The Life Plan Read Online Free PDF Page B

a damaged endothelium (the thin, one-cell layer lining the interior of your vascular tree) ultimately creating plaque buildup.
    Plaque is not a normal result of aging, and if you have any plaque, you have disease that needs to be aggressively treated. More than 90 percent of heart attack events occur in men with significantly diseased blood vessels at arterial sites undetectable with conventional diagnostics, such as stress testing. Stress tests pick up vascular disease that blocks the lumen of the arteries that feed your heart. It takes at least a 70 percent blockage in one of your coronary arteries to fail a stress test. Eighty-six percent of heart attacks occur with less than a 70 percent blockage. Tim Russert, the former
Meet the Press
host and NBC Washington bureau chief, is a prime example. He passed his stress test and died two months later of a heart attack caused by cholesterol plaque in the wall of one of his coronary arteries that ruptured into the lumen. He was 58 years old. This happens often because as much as 99 percent of all plaque in the artery is in the wall of the blood vessel and does not block the flow of blood.
    Yet most physicians base their therapies for heart attack and stroke prevention on traditional risk-factor identification: monitoring blood pressure, cholesterol, smoking, and diabetes. But improving or eliminating risk factors alone fails to identify many men who have hidden disease. These “surprise” heart attacks and strokes can also be prevented with optimized healthcare, which is a paradigm shift away from the current status quo or standard of care, which frequently misses critical markers that could save your life. But to achieve this optimized care, you and your physician must take the right steps. The bottom line is that you need to identify blood vessel disease as early as possible in order to get the right treatment that will stop its progression.
    In order to do this, make sure that your physician looks for early vascular disease and, if discovered, closely monitors your treatment with a comprehensive program that is tailored specifically for you. I have listed in Chapter 14 the testing that I believe is necessary to diagnose subclinical atherosclerosis and avoid a heart attack or stroke. For example, Carotid IntimaMedia Thickness testing (CIMT) is now considered one of the best, least expensive tests to detect subclinical atherosclerosis, which allows your physician to take the right steps to halt its progression or even reverse it.
    Most heart attacks and strokes occur when a blood clot forms in an inflamed artery, cutting off the blood supply to the affected heart or brain tissue. Blood clots occur when soft plaque in the wall of the artery ruptures or erodes through the lining (endothelium) of the blood vessel. There are several reliable tests for vascular inflammation that causes plaque rupture or erosion. These nontraditional blood tests are beneficial for determining whether you have blood vessel disease and how far it has progressed. They can predict your risk of a heart attack or stroke and can also be used as markers of treatment success.
    Another important cause of heart attacks and strokes that many men overlook is periodontal disease, a chronic infection of the gums. At least 75 percent of men have periodontal disease. Periodontal disease can increase the risk of coronary artery disease in men less than 50 years old by 72 percent. If you have severe periodontal disease you are 3.8 times more likely to have a heart attack and twice as likely to have a stroke. Your dentist can play a major role in keeping you from having a heart attack and stroke: Be sure to see him/her often.
    I believe, and the medical literature supports me, that the better care your heart gets—including the right exercise, nutrition, nutraceuticals, and healthy hormone levels—the easier it is to reduce your risk of heart disease and prevent other age-related illnesses, including diabetes,