Russert, Heart, Brain and Predictable Vascular Inflammation

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June 22, 2008
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June 25, 2008

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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:

  1. 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.
  2. This Blog also by Davis: The Heart Scan Blog which answers very specifically "what-to-do-with-evidence."
  3. 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.

5 Comments

  1. Gina,
    We really do think alike! Magnesium deficiency and heart disease do run on the same track – along with metabolic acidosis… and all of that is measurable, well documented by my colleague Dr Russell Jaffe, who notes that morning urine testing for pH is the cheapest [<1$] way to stay on top of these matters.

    And, you got that right as well, inflammation is the new target, as is VAP comprehensive lipid assessment - as described in Track Your Plaque above.

    This is a good thing... a non medical person is tracking important parameters that do appear off of the customary radar! - Well done.

    Thanks and have a great week!
    Chuck

  2. Jeffrey,
    Thanks for your note here – went over to your site to see an excellent, well documented review of the issues I only touched upon. I do hope those interested in the vascular problems of brain and heart take a moment to see the confirmatory work over at your site.

    Look forward to meeting one day!
    Chuck

  3. Two beloved American celebrities have succumbed to heart disease before their time. The national response has been disappointment in a medical system that could allow this to happen. What could have been done differently to save the lives of both Tim and George, to avoid this fatal outcome?

    For more….
    Saving Tim Russert and George Carlin by Jeffrey Dach MD

    http://jeffreydach.com/2008/06/26/saving-tim-russert-and-george-carlin-by-jeffrey-dach-md.aspx

    Jeffrey Dach MD
    4700 Sheridan Suite T
    Hollywood FL 33021
    http://www.drdach.com

  4. Tim Russert and George Carlin

    Two beloved American celebrities have succumbed to heart disease before their time. The national response has been disappointment in a medical system that could allow this to happen. What could have been done differently to save the lives of both Tim and George, to avoid this fatal outcome?

    To read more…Saving Tim Russert and George Carlin by Jeffrey Dach MD

    Jeffrey Dach MD
    4700 Sheridan Suite T
    Hollywood FL 33021
    my web site

  5. Gina Pera says:

    This is so helpful, Dr. Parker. Thank you.

    Now, I do have a reputation for nagging people about their magnesium, but I couldn’t help but wonder about Mr. Russert’s magnesium intake.

    I’d also like to know his homocysteine levels.

    Overall, it sort of made me ill to read that his care was so “by the numbers.”

    I would love to hear your thoughts at some point about docs who push down a patient’s cholesterol score as though it was their golf game. 🙂

    Don’t we need cholesterol for brain function? Perhaps to avoid depression?

    Thanks for your well-rounded approach to health.