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Are there any members of the blog who have stabilized their CVD?

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  • Are there any members of the blog who have stabilized their CVD?

    Without John L.'s example and guidance we are in open loop. By stabilization I mean keeping your CAC score from increasing by no more that 15% per year on average. Not stabilizing CIMT, as it's too easily affected by human interpretation. See the attachments.

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  • #2
    While CAC scores are useful, what does a 15% increase mean when a person has been on a high dose statin for a few years? We know that statins actually can increase CAC scores for many people by hardening soft plaque, and thus are somewhat protective from heart attack and stroke. Most people with a CAC score of 100 or greater are put on a statin. Does the 15% increase mean an increase in cardiovascular risk or not? The answer is we don't know. A patient with increasing CAC scores would have to look at several factors to understand what a modest increase in CAC scores indicates. A CIMT test, done by a well-trained experienced technician, can give repeatable results and will provide additional information for the patient and doctor to ascertain whether the overall plaque burden is increasing or decreasing beyond calcification of soft plaque.

    Comment


    • fatmax
      fatmax commented
      Editing a comment
      The supposed experts who measured John L.'s plaque burden with CIMT gave bogus results:
      https://www.youtube.com/watch?v=aoZ4gJZ0qHY&t=1767s
      See the discussion at 34:35.

      Mathew Budoff who is a world recognized cardiologist says this about CIMT vs CACS:
      http://www.stayinghealthytoday.com/c...atthew-budoff/

      Carotid Intimal Media Thickness (CIMT) testing is not the optimal test for evaluating atherosclerosis. It is mostly measuring the media thickness. The media is much thicker than the intima. The intima is where the atherosclerosis occurs. So the CIMT misses most of this. 80% of what it is measuring is the normal wall of the carotid artery. CAC scoring is a much more accurate assessment of coronary artery risk. CIMT really is outdated for this evaluation.

  • #3
    Yes statins frequently do increase the score as soft plaque becomes replaced by more stable calcium over a period of years. But the score will also increase because the calcium becomes more dense and not in a linear fashion. When Agatston conceived the current scoring method in the late 1980s it was postulated that more dense calcium was more dangerous and it was given more of a weighting factor. The assumption was wrong but the density weighting remains. A good calcium scan report will also give the calcific volume which is a better way to look at progression,

    Comment


    • #4
      Fatmax,

      You totally misunderstood what was said on John Lorscheider's video that you referenced. No, the CIMT test result did not give bogus results. What John was talking about was that the CIMT test result showed over time was an increase in calcified plaque vice soft plaque. John said that he was less worried about the calcified plaque than the soft plaque as it is the soft plaque that is more likely to rupture and cause a heart attack or stroke. John said that the soft plaque is hard to see on a CIMT test. What you seem to have wrongly inferred from that was that the CIMT test didn't provide valuable info on that soft plaque. Oh it did.

      The supposed experts who measured John L.'s plaque burden with CIMT gave bogus results:
      https://www.youtube.com/watch?v=aoZ4gJZ0qHY&t=1767s
      See the discussion at 34:35.

      You also brought out this old article from which there is one paragraph I already put a long comment together on another topic a while back which you never replied to. I basically said in my comment was that whoever wrote this part had no direct experience with CIMT testing. The author of this section confuses standard carotid ultrasound measurements with CIMT testing, and it is like confusing night and day. There is a definite problem with people reading a short paragraph like this and somehow think that they have become knowledgeable on this topic. Where do you think that the calcium in the CAC score is physically located along with the plaques and cholesterol? It is in that media thickness area that the paragraph seems to dismiss. I have to say that there are a good number of cardiologists who don't think that CIMT testing is valuable to their practice and patients. The reason is that you aren't sent to a cardiologist for wellness, you are sent to a cardiologist to try to save you from a combination of your lifestyle and genetics. A CIMT test is a wellness indicator more than anything. If you have a CAC score of 1000+, then the cardiologist may well go for a CT angiogram to decide whether to operate or not. A CIMT test at that point isn't as useful, but it can be afterwards when a long-term healthy lifestyle is implemented. The second reason that some cardiologists (and some wellness doctors for that matter) don't like CIMT tests is because repeatability has been an issue depending upon the operator. There are companies that can provide good repeatability, and I emphasize the need for repeatability often.

