How to Get Clean Arteries

The problem with most prevention programs is that you never really know whether your prevention program is working or not. Your cholesterol may be normal. But half of heart attack victims have a normal cholesterol (1).

How do most people discover their prevention program isn't working? They have an event. Or a procedure.

An event can be lethal. A procedure can be expensive.

Artery disease is usually a relentlessly progressive disease. By that we mean that it naturally gets worse over time. Measuring cholesterol and blood pressure only gives us a picture of those two risk factors. Measuring individual risk factors can never tell us whether the artery disease is getting better or worse. To get that information, Ask the Arteries.

At CardioSound, we use the actual arteries to tell us whether you're getting better or worse.

This is one of Dr. Hight's patients:

Untreated Plaque with Soft Vulnerable Plaque.png

untreated

This is a real patient with artery disease, called "plaque," the gray stuff highlighted by the orange rectangle. His plaque obstructs the flow of blood. Turbulent blood flow is seen in the yellow cloud to the left of the "flow" arrow. In the light blue oval is "soft plaque" which is the most dangerous type of plaque. Soft plaque ruptures and causes a clot or thrombus (which causes heart attacks and strokes). His 10y event risk is 90%.

After 6 months aggressive Treatment Plaque.png

after 6 months

After aggressive medical therapy for 6 months, his plaque is smaller, the blood flow is better, there is no more turbulence, and his soft plaque (in the blue oval) is almost gone. His 10y event risk is down to 40%.

Clean Arteries.png

after 4 years: clean arteries

Although this is not the same artery, this is what all his arteries look like after 4 years of aggressive medical therapy (2). A surgical procedure like a stent would only fix that small area of blockage where the stent was placed. Aggressive medical therapy treats all the arteries, all over the body. His 10y event risk is now < 5%. 

cleaning arteries.jpg

it didn't get there overnight

Arterial plaque takes years to develop. It doesn't go away quickly. Effective prevention can take years. Start by asking the question, "How much risk do I carry?" Once that has been established, the next question follows, "Who can help me lower my risk?"

We have a track record

At CardioSound, we specialize in lowering risk for high risk patients. Here are some other examples of real patients whose arteries improved. We are measuring the disease inside the arteries, which we call "plaque thickness" or more precisely "intimal-medial thickness" or "IMT." The numbers you see here are the mean or the average plaque thickness (IMT) measured in predetermined locations in at least 4 arteries.

Patient #1 came to our office after surviving a heart attack. His first words were "You've got my attention now. I'm ready to do whatever it takes." He started a diet, started exercising in cardiac rehab and then kept exercising, started medications, and submitted to lots of blood tests. His avg. IMT dropped from 0.80 to 0.67, a 16 % improvement in 16 months!

Patient #2 was asked to exercise and lose weight and take medications after her mean IMT was 0.86 and her estimated 10 year event risk was 40%. She did. Her average plaque thickness ("IMT") after 3, 4, and 5 years was 0.70, 0.66 and 0.58 respectively. As her plaque thickness improved, her 10 yr. event risk dropped dramatically. 

Patient #3 had artery disease that was getting worse over time, with avg. IMT increasing every year from 0.69 to 0.81 three years later (8% worse per year). He got serious about prevention and his avg. IMT decreased the following year to 0.73, then 0.65, then 0.64. As his plaque thickness improved by 21%, his risk also improved.

Patient #4 had artery disease that was getting rapidly worse. We call it "rapidly progressive disease." And it's associated with higher risks. Her avg. IMT increased from 0.45 to 0.77 in to years. She was getting worse by 35% per year. She got serious about her risk and reduced her avg. IMT to 0.65, then 0.56, then to 0.53, dramatically lowering her risk for having an event.

Patient #5 also had rapidly progressive disease, increasing by 13% per year. She was able to reduce her avg. IMT from 0.63 to 0.50 in one year, dramatically reducing her risk.

Patient #6 reduced her avg. IMT from 0.72 to 0.54 in 3 years, reducing her CV event risk.

Patient #7 reduced her avg. IMT from 0.72 to 0.54 in 3 years. 

Patient #9 had rapidly progressive disease, getting worse by 18% per year. He then reduced his avg. IMT from 0.81 to 0.65 in 3.5 years.

Patient #10 was getting worse by about 4% per year, when he decided to address his increasing risks with an aggressive prevention strategy. His avg. IMT dropped from 0.89 to 0.64 (28%) in two years.

How do we do it?

One of the most common questions we get is "How do you do it?" Another is: "Can I get the drug they were taking?"

All these patients are different. They have different genetics and different risk factors. Each one had a different treatment program. If cardiovascular disease was caused by just one risk factor, then everyone could be treated the same. It's not. And they can't be.

 

references

1. Sachdeva et al. Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines. Am Heart Journal. 2009;157(1):111-117.e2.

2. This picture shows the doppler flow study done on one of the arteries we tested that day, after 4 years of intensive medical management. The other arteries were done in "gray-scale" without the red doppler coloring. Doppler technology is used by the technician when there is a flow problem. The artery pictured to the left (with plaque that improved) was one of those gray-scale pictures that day. There was no flow problem. All the arteries looked great. But when patients looked at the pictures, they wanted to see that same red doppler blood flow that the other pictures depicted. The average intimal-medial thickness (called "IMT") initially was 1.4 mm at the first picture, 1.07 mm after 6 months, and 0.68 mm after 4 years (over 50% reduction). For communication purposes, the prettier picture of a different artery in the same patient, the one with the red doppler coloring, is used here instead of the gray scale picture of the same artery.