Cardiologist Dr. Richard Taw answered questions about heart disease after a recent talk at the Palisades Optimist Club.
“Seventy-five percent of strokes are a first-ever event and happen with no warning,” cardiologist Dr. Richard Taw warned Palisades Optimist Club members on November 12. “They are 95 percent preventable.”
Taw also warned that although people are routinely screened for skin, prostrate, breast and colon cancers, they are rarely screened for the world’s number-one killer: heart disease.
There is a test available, “artheroSCAN,” but “Not enough people know about it,” Taw said. “Not enough people are doing the test,” which provides a coronary artery calcium score, the most predictive study for future heart attack risk.
Calcium? Heart? How does that work?
Cholesterol penetrates the lining of an artery and that area becomes inflamed, much like a small pimple, which then grows larger. That “sore” attracts calcium, and as it heals, it forms a scar on the artery wall, thickening it. After healing, other plaques can form on top of it.
Most heart attacks are caused by the rupture of the plaque, which then forms large clots and blocks blood flow.
Courtesy: The Heart Foundation
Many people think that atherosclerosis is genetic in origin, but Taw said that is not true. The most common cause is cholesterol, which is manufactured in the liver and is a result of diet. People with low cholesterol levels are at less risk of forming plaques.
The artheroSCAN test, which costs about $150 to $200 and shows one’s risk of a heart attack, involves a person laying in a CT scanner for 20 seconds. “This is a simple test, but Medicare/ insurance doesn’t cover it,” said Taw, who works at the Preventive Cardiology Center in Santa Monica.
It is recommended that if you are male and over 45, or a female over 55, or if you come from a family that has risk factors, you should be tested. “I spend a lot of time screening people for this disease,” Taw said.
How does cholesterol cause heart disease? The more of it, the more likely you will add calcium/plaque to artery walls.
United States diets generally have a fat content equal to 35-40 percent of all calories. Reducing the diet to 20 percent fat calories leads to a 20 percent drop in total and LDL cholesterol.
When a person eats fat (triglycerides and free fatty acids) it is processed and broken into VLDL (very low density lipoprotein) and LDL (low density lipoprotein), which are released into the blood.
Each triglyceride particle contains a saturated, monounsaturated and polyunsaturated fatty acid. The dominant portion of that triglyceride determines cholesterol level: the saturated portion raises total and LDL cholesterol levels; the mono- and polyunsaturated portion, when dominant, either lowers them or has a neutral effect.
Taw spoke about the Tsimane people in Bolivia, who were discovered to have almost no atherosclerosis.
In a March 2017 article in The Lancet (“Tsimane People: Indigenous Bolivian Group Have ‘Worlds Healthiest Arteries,’ Study Finds”), the writer noted that more than 700 Tsimane people, over 40 years old, were involved in a study funded by the US National Institute on Aging and National Institutes of Health. “The research found the arteries of an 80-year-old member of the Tsimane people resembled that of an American in their mid-50s.”
“Almost nine out of 10 of them were found to have clear arteries, indicating no risk of heart disease.
“The Tsimane diet largely consists of rice, plantain, cassava root, corn, nuts and fruits, with protein, mostly from animal meat, accounting for 14 per cent of their diet, with and fat accounting for the same proportion,” the story noted. “The people are active about 90 percent of the day.
Taw said that the Tsimanes routinely have 17,000 steps a day or more. “We’re not meant to sit,” he said. He was asked about using standing desk. “It won’t make a different, you have to move.”
The Tsimane results were compared with a study done on 7,000 Americans that showed 86 percent had some risk of heart disease – with half of those at a moderate-to-high risk, “a five-fold greater prevalence rate than that seen in the Tsimane population.”
“Heart disease is everywhere in industrialized societies,” Taw said, noting that coronary heart disease is the leading cause of death in developed countries, but it has generally been rare in Africa.
Scientists have also put mummies from Peru, Egypt, North America and Europe into CT scanners looking for atherosclerosis.
A 2014 Science Digest story (“Computed Tomographic Evidence of Atherosclerosis in the Mummified Remains of Humans From Around the World”) stated that “Although atherosclerosis is widely thought to be a disease of modernity, computed tomographic evidence of atherosclerosis has been found in the bodies of a large number of mummies.” About 29 percent of the 76 tested had atherosclerotic calcifications.
In Egyptian mummies, researchers speculated, “From surviving papyri and the paintings on the walls of tombs, it is clear that the elites, at least, ate plenty of fat and protein. . . . Relative physical inactivity and a high fat diet may well have been common in the Egyptians whose mummies survived to modern times.”
In 13 of 51 Peruvian mummies, there was also evidence of atherosclerosis. “The ancient Peruvians were as advanced in many ways as the ancient Egyptians. . . .They domesticated alpaca, Muscovy ducks, and guinea pigs, and it is known that they consumed fish, birds, deer, corn, hot peppers, potatoes, sweet potatoes, and manioc.
The paper concludes, “Although atherosclerosis is widely thought to be a disease of modernity, CT evidence of atherosclerosis has been found in the bodies of a substantial number of mummies. . . We have hypothesized that nontraditional risk factors such as the inhalation of cooking fire smoke and chronic infection or inflammation might have been important atherogenic factors in ancient times.”
“Lifestyle makes a huge difference,” Taw said. He was asked about obesity, which is resulting in a huge increase in diabetes. “Diabetes is terrible for plaque,” he said, noting that people who are pre-diabetic should also be screened because during this time, they are already laying down plaque in arteries.
Taw said that Dan Buettner wrote a November 2005 National Geographic magazine story “The Secrets of a Long Life” and then a book, “The Blue Zones,” which he recommends.
“Buettner asked the question, ‘Why do they live so long?’” Taw said, noting that the five areas Buettner explored were: Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica; Ikaria, Greece, and Loma Linda, California.
“He discovered that three things these people had in common was: 1) a reason to get up in the morning, a job to do or they were physically active; 2) social support, such as a church or club network; and 3) they ate very little animal products.”
Visit: preventivescreening.net or preventiveCardiology.com or call (310) 829-4327.
A Big Thank You Sue for all your great reporting!!! I no longer take our “local” newspaper because : I don’t need to with CTN! Keep going – you’re appreciated!