      Is Carotid Intimal Media Thickness (CIMT) Testing of Value for Coronary Risk?
      Carotid Intimal Media Thickness (CIMT) testing is not the optimal test for evaluating atherosclerosis. It is mostly measuring the media thickness. The media is much thicker than the intima. The intima is where the atherosclerosis occurs. So the CIMT misses most of this. 80% of what it is measuring is the normal wall of the carotid artery. CAC scoring is a much more accurate assessment of coronary artery risk. CIMT really is outdated for this evaluation.

      Comment


      • fatmax
        fatmax commented
        Editing a comment
        During Dr Brewer's recent YouTube video "Prolon Day 3, Fasting, FMD & Cancer - FORD BREWER",

        https://www.youtube.com/watch?v=ggWGVlkG7d8

        at 42:52, here's a comment from a viewer showing how superior a CT scan compared to a CIMT:
        "SC: Hello Dr. Brewer, couldn't agree more about IR and CVD. After getting a CT Angiography despite a CIMT score of <50 I had 50% LAD blockage. How, due to having an IR of 180 with meals."

    • #5
      Fatmax,

      Have you ever heard the term confirmational bias? That essentially means that a person absolutely rejects everything on a topic that doesn't agree with their belief system regardless of the science. Do you want me to explain how a person had a CIMT score of <50 and a 50% LAD blockage? I say that I cannot because I don't know what that person means by a CIMT score<50. I have no idea what the 50 means as there is no reference point. When a person talks about a CIMT score, they list the right and left carotid arteries plaque burden and the presence or absence of a discrete plaque (size). None of those have anything like 50 as a good or bad or even relevant score. So, I can't say for sure what that person was actually trying to get across because the context didn't make sense. The likely reason that Dr. Brewer danced around this is because he often has to deal with people who are misinterpreting something, and sometimes it is easier to steer around them with a general comment that doesn't exactly cover that person's point which made no sense in the context it was presented.

      To me a CIMT test or a CAC score is a tool. I have no emotion tied into those. If I find a better tool, I will use it. If I learn more about those tools, I will add that knowledge. Maybe you should study up a little bit on the subject before commenting rather than keep trying to find gotcha snippets of videos.

      BTW, you have never responded to my comments in the previous posts with anything meaningful.
      Last edited by Tom; 05-17-2019, 09:49 AM.

      Comment


      • fatmax
        fatmax commented
        Editing a comment
        Respond? There's nothing to debate: CIMT is grossly inferior to CACS.

    • #6
      Fatmax,

      Don't you need to know something before you give an opinion? This is the typical use of confirmation bias rather than knowledge and logic.
      Last edited by Tom; 05-17-2019, 10:44 AM.

      Comment


      • #7
        Even more evidence that CACS is vastly superior to CIMT:

        https://thefatemperor.com/2016-3-3-c...les-the-roost/

        QED.
        Last edited by fatmax; 05-17-2019, 12:08 PM.

        Comment


        • #8
          Tom, thanks for keeping this thread running. Despite your verbose obfuscations, here as elsewhere, prospective patients will know that CAC is the correct diagnostic procedure for CVD.

          Comment


          • #9
            You somehow want to make this a contest of "my test is better than your test". I don't believe that is a meaningful way of thinking. In the end the biology is what counts, not the test. If the test gives insight into the biology, it is useful if you understand the limitations. I use both a CAC score and a CIMT test along with many blood markers to provide more than a one-dimensional look at my cardiovascular health. I read what was stated in the link that you provided above but there is no real reference to the report, just some conclusion that someone copied I guess. The link further down does go to an abstract that says nothing about CIMT tests. Do you make up your mind on such limited information? I don't. Some people believe that the world is flat, and they will write a similar conclusion explaining just why they are correct. I look for science, and in this case biology. There is none in what was referenced relative to CIMT testing.
            Last edited by Tom; 05-18-2019, 12:38 AM.

