A CT heart scan is a crucial test to have done
at low cost, relatively modest radiation
exposure, that tells you whether or not you
have coronary heart disease. It’s the
only test that tells you with confidence
whether or not you have atherosclerotic plaque
in your heart’s arteries. It is
quantitative and can be used to track progression,
regression, or stabilization over the years.
Sadly, there is a lot of misinformation floating
around about heart scans, so be armed with better
information.
Transcript:
Hi, Doctor William Davis here, author of
Wheat Belly and
Undoctored books. I want
to talk about why I think you should get a
heart scan. Now I got involved with heart
scanning over 20 years ago, when I
brought Wisconsin’s first heart scan
device to Milwaukee. I did that because
my mom died of sudden cardiac death after a
successful two-vessel coronary angioplasty
she underwent in New Jersey.
I was practicing in Milwaukee, just starting out,
and I was doing lots of heart procedures. My mom
died, ironically, of the disease I dealt with, or
I thought dealt with every day. That event shook
me, and it made clear to me that we needed to do
a better job of looking for heart disease
years before something bad happens, like
a heart attack, or sudden cardiac death. Well,
how do you do that?
Can you look at your cholesterol and say “Oh,
my cholesterol is 240. I must have heart
disease.”? No, of course not — cholesterol
is virtually worthless when it comes to predicting
heart disease. I don’t even think we should
bother measuring it. It’s stupid, but
nonetheless, that’s the prevailing attitude.
Or you have a stress test. Well, stress tests are
uniformly useless in people without symptoms. If
you’re having chest pain, you can’t
breathe, maybe a stress test in some form would
be helpful. But if you’re just going to work,
or going to school, feeling good, a stress test
almost never tells you anything. Because stress
tests become abnormal very late in the process,
when you’re about to have a heart attack, or
you have a very serious blockage in one of your
arteries. But for the decades that precede a heart
attack, a stress test will not detect it.
Some of my unscrupulous colleagues, of which there
are many, would say things like “Well, we do
the real test; a heart catheterization”,
right? … an invasive procedure. Well, no; no.
I’m talking about the people who are just
going about their business, feeling fine, often
exercising, right. They do not need an invasive
procedure. You’d be shocked how often
that’s done, though.
Okay ,what are we left with? You’re left
with a CT heart scan. It’s just a CT (a
CAT scan device), and it’s set in a specific
way so that you get very low radiation exposure
— it’s about 10 chest X-rays worth of
radiation exposures — it’s come down over
the years, and it’s trending downward,
even now. But it’s about 10 chest
X-rays equivalent.
You have to pay for it yourself in most cases,
but you can typically get it for about $100-150.
Any more than that, you can shop around. You
might have to call some places that do heart
scanning. Hospitals do it for cheap; you know
why? They secretly hope you have a really high
score, so that you “need” more procedures: a
stress nuclear study (for $5,000), a heart
catheterization (for $38,000), a bypass
operations (for $150,000). That’s
what they hope.
So they view the heart scan as a loss leader. But
you don’t care about that. Don’t pay
any attention to that, and do not let them up-sell
you to a CT coronary angiogram, without a very
thorough discussion of why, because that’s
how they make money, you see. They try to tell
“You have a high score” (that’s
how heart scan results are reported) “You
need a CT coronary angiogram”. Almost never
should that be done, okay.
When you get a CT heart scan — very easy,
it’s really fast. These devices are very
fast nowadays. Then typically, in a couple of
days or so, you’re given a score. What
that score is, is the volume of calcium in your
heart’s arteries. People go “Why
are we measuring calcium?”
One, it’s easy to see on a CT scan, so is
thereby easy to quantify. Think of it this way.
My friend Dr. John Rumberger, when he was
at Mayo Clinic, did much of this research — very
brilliant research. Calcium occupies 20% of total
atherosclerotic plaque volume. So it’s a
gauge, a dipstick, for the amount of plaque you
have in your arteries. It doesn’t tell you
about blockage, okay, that’s different
kind of perspective.
Think of it this way: think of your arteries as
being a foot long iron pipe. A heart
catheterization would tell you stuff like:
there’s a blockage halfway down,
that’s blocking 70 percent of flow.
That’s kind of information you get on a
heart catheterization. A heart scan tells
you something like this: in this 1 foot
long piece of iron pipe, there’s
273.85 cubic millimeters of rust — two
different perspectives on the same disease.
A heart scan gives you a score, a calcium score.
Normal is zero. The higher the score, the more
plaque you have, and the more likely it is that
can lead to heart attack and abnormal symptoms.
There’s no specific cutoff. You can’t
say “at a score of 500 you likely have a
70% block”. You can’t say things
like that. Though, the higher it does go, it does
indeed suggest greater potential for a blockage,
that blocks flow.
But your primary concern here is not to detect
blockage. It’s to quantify the amount of
plaque, because the more plaque you have, the
more likely it is to rupture. That’s what
heart attacks are. It’s when plaque has
inflammation in its walls, and it ruptures, and
the exposure of the underlying contents of that
plaque trigger blood clot formation. That’s
what you’re looking for. But you want to
know this years before that kind of
stuff happens, right?
Let’s say you have a score of 500, what now?
