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RE: Carotid IMT

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>>Does anyone have a source for information about the reliability of

carotid IMT as an indicator of CHD? In other words, is the carotid IMT

measurement(s) well correlated with the degree of coronary artery

stenosis? One might logically think it would be. But it would be nice

to know for sure that logic is applicable in this particular case.

We started using this just over a year ago. There is more and more

being published about it and it is becoming a new standard to use in

research. There are several versions of it and several ways to read it

and interpret it.

We use the programs by Jacques Barth who was one of the inventors and

has published info on it. I will find and post more info on it, as we

have a bit here in our files, somewhere

Jeff

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  • 2 years later...
Guest guest

>

> Tony,

>

> >I think the critical factor was that your friend was not used to

> >vigorous exercise and he overexerted himself beyond the capacity of

> >one of the subcomponents (heart muscles, heart capillaries, etc).

>

> People don't suffer heart attacks just because they overextend

themselves.

> In the absence of underlying CVD, no one suffers a heart attack

regardless

> how hard they push themselves. They get tired, they get prematurely

winded -

> that's it. Heart attacks *always* indicate an underlying pathological

> process.

>

> Al

>

Al,

Just Googling " snow shoveling heart attack " gets over half a million

hits. Apparently shoveling snow can cause death rates from heart

attacks to triple among men 35 to 49 years old, and the American Heart

Association recognizes the significant correlation. I would not

dismiss overexertion, rather than pathology, as a cause of heart

attacks. Strenuous activity causes the heart to pump harder and

increases blood pressure. Couldn't this increased pressure burst some

capillaries? I think that the statistics say yes. Does this

constitute pathology? Not necessarily. Everything including tendons,

muscles, and bones will break when stressed enough. They will always

break at its weakest point.

Tony

==

http://www.americanheart.org/presenter.jhtml?identifier=3027990

Don't Let a Snow Forecast Also Forecast Your Heart Attack:

Heart-Health Tips from the American Heart Association

ALBANY - Cardiac deaths rise during the holiday season, and the

American Heart Association recommends the following tips to help

prevent sudden cardiac arrest:

Avoid Sudden Cold Weather Exertion:

Snowstorms present challenges for everyone, primarily because getting

rid of snow usually means sudden exertion in cold weather. Snow

shoveling can be healthy, good exercise, but not if you are normally

sedentary, are in poor physical condition, or have risk factors that

make snow shoveling inadvisable for your health. Everyone who must be

outdoors in cold weather should avoid sudden exertion, like lifting a

heavy shovel full of snow. Even walking through heavy, wet snow or

snowdrifts can strain a person's heart.

==

http://www.cbsnews.com/stories/2005/01/24/earlyshow/contributors/emilysenay/main\

668725.shtml

If you shovel for 30 minutes, you'll clear away 200 calories along

with the snow. Snow shoveling is very demanding on the body. Typical

winter conditions (a little more than an inch of snowfall and

temperatures that dip below 20 degrees) cause death rates from heart

attacks to triple among men 35 to 49 years old. Shoveling snow can be

very dangerous if the right precautions aren't taken.

What makes shoveling more dangerous than other average tasks around

the house is the temperature. Your heart rate and blood pressure

increase during strenuous activity. That, coupled with the body's

natural reflex to constrict arteries and blood vessels when exposed to

the cold, is a recipe for a heart attack.

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Rodney wrote:

>

> His appearance - younger than his chronological age, slim, sensible

> diet, and in all other respects *apparently* fit and healthy - looked

> to me to fit a profile for low LDL. It was his heart attack that

> seemed like the aberration.

>

>

I think we may be missing the point. When would this first heart attack

have occurred if the person ate a lot of meat and had a large BMI? The

point of CR and ON is to move your own personal longevity chart to to

right.

We can not know what this person's natural tendencies would be in a

different situation. One person is one person and one can not

extrapolate from them.

Positive Dennis

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Hi Rodney and All,

I believe that his height and weight can be estimated

accurately by you. What his diet was is something

that presents questions? People are incorrect in

their eating habits. Those who have suffered ill

health are often reticent to admitting that the cause

of their misfortune is their fork and knife. My

brother had a heart attack and claimed that it had

blocked completely his main artery, and that he had

survived because his heart had bypassed the block.

When I read his actual doctor's report, however, it

was a branch from his main artery that was blocked.

