Just a quick note in response to the recent New York Times piece on Tim Russert’s passing "…Some Painful Truths."
Many of the comments speak to the futility of the inability to make the diagnosis, when, in fact, it was previously made, – and many have been talking about these preventative issues regarding vascular health for years.
Vascular health is a subject implicit in many conditions from heart to brain, and, just as evidence with brain science has a difficult time finding a place in everyday practice, many cardiologists are missing the evidence boat.
Why are we so soft on specific prevention [read intervention] practices?
Consider these comments from the NYT:
"…cardiologists say the main problem is that there is no way to figure out who has “vulnerable plaques,” those prone to rupture. Researchers are trying to find biomarkers, substances in the blood that can show the presence of these dangerous, ticking time-bomb plaques. So far, no biomarker has proved very accurate.
Mr. Russert’s heart disease was a mixed picture. Some factors looked favorable. There was no family history of heart attacks. Though he had high blood pressure, drugs lowered it pretty well, said his internist, Dr. Michael A. Newman. His total cholesterol was not high, nor was his LDL, the bad type of cholesterol, or his C-reactive protein, a measure of inflammation that is thought to contribute to plaque rupture. He did not smoke. At his last physical, in April, he passed a stress test, and his heart function was good. Dr. Newman estimated his risk of a heart attack in the next 10 years at 5 percent, based on a widely used calculator [my emphasis].
On the negative side, Mr. Russert had low HDL, the protective cholesterol, and high triglycerides. He was quite overweight; a waist more than 40 inches in men increases heart risk. A CT scan of his coronary arteries in 1998 gave a calcium score of 210, indicating artery disease — healthy arteries do not have calcium deposits — and a moderate to high risk of a heart attack. An echocardiogram in April found that the main heart pumping chamber had thickened, his ability to exercise had decreased slightly, and his blood pressure had increased a bit. Dr. Newman and his cardiologist, Dr. George Bren, changed his blood pressure medicines, and the pressure lowered to 120/80, Dr. Newman said.
Remember my recent post on these matters of vascular health as it relates to heart and brain? Read on regarding a book that discusses what to do about these "calcium score" [using EBT - Electron Beam Tomography] findings in considerable detail: Track Your Plaque:
If you simply read the brief review regarding Track Your Plaque on this Amazon link, you will catch what I am saying about a very different cardiologist’s view of the Times piece. Evidence [this ref from JAMA 2004] and specific intervention strategies do exist for those with Russert’s symptoms and should be practiced routinely… but it appears that some are waiting … for what?
Leading cardiologists do recognize specific, more comprehensive, intervention strategies.
Sound familiar? We see this everyday with SPECT imaging and the brain evidence controversy we have been writing about here at CorePsychBlog.
If you or your loved ones have any of these "vascular/cardiac" signs that Russert had, if you have had a heart attack or any cardiac problems at all, I strongly suggest you read:
- Track Your Plaque by Dr William Davis discusses exactly how to use that calcium score [noted in the NYT Russet piece] proactively for specific intervention strategies to prevent deterioration.
- This Blog also by Davis: The Heart Scan Blog which answers very specifically "what-to-do-with-evidence."
- This, my most recent favorite book on this topic: Reverse Heart Disease Now, -by Drs Sinatra and Roberts – who both agree emphatically with Davis.
If any cardiologist is really puzzled about what to do next, these are all terrific reads.
And, as a side note, anything vascular carries enormous relevance with brain function and brain evidence as we have seen on SPECT imagining, as posted on this link at CorePsychBlog, in October last year.
Let’s take a better look at this new metabolic/plaque information so that others like Russert can stay for the duration of their tour.
Digitally available now at Nook, Kindle, Barnes and Noble.
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