More on Treadmill Stress Tests...

Last month NBC’s Tim Russert suffered a fatal heart attack at age 58, shocking the country. He recently passed a stress test, so how could this happen? In a post Dr. Fuhrman explains why stress tests fail to determine heart attack risk. Here’s an excerpt:
A stress test is not an accurate test for determining the risk of a heart attack. A stress test only identifies obstructions, it doesn't identify vulnerable plaque—the plaque that is likely to throw a clot. A stress test can only detect a blockage of more than 80% and the propensity of plaque to rupture has nothing to do with the amount of obstruction…

…Stress tests are big money-makers for doctors. They identify those people with large blockages who qualify as candidates for costly angioplasty or bypass surgery. However, drugs and medical procedures reduce risk only slightly.
Now, Jane E. Brody of The New York Times talks to Dr. Todd D. Miller, a cardiologist and co-director of the Mayo Clinic’s Nuclear Cardiology Laboratory in Rochester, Minn., about the shortcomings of stress tests. Take a look:
Mr. Russert’s treadmill test may have put him in the low-risk category, Dr. Miller said, “but that doesn’t mean no risk.”

“Maybe 3 patients in 1,000 with a low-risk test will die from heart disease within a year,” he said. “Among those deemed at high risk, more than 3 patients in 100 would die within a year.”

Furthermore, when the stress test is used for people who are at low risk for heart disease, an abnormal finding is most often a false positive that prompts further testing that is far more costly, Dr. Miller said.

The stress test’s main advantages are its rapidity and low cost — one-fifth to one-quarter the cost of more definitive and often more time-consuming tests like a nuclear stress test, CT coronary angiogram or standard angiogram. Medicare pays about $150 for a standard stress test, though hospitals typically charge three to four times that when the test is done on younger patients.
Criticism for stress tests is not new. In 2007, Karen Dente, M.D., a medical journalist based in Brooklyn, New York, stated that as stress-testing and coronary angiograms may no longer be the true gold standard for detecting coronary stenosis. Via Medscape:
"Conventional stress-testing and angiogram gives you no information on whether a plaque is going to rupture," David DuBois, MD, an attendee at the symposium and emergency medicine specialist from Pinehurst, North Carolina, told Medscape. "[With these tests] there are a lot of false-positives and false-negatives," he said.

One of the hottest current discussions in the evaluation of acute coronary syndromes is centered around the use of computed tomography coronary angiography. "CT technology is advancing at a very fast rate," said Amal Mattu, MD, associate professor and program director of emergency medicine residency at the University of Maryland, explaining the technology's improved detection in plaque composition and remodeling compared with conventional diagnostic tests.

"If you have a radiologist that can give you an accurate reading with the new 64-head multidetector CT scans, you can detect occlusions better," according to Dr. Dubois. But we are still a long way from having the new technology replace standard coronary angiography for the detection of large coronary stenoses, he said. "It is not going to change the [current] practice any time soon."
Sadly, this information can’t help Tim Russert, but doctors and patients should now take note that traditional testing procedures might be lulling us into a false sense of security by not revealing crucial life-saving data.

Study: High Apoprotein B Not Good

Dr. Fuhrman talks about the new research on lipids, lipoproteins, and apolipoproteins as risk markers for myocardial infarction—via The Lancet.

This study reveals that the ApoB/ApoA1 ratio is more predictive of heart attack occurrence compared to cholesterol levels or cholesterol ratios. That means that a high ApoB (Apoprotein B) is not good and a better indicator of risk compared to LDL cholesterol.

Keep in mind that a calculated LDL is not as accurate as a direct LDL and the type of LDL measured in Apoprotein B is even a better predictor. Also the LDL particle number is still likely the most accurate test for heart attack risk.

In spite of all these numbers and their potential to predict risk, the bottom line is that all of them go down with a vegetable-based diet and go up with sloppy eating habits. But not only that, the high-nutrient diet, contains positive benefits to reduce risk of heart disease not reflected in these numbers, so the numbers are not as predictive compared to a qualitative index of one’s diet such as the proportion of the diet made up of high-nutrient plant food and a tape measure around ones’ waist.

In summary, to predict one’s risk of heart disease, or to give someone assurance they are not at risk, it is important to consider:

  • Waist measurement or waist fat accumulation (body fat)
  • Nutrient density of the diet
  • Exercise tolerance
  • Non-medicated systolic blood pressure
  • The blood risk markers noted above

Vytorin, Going Down the Toilet

A clinical trial has determined that the cholesterol-lowering drug Vytorin fails to help people with heart disease AND increases their risk of cancer. Alex Berenson of The New York Times reports:
The scientists who reported on the trial, called Seas, cautioned against panicking over the cancer findings, saying that even well-designed clinical trials sometimes produce chance results. A review of two other, much larger trials did not find a similar risk, they said.

