Need input into my lipids please

[Stavia]

Apolipoprotein B might be easily available to you. It appears to be easily done - I think its just mot as fashionable as MMR and also NMR gives more data. But apob IS a particle number measure. Id love to know what yours is on your diet.

[circular]

Hi Silverlining,

I have taken the cholesterol absorption/synthesis tests, but I didn't have to pay for it (story there). I am optimal for synthesis and campesterol plus ratio and sitosterol plus ratio, but I am hyper for cholesterol plus ratio.

I'm not sure the significance of having just one out of whack like that.

I'm also not sure if these are a one-time test or if they need to be followed. If one time then maybe that will feed your decision, since the expense won't be repeated.

[Julie G]

Susan, I had already convinced myself to do the EBT (thanks to George's great info!) but your husband's story gives me another big push. Heart disease is silent. Every other biomarker is a mere correlation; some (like standard lipids) are quite weak...yet regularly used. Given our higher risk factor for CVD, this is something we ALL ought to consider.

Stavia, I'd love to fly around the world to hold your hand. Know I'll be with you in spirit . Does anyone know how to find a screening EBT? I can't seem to find one nearby that isn't connected with a cardiology appt. that I don't seem to need at this point. Any advice would be much appreciated.

[SusanJ]

That's just it, CVD can be really silent. The hubs felt fine, but the scan begged to differ. He could have been one of those that just keeled over without a clue. (He's 3/3 BTW.)

I've said it before. If you have CVD history in your family, it's worth doing at least one scan at a critical age. If I had it to do over, I might have waited until I was post-menopausal by a few years. But timing is a good discussion to have with your doctor.

Once they found my hub's blockages, his cardiologist said he really didn't need additional scans because of the additional radiation exposure and it would not change his treatment strategy.

[Tincup]

Does anyone know how to find a screening EBT? I can't seem to find one nearby that isn't connected with a cardiology appt. that I don't seem to need at this point. Any advice would be much appreciated.

How about:
http://www.bestheartcare.com/programs-s ... heartscan/ Not sure what the scanner is or the radiation, you'll need to call. {edit - another thought - how reproducible is the result for $49 - how much time do they really spend looking at it. Dr. Blanchett, in Boulder, seems to make this reproducibility a priority} Also pretty sure University of Illinois-Chicago has an EBT scanner. Not sure how to access this one.

Once they found my hub's blockages, his cardiologist said he really didn't need additional scans because of the additional radiation exposure and it would not change his treatment strategy.

Susan,

According to Bill Blanchet, in Boulder, the understanding has changed in the last 5 years. The risk is due to ruptured plaque. Hence stents & bypasses can treat symptoms, but don't reduce risk. What reduces risk is stabilizing soft plaque. This is indicated by a <15%/year increase in the calcium score. If you can keep increase to <15%/year, you've reduced risk by 95%. See the figure from the Raggi paper https://www.apoe4.info/forums/viewtopic ... ebt#p14817

For those who missed the original thread, it is here: https://www.apoe4.info/forums/viewtopic ... &hilit=ebt

[Ski]

The risk is due to ruptured plaque. Hence stents & bypasses can treat symptoms, but don't reduce risk

I dont quite understand this statement. Even with minor growth, at some point you are going to need intervention like a stent. Yes while you may reduce risk through stabilization you still increase your odds as that lumen gets smaller. I have a woman friend, active, that started getting symptoms of shortness of breath. Found a 95% blockage, got a stent and has been symptom free for 6-7 years now. So I dont buy the whole, stents are not needed or help, argument. I think both interventions are needed. This woman was close to hitting the floor for good.


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[SusanJ]

George, the hubs did a second scan one year after the first. Showed more problems, but the cardiologist explained it takes time to stabilize the situation, and was not surprised the second score was worse. That's when the doc said he didn't think it was necessary to keep doing them. Perhaps a 10 year repeat would be worth it, but right now my hubs said he's had enough radiation between the scan and recent chest X-rays for broken bones (twice in 3 years! And no, not from hang gliding), so he's going with the cardiologist recommendation.

I personally am considering a second scan because now I am clearly post-menopausal, and my status is likely to have changed in 10 years, given my family history of CVD and E4 status and a good bit of stress along with a few years of not eating well in there.

[Tincup]

Ski,

The risk is due to ruptured plaque. Hence stents & bypasses can treat symptoms, but don't reduce risk

I dont quite understand this statement. Even with minor growth, at some point you are going to need intervention like a stent. Yes while you may reduce risk through stabilization you still increase your odds as that lumen gets smaller. I have a woman friend, active, that started getting symptoms of shortness of breath. Found a 95% blockage, got a stent and has been symptom free for 6-7 years now. So I dont buy the whole, stents are not needed or help, argument. I think both interventions are needed. This woman was close to hitting the floor for good.
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I'm not making the argument, listen to Blanchett's talk, linked in my post above. He says the point of stents/bypass is the relieve symptoms. Your friend clearly had symptoms. His point is that even if you get a stent, you need to do something to reduce plaque deposition to reduce risk.

[Ski]

No, I realized it wasn't your statement and mine was directed at those kinds of statements, Ive seen other practitioners argue too. But yes, agree on still reducing the risk of buildup. But, I think thats pretty standard treatment that if someone gets a stent, they're on lipid lowering medication/diet modification by default.

[Tincup]

Ski,

I think his point was directed at (over) use of stents/bypass for asymptomatic patients. That the stent/bypass didn't reduce your risk. Stabilizing existing and reducing new plaque deposition does. If you are asymptomatic, you don't really need the stent. In his talks, he said he had ~93 patients with coronary calcium scores over 1,000 and stable. One of those patients just posted on another site that his score was ~1100 but his annual increase was 2 or 3 %.