Saturday, November 28, 2009

Defining a Cure for Heart Disease

When can I be considered "cured" of heart disease or, more accurately, Coronary Artery Disease (CAD)? This is a subject that has plagued me for years and especially since I became involved with Track Your Plaque (TYP).

It seemed so simple at first. If I reversed or halted the progression of coronary calcium then I was "cured" (note that TYP does not make this hard claim of a cure - but you DO dramatically reduce your risk of a heart attack and I need a frame of reference to start the conversation).

The subject becomes even murkier when you consider the independent clinical experience of heart attack prevention pioneers Dr. Davis and Dr. Blanchet. Davis seem to feel that there is considerable risk reduction even if coronary calcium progresses but is held under 10% per year. Blanchet pushes the limit to about 15%. Both doctors rarely see heart attacks in their practices and other leading heart docs like Dr. Arthur Agatston (the doc of South Beach Diet fame and inventor of the gold-standard Agatston coronary calcium scoring system) made this statement.

"I'll let you in on a big secret. Physicians who practice aggressive prevention have seen heart attacks and strokes practically disappear from their practice. It's that simple — this approach [plaque reduction] can literally prevent heart attacks and strokes and save lives."

So when can I consider myself "cured" of heart disease and why is it so important to define a standard for a cure? Let's tackle the second, and easier, question first.

It is no secret I am a numbers guy. I need a target a goal. More selfishly (my competitive neurosis is showing) I need to know when I am winning and when I am losing. Put more simply, I need to know how to "keep score!" What number and unit of measure signals that I am “cured.” Even more importantly, I need a method of comparing and ultimately selecting the different heart disease treatments and programs available in my search for a cure.

To answer the first question, I believe there is a spectrum of possible standards in defining a cure for heart disease. At one end we have a practical definition, "No heart attacks." At the other end of the spectrum we have a far more complex definition, “No detectable coronary plaque.”

Without tipping my hand I’d like to ask those who read my blog to answer a simple poll question, “Under which condition would I consider myself "cured" of Coronary Artery Disease (CAD)?”

I’ll follow-up later with more thoughts on the subject of what constitutes a cure and we can begin to debate the issue!

Looking out for your heart heath (and a cure),


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