Vytorin and Zetia, a companion drug, are prescribed each month to almost three million people worldwide and are among the world’s top-selling medicines.

But other cardiologists and epidemiologists said that the cancer risk could not be so easily dismissed.

The findings of the Seas trial will heighten concerns about Vytorin’s safety and effectiveness, said Dr. Steven Nissen, a former president of the American College of Cardiology and a longtime critic of Vytorin. Six months ago, a fourth clinical trial, called Enhance, also failed to show that Vytorin benefited patients, leading a panel of top cardiologists to recommend using Vytorin and Zetia only as a last resort.

Since that recommendation, Vytorin and Zetia prescriptions have plunged, though the drugs remain among the largest sellers for Merck and Schering- Plough, which jointly sell them. The drugs had combined sales of $5 billion last year.
These drugs have been sinking for months. Take a look:
Oh no. Without that $5 billion, how will all the fat cat executives pay for their yachts and facelifts!

Ways to Lower Your Cholesterol...

I was reading That’sFit and found this link to Jonny Bowden’s Simple Ways to Improve Your Cholesterol—Now, on Remedy Life. Here are Jonny’s 5 tips:
  1. Eat more fiber.
  2. Lose weight.
  3. Exercise.
  4. Choose cholesterol-lowering foods.
  5. Take your supplements.
I was a little skeptical at first because Jonny has popped up on low-carb blogs—we all know how kooky those are—but his tips are right on point; especially when he suggests eating healthy foods like fruits, vegetables, nuts, seeds, cereals, and legumes.

As for taking supplements, Dr. Fuhrman sells his own, so that’s a good place to start. Also, Jonny recently provided the Well blog with his list of super foods. If you skip the canned sardines and canned pumpkin, it’s pretty good too. Via Well:
  • Beets
  • Cabbage
  • Swiss chard
  • Cinnamon
  • Pomegranate juice
  • Dried plums
  • Pumpkin seeds
  • Turmeric
  • Frozen blueberries
You should also check out Dr. Fuhrman’s Ten Super Foods and his Seven Best and Seven Worst Foods for Health and Longevity.

More Doctors Bashing Statins for Kids

Dr. Fuhrman wasn’t the only doctor to blast The American Academy of Pediatrics’ recommendation to give statins to young children. Tara Parker-Pope of The New York Times found more. Here’s a mini-round up from the report:
  • “What are the data that show this is helpful preventing heart attacks?” asked Dr. Darshak Sanghavi, a pediatric cardiologist and assistant professor at the University of Massachusetts Medical School. “How many heart attacks do we hope to prevent this way? There’s no data regarding that.”
  • “To be frank, I’m embarrassed for the A.A.P. today,” said Dr. Lawrence Rosen of Hackensack University Medical Center in New Jersey, vice chairman of an academy panel on traditional and alternative medicine. He added: “Treatment with medications in the absence of any clear data? I hope they’re ready for the public backlash.”
  • “It will open the door for pharmaceutical companies to heavily advertise and promote their use in 8-year-olds, when we don’t know yet the long-term effect on using these drugs on prepubertal kids,” said Dr. Alan Greene, a pediatrician in Danville, Calif.
  • “When you have a kid whose cholesterol looks like an overweight 65-year-old, what do you do?” said Dr. David Ludwig, director of the childhood obesity program at Children’s Hospital in Boston. “The committee had to balance the risks of treating children with powerful drugs, about which there is limited long-term data, with the risks of not treating children with unprecedented cardiovascular disease risk factors.”
Good to know there are SOME sane minds out there.

My Thoughts on Giving Children Cholesterol Drugs

Dr. Fuhrman responds to The American Academy of Pediatrics’ recommendation to give young children cholesterol-fighting drugs.

Clearly the medical profession and the drug companies form a coalition that economically monopolizes the health delivery to Americans. The effect is a health care system dependent on drugs, instead of encouragement of rationale lifestyle habits. When you consider that most antibiotics (which are highly toxic and already linked to later life cancers in scientific studies) prescribed to children are given for inappropriate reasons and viral illnesses in which they have no value, you could almost say that most pediatricians spend a large portion of their time delivering toxic medications to fragile children without justification. The harm they do may be much greater than anyone ever imagines. Now it gets even worse.

We have a nation of overweight parents, addicted to processed foods and convenience foods, who are poisoning themselves and creating a nation of overweight, diabetic and cancer-prone children, and the answer of the American Academy of Pediatrics and the American Heart Association is to recommend a more aggressive use of cholesterol-lowering drugs. Why don’t we just give all these kids gastric bypass surgery instead? Besides nobody knows the long-term risks of statins taken since childhood. This is just another example of the failure of health care in this country and that things will continue to worsen in the future as we continue to place drugs as the focal point of health care interventions.