            Comment


            • #10
              How's this science for you? Got any comparable CIMT research?
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              • #11
                Fatmax,

                Yeah, anybody who has studied up a bit on CAC scores knows the science behind that chart, but I am not sure you are doing more than just parroting what you find from a search. I have actually done some studying on CAC scores, but it isn't apparent that you have given much thought to what CAC scores can and importantly cannot indicate (both of those are really useful to know).
                I could indeed show studies on CIMT tests, but unfortunately I think you would not understand those and dismiss them without reading. It is kind of sad that you don't want to learn anything about CIMT tests, and this isn't a debate as much as it is me talking to a wall. I tell you what, never to late in life to learn. Here is an assignment, view this video on CIMT tests and come back to me with something intelligent.

                https://www.youtube.com/watch?v=KQdplHWQ9ZU
                Last edited by Tom; 05-18-2019, 11:00 PM.

                Comment


                • fatmax
                  fatmax commented
                  Editing a comment
                  What you need to learn is that CIMT is a measure of CAROTID artery plaque, not CORONARY plaque burden. Also, a CIMT measurement is a relative, not absolute, measurement and depends on the interpretation of the provider, unlike CAC which is an absolute, repeatable, scientific measurement. What is it about this that do you not comprehend?
                  Last edited by fatmax; 05-19-2019, 03:33 AM.

              • #12
                Fatmax,

                A little learning could go a long ways. The deal is you are trying to explain CIMT testing to me, about which you know little to nothing. It is ironic that I know a lot more about CAC scores than you do, and you keep trying to convince me that CAC score tests are the only valid non-invasive tests. If you ever bother to stop posting and start learning, you could understand that your statements above are a combination of entirely not valid to partially valid depending upon the operator. Do you know the difference? I surely do and often mention it.

                Studies of CIMT tests found that there is a 96% correlation between amount of plaque in the carotid arteries and in the rest of the cardiovascular system. You seem also to make a common mistake that the heart is the only place to be concerned about cardiovascular disease. A clot from a plaque outside the heart can and does cause heart attacks (also strokes for that matter). You also seem to misunderstand the difference between information and knowledge with your statement about a relative, not absolute measurement. That statement has no basis unless you think that calcium will kill you. It would be a ridiculous statement to make, but that is the basis for this absolute measurement fixation. Oh, and don't forget that it isn't the calcified plaque that is likely to rupture and cause a heart attack or stroke. It is the soft plaque that the CAC score test CANNOT see that in fact causes heart attacks and strokes. So much for absolute measurement nonsense.

                Finally the only point that you make with some validity, and it has been covered over and over (you seem to never learn) is that repeatability is important for CIMT tests. In order to have good repeatability the operators need to be well trained. Dr. Brewer has made several videos mentioning this, and I think that it is in the video that I listed above (obviously you declined the opportunity to watch that video and learn something for a change).
                Last edited by Tom; 05-19-2019, 03:47 AM.

                Comment


                • fatmax
                  fatmax commented
                  Editing a comment
                  You are correct that CAC does not measure soft plaque. That is well known. However, it has been shown that:

                  "CAC is a surrogate marker of the total burden of coronary AS: for each quantity of CAC there is five times higher quantity of non-calcified soft plaques"

                  See:
                  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4860479/

                  Why is it that a self-described expert doesn't know this?

              • #13
                Fatmax,

                Duh, you are not telling me anything that I already didn't know. I have never said that a CAC score was not a good thing to have done and know for that very reason. You really need to figure out how to learn and express yourself as your conversation is very one-dimensional and shallow.
                Last edited by Tom; 05-19-2019, 04:59 AM.

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