Well, those of you who have been following along
my programs, know that all the things that I do:
the Wheat Belly Total Health
program, the Undoctored
Wild-Naked-Unwashed program — all those
programs, the prescriptive part of the programs,
came from my efforts to reduce heart scan scores,
or at least stop them from increasing.
Because if we do nothing, if you have a heart scan
score, say, of 500, and you do nothing, the score
goes up
25% per year.
It’s horrifying. If you allow that to
happen, you’re getting closer and closer and
closer to death, heart attack, those things.
What if you take a statin drug, an aspirin, and cut
the fat in your diet — cut the saturated fat, and
exercise? How fast does your heart scan score go up?
25% per year
… does nothing. Those conventional solutions
do nothing to prevent plaque from growing.
So what do you do you do? You do the programs,
okay — Wheat Belly Total Health,
or now the Undoctored
Wild-Naked-Unwashed program. Those
strategies that I put together over the years,
and we showed that you could reduce heart scan
scores, or at least put a stop to the continual
rise. But it’s not uncommon for heart scan
score of say, 700, to drop to 300, 400,
something like that.
You can actually see on the heart scan images,
you see can see the plaque has shrunk (at least
the calcium part of it has shrunk). Now some
people say “aren’t you measuring only
hard plaque?” No, the calcium score is an
index of total plaque and all its varied
components: calcium, fibrous tissue, inflammatory
cells, soft plaque, everything. It’s an
index of total plaque.
So don’t let my colleagues — who often
don’t understand heart scans, because they
don’t care about prevention; they care
about heart catheterizations and defibrillators,
and those kinds of high ticket items — if they
say “that’s a stupid test”. No. It’s
been over 20 years, this test is actually
good. It took a long time to gain acceptance among
most of my colleagues, but it has happened. Now if
it was $10,000 a scan, and the professional fee
was $3,000, you bet they’d recommend heart
scans. But they’re $100 or so, and
there’s virtually no professional fee —
there might be a few dollars for a reading of
the scan, but hardly worth their time, so they
call it stupid.
That’s how health care operates nowadays.
It’s based on money, and revenue returned
on your effort. So if you have a positive heart
scan score, you engage in the program.
That’s that’s as good as it gets.
There is no other program that reduces your
heart scan score. So, Wheat Belly
Total Health |
Undoctored program.
What’s better than one heart scan score?
two heart scan scores
Let me tell you why.
Let’s say you have a score of 500, and
the report says your risk for heart attack is
about 7-8% per year, and it’s
gonna go higher as your score grows, right?
Well, what if you engaged in the program, the
Undoctored program, the
Wheat Belly Total Health
program a year ago, and your score a year ago
was 700, and it’s been reduced to 500?
Well, your risk for heart attack is not
7 or 8%. It’s zero, because
you reduced. Now, you won’t know that,
because you didn’t have a score perhaps
a year ago.
What if the score a year ago was 300, and now
it’s 500? Now your heart attack risk is
higher than 7%.
So you get the point. Better than one score is
two scores. It gives you an index, a rate of
change. We can actually calculate the annual
rate of change. But you want it to do this
{declining trend
gesture}. You do that by engaging in
all my programs.
So if you, or someone close to you, is at risk
for heart disease — now this [CT] is typically
offered to men 40 and over, women 50
and over, but that’s kind of a soft cut
off, depending on your mix of risk factors for
heart disease. If you’re, let’s say,
a guy, and your dad had a heart attack at 37,
don’t wait till you’re 40. Or
if you’re a woman, and your mom had heart
failure and sudden cardiac death at age 43,
don’t wait till age 50, right? Go
probably in your 30s. Be aware of those
kinds of modifying effects on when you should
get a heart scan.
If you have a heart scan score of zero — if
you’re lucky enough to have a heart scan
score of zero, don’t get it done for at
least 5 years. If you have another zero in
5 or 6, 7 years, your lifetime risk for
heart disease approaches zero. That’s
really good news. And by the way, if you have a
heart scan score zero, do not let your
doctor talk you into a stupid statin drug. Because
your risk for heart disease is virtually zero. You
can’t reduce it any further with a statin drug.
And also, if you have a positive score, whether
it’s 14, 500, or 1500, don’t let the
cardiologist or your primary care talk you into a
statin drug. It does not have an effect. The only
thing that a statin drug does is prevent plaque
rupture — reduce the likelihood about 1%
(not 36%, not 50%, like my colleagues
quote; that’s BS; that’s statistical
manipulation; it’s very deceptive), it
reduces risk for plaque rupture about 1% over
several years. That’s it. And those are in
people who are doing nothing else, right. Going
on a low-fat diet, and taking aspirin, hardly
does anything.
It’s the program — the program, the
Undoctored program,
Wheat Belly Total Health.
We eliminate the expression of small LDL
particles. We raise HDL, reduce triglycerides,
reduce blood sugar, reduce insulin resistance,
reduce inflammation. We use high-dose fish oil.
We use vitamin D restoration, iodine and
thyroid optimization, magnesium, cultivation of
bowel flora. Those are the strategies that have
dramatic effects, so much so that you can reduce
your heart scan store. Aspirin doesn’t do
that. Statins don’t do that. A low-fat
diet most certainly does not do that. So, know
what a heart scan is. Use it properly, and it
can be part, a crucial part, of a very powerful
heart disease prevention program.