Dr Ford Brewer - PrevMed

If you, or someone you know, is on Lipitor, you should be aware of this.

The METEOR reanalysis went into detail to see if the impact on CV inflammation was due to improved LDL. It wasn't. What does that mean? Statins that lower LDL, but not CRP may not be helping you. Is that a problem? Yes. The most popular statin - Lipitor (Atorvastatin) does NOT lower cv inflammation as well as the others: Pitavastatin ( Livalo), Crestor (rosuvastatin), Simvastatin, Pravastatin, etc

Know Your Numbers! There is a way to measure your CV (CardioVascular) Inflammation. This is what leads to endothelial damage. This is what leads to LDL seeping through the cracks & holes & lodging in the artery wall. (One of the tests - MACR - is an actual measurement of the holes in the endothelium). The panel also includes measurement of the actual enzymes the immune system releases in an attempt to dissolve plaque (MPO & LP-PLA2). The final component is more well-known - CRP. CRP is made by the liver as a reaction to inflammatory processes. We describe the most common false positives and other traps in lab interpretation.

The comment was regarding this video: https://www.youtube.com/watch?v=QOWF0KTNu2g&t=0s

A viewer said, "My cardiologist (a leading cardiologist at Cedars-Sinai) said this is not possible... You can't (reverse CV plaque)." So I must be a crazy YouTube doc, right?

Wrong. It's true that plaque reversal is uncommon. And "drinking 1 cup a day" of anything alone is not going to do it. But the science (like JACC - the Journal of the American College of Cardiology) is full of studies of measuring plaque reversal. https://www.jacc.org/doi/10.1016/j.jacc.2015.05.065

https://www.youtube.com/watch?v=eqbacepqDHs&t=0s

https://www.youtube.com/watch?v=TkWIy_NUyPI&t=0s

Another patient came to me with a routine carotid ultrasound. I had to break the bad news that this study, although by far the most common, is rarely needed. And it doesn't help us much. These are "flow studies", measuring the flow in the carotid arteries. They don't help us understand heart attack & stroke risk.

In this video, we go deeper into why CIMT is not done so often: it's hard to do right. Why? Perspective matters - just like photography.

Todd Eldredge, the founder of CardioRisk, wrote a book called Cardiovascular Wellness Management Success Plan. His stated readership was going to be docs. But most of the viewers of this channel will understand it better than a lot of docs. He engages the reader quickly in describing his own family tragedy, losing a brother unexpectedly to a car wreck. The point is that this happens throughout the country on a regular basis. Heart disease is the #1 killer and half of them are unpredicted. He's got great sections describing the science on CIMT. He also describes an interesting patient portal for CV risk management. Unfortunately, like CIMTs in general, there is not enough recognition - so it's vastly under-utilized. I personally got a lot out of the book. I'd recommend it. Here's an Amazon associate link to the book: https://www.amazon.com/gp/product/B07DHZ3DWD/ref=as_li_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=B07DHZ3DWD&linkCode=as2&tag=fordbrewer-20&linkId=14521826a520c573d361b5db4a7c7319

This video is about the OBESITY PARADOX. What is it? Who cares? Why is it important? The bottom line is it's important for managing your heart attack risk. In fact, which is more important - weight loss or exercise? That actually depends on your age, weight, and RFM ( Relative Fat Mass).

This is part 2 of an interview with James West. He started a diet recently. He took some standards (like low carb and Intermittent fasting) and developed some of his own versions.

James West started a diet this weekend. There are several different components and questions raised.

In the first video, we covered:

1. His motivation. We start with some discussion re: stages of motivation to change. He also talks about a structure he's created to keep himself involved. And he also discusses how to enroll his family's support in this long-term activity;

2. James' background - he started in the finance industry and moved to healthcare, where he started a genetics lab and a managed care organization; and

3. How he's applied that background and other information to start his own personal diet approach. (It would be hard to classify. But the best diet is one you can actually follow. Don't be too rigid with your diet. Do what works for you long-term.)

Doug Thompson, DDS is the founder of the WDN (Wellness Dentistry Network). The WDN team is developing a series of patient education tools for CV (cardiovascular) risk.

Can sleep apnea kill you? Did it kill Carrie Fisher? Those might be 2 different questions; drugs may have been involved with Fisher's death. The reality is that sleep-disordered breathing is associated with increased cardiovascular & stroke death rates. It's also associated with increased diabetes, drug use, and mental health problems.

The question of causality can get murky. Does Insulin resistance cause death? It causes cv inflammation which can, in turn, cause heart attack & stroke. And AIDS causes the inability to fight routine infections which can in turn cause death.

The ASAA (American Sleep Apnea Association) has some good points about this issue. So did sleep apnea kill Carrie Fisher? They think it did. I think it at least helped.

Adiel et al went crazy on molecular biomarkers of Niacin treatment. The results were not unexpected, but the answers generate a lot of new questions. Do these explain some of the mixed signals in the literature; improved lipids & inflammation, but increased insulin resistance (HOMA - IR). I don't think so; it's only an 8-week study on 19 obese middle-aged men with pre-existing metabolic syndrome.

https://www.sciencedirect.com/science/article/pii/S1933287418301788#!

It still, however, raises very interesting questions re: biomarkers and potential mechanisms for Niacin's impact. Part 1 sets up the context and goes into the lists of biomarkers and correlations. Part 2 goes into the undeniable clusters seen in statistical analysis of these biomarkers.