I say—our health is tied to our country’s fertile soils with access to micronutrient rich produce never so available in recent human history; fresh fruits, vegetables, beans, seeds, nuts and other natural foods that are infinitely more effective than drugs. We have an unprecedented opportunity to be healthier than ever before and we can better use our resources educating and motivating our country to eat healthier and utilize less medical care and drugs, not more.

Kids on Cholesterol Drugs: American Academy of Pediatrics Goes Bonkers!

Why bother teaching kids to eat right. Let them eat all the junk they want and then prescribe them meds just like their fat parents. Get this. The American Academy of Pediatrics is now recommending giving children as young as 8 cholesterol-fighting drugs. The Associated Press reports:

Several of these drugs are approved for use in children and data show that increasing numbers are using them.

"If we are more aggressive about this in childhood, I think we can have an impact on what happens later in life ... and avoid some of these heart attacks and strokes in adulthood," Daniels said. He has worked as a consultant to Abbott Laboratories and Merck & Co., but not on matters involving their cholesterol drugs.

Drug treatment would generally be targeted for kids at least 8 years old who have too much LDL, the "bad" cholesterol, along with other risky conditions, including obesity and high blood pressure.

For overweight children with too little HDL, the "good" cholesterol, the first course of action should be weight loss, more physical activity and nutritional counseling, the academy says.

Pediatricians should routinely check the cholesterol of children with a family history of inherited cholesterol disease or with parents or grandparents who developed heart disease at an early age, the recommendations say. Screening also is advised for kids whose family history isn't known and those who are overweight, obese or have other heart disease risk factors.

Well, if it wasn’t official before. It sure is now! American medicine has gone nucking futs! No doubt, drug companies have their hands in this—it reeks of their stink. Now, I also read about this on the Well blog. Check this out:

The guidelines give no guidance on how long a child should stay on drug treatment. But they do say the first goal should be to lower bad cholesterol levels to less than 160 milligrams or possibly as low as 110 milligrams in children with a strong family history of heart disease or other risk factors like obesity.

Because statins have been around since only the mid-1980s, there is no evidence to show whether giving statins to a child will lower the risk for heart attack in middle age.

Clearly there is plenty of merit behind this recommendation—give me a break!

UPDATE: More from Dr. Fuhrman: My Thoughts on Giving Children Cholesterol Drugs.

Low HDL Linked to Poor Memory, So Go Nuts!

A new study associates HDL cholesterol—good cholesterol—with bad short-term memory in middle-aged adults. Reuters reports:
The researchers examined the relationship between blood fats and memory using data on 3673 individuals, who were an average of 55 years old when tested between 1997 and 1999.

Short-term verbal memory was assessed at the outset with a 20-word free recall test. Memory deficit was defined as recalling no more than four words. Memory decline was defined as a reduction of two or more words between the first test and a second test, performed in 2002-2004.

The results are reported in the medical journal Arteriosclerosis, Thrombosis and Vascular Biology.

Compared with a high HDL level, low HDL was associated with memory deficit during both tests. After adjusting for sociodemographic factors, illnesses, and medication use, those with low HDL were 27 percent and 53 percent more likely to have a memory deficit on the first and second test, respectively.
Fret not, nuts and seeds are a great natural way to boost your HDL cholesterol. Dr. Fuhrman explains in Nuts & Seeds Protect Against Heart Disease. Here’s a bit:
Perhaps one of the most unexpected and novel findings in nutritional epidemiology in the past five years has been that nut consumption offers such strong protection against heart disease. Several clinical studies have observed beneficial effects of diets high in nuts (including walnuts, peanuts, almonds, and other nuts) on blood lipids.1 A review of 23 intervention trials using nuts and seeds demonstrated convincingly that eating nuts daily decreases total cholesterol and LDL cholesterol.2 Not only do nuts and seeds lower LDL (bad) cholesterol and raise HDL (good) cholesterol, they can help normalize a dangerous type of LDL molecule (the small, dense LDL particles that damage the endothelial cells that line the blood vessels).3

Ellagitannins (ETs) are dietary polyphenols with potent antioxidant and other cancer chemopreventive activities that are found in berries, nuts (especially walnuts), and seeds.4 Walnuts can reduce Creactive protein and harmful plaque adhesion molecules, two significant markers of inflammation in arteries. The result is improved, and even restored, endothelial function (which includes the elastic property of arteries that allows dilation when necessary to meet an increased demand of blood).According to the researchers, walnuts are the first food to show such cardiovascular benefits.5
See, going nuts is a good thing!
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