderate servings of naturally occuring saturated fats and protiens and complex carbohydrates for a minimum of 6 weeks before undergoing surgery if possible. Do you expect to see significant changes in pathology in six weeks or is this more a preparation for positive surgical results? plaque stability can develop within 6 weeks. plaque regression takes up to a year and beyond. Finding the best surgeon and technique for intervention is a completely different topic. Yes it is and thanks again. http://antwrp.gsfc.nasa.gov/apod/ap030724.html Lift well, Eat less, Walk fast, Live long. -- ~~~ Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice |
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On Wed, 29 Oct 2003 14:30:39 -0600, "Patrick Blanchard, M.D." tag"
***remove wrote: ummm, could you take this outside please? You will have to excuse Troll Chef Pastorio. He's a little ****ed off since he ate, drank and refused to exercise. Then had a quad bypass when he knew better. Oh well. http://antwrp.gsfc.nasa.gov/apod/ap030724.html Lift well, Eat less, Walk fast, Live long. |
#17
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Mars at the Mu_n's Edge wrote:
On Wed, 29 Oct 2003 14:30:39 -0600, "Patrick Blanchard, M.D." tag" ***remove wrote: ummm, could you take this outside please? You will have to excuse Troll Chef Pastorio. He's a little ****ed off since he ate, drank and refused to exercise. Then had a quad bypass when he knew better. Oh well. Well, Patrick, it would be good not to have it at all, as you imply. But the fraud who calls himself Mu (in all its incarnations to evade the myriad killfiles he's been in) is a notorious liar, troll, spammer and crossposter with the sole intent to stir up anger and animosity. He has appeared in the diet, fitness and cardiology groups trolling and denigrating people for a good while. He has used the names Roose, SUT, arete, Mu and others, changing often while never giving a real name or identity. He claims many skills and many accomplishments but shows them to be mere braggadocio with further contradictory posts. The characterization he offers about me above is utterly fraudulent and he can't seem to recall that it was a triple and he can't seem to recall that his assertions about my lifestyle have been asked and answered and shown to be false. He simply lies about it because he can. And because nothing more ethical will ever come from him, if history is any predictor. Here's one of the times I dealt with his spurious "facts." http://tinyurl.com/qs7t It is customary for Mu to follow Chung and mock the intelligent and knowledgeable people who either ask questions about or criticize Chung for his "information" or tactics. They're like ventriloquist and dummy with identities that change back and forth making it hard to distinguish one from the other. Pity, that. Pastorio |
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