Anecdotes should be treated as such. Also, Al Young

has said in a separate message that snow shoveling

could lead to a burst artery, but heart attacks that

require stents are due to blocked arteries, as you

have pointed out.

Cheers, Al.

--- Rodney <perspect1111@...> wrote:

> Hi :

>

> Well I don't know what you have in mind for me to

> provide as a

> satisfactory answer to your question. Are you

> expecting me to demand

> he produce a signed certificate from his doctor?

>

> His appearance - younger than his chronological age,

> slim, sensible

> diet, and in all other respects *apparently* fit and

> healthy - looked

> to me to fit a profile for low LDL. It was his

> heart attack that

> seemed like the aberration.

>

> And that, of course, was the reason for my original

> post about this.

> It was *because* it was surprising to me that anyone

> would have a

> heart attack, and require a stent and blood thinning

> medication with

> an LDL that low that I posted about it. If he had

> told me his BP was

> 180/120 and his LDL was 300 I would never have

> mentioned it here,

> since it would have contributed nothing new to the

> knowledge base of

> this group.

>

> If someone knows of any papers that reported on

> studies that looked

> at the relationship between LDL and occlusion in

> coronary and/or

> carotid arteries we would be much better able to

> assess this

> information. Is he a 5 sigma event that it would be

> reasonable to

> ignore? Or is his case not especially unusual? If

> the latter then

> we all need to have carotid IMTs done, imo.

>

-- Al Pater, PhD; email: Alpater@...

________________________________________________________________________________\

____

We won't tell. Get more on shows you hate to love

(and love to hate): TV's Guilty Pleasures list.

http://tv./collections/265

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Guest guest

>

> Tony,

>

> >I think the critical factor was that your friend was not used to

> >vigorous exercise and he overexerted himself beyond the capacity of

> >one of the subcomponents (heart muscles, heart capillaries, etc).

>

> People don't suffer heart attacks just because they overextend

themselves.

> In the absence of underlying CVD, no one suffers a heart attack

regardless

> how hard they push themselves. They get tired, they get prematurely

winded -

> that's it. Heart attacks *always* indicate an underlying pathological

> process.

>

> Al

>

>Just Googling " snow shoveling heart attack " gets over half a million

hits. Apparently shoveling snow can cause death rates from heart

attacks to triple among men 35 to 49 years old, and the American Heart

Association recognizes the significant correlation. I would not

dismiss overexertion, rather than pathology, as a cause of heart

attacks. Strenuous activity causes the heart to pump harder and

increases blood pressure. Couldn't this increased pressure burst some

capillaries? I think that the statistics say yes. Does this

constitute pathology? Not necessarily. Everything including tendons,

muscles, and bones will break when stressed enough. They will always

break at its weakest point.

Tony,

I'm certainly not surprised to hear that in a middle aged American

population death from physical over exertion in cold weather is 3 times as

likely. Consider that population: it's generally sedentary and the standard

american diet is, well, the standard american diet.

I think you probably know as well as I do that the etiology of heart attacks

usually, if not always, involves the rupturing of plaques that provoke clots

that subsequently occlude coronary arteries. This scenario represents

the disease process we both know as " arteriosclerosis " . My strong sense is

that if it weren't for arteriosclerosis, heart attacks (focal necrosis of

heart tissue due to arterial blockage) would not exist.

I personally have never heard of heart attack resulting from burst

capillaries. Have you? It's simply not normal (in the sense of an absence of

underlying pathology) for a healthy human being to fall prey to a heart

attack, even while exercising heavily in the cold. I doubt, for example,

that traditional eskimo populations experience much in the way of heart

attack.

Otoh, my sense is that the life style most Westerners predisposes them to

arteriosclerosis and most of us probably have at least some

arteriosclerosis. We've all heard the accounts of autopsies on young men

(soldiers, accident victims) that reveal at least the beginnings of

arteriosclerosis.

Maybe I'm too influenced by testosterone-sodden thinking, but I have a hard

time accepting the idea that I risk death by the mere act of shoveling my

driveway...given that I have a physical job, that I stairclimb 6 days/wk at

moderately high intensity (labored conversations), and that there's no heart

disease in my family (lotsa cancer, thankyou) that I know of. When I shovel

my driveway, it's much like a stairclimbing session - 50 minutes of moderate

exercise. In fact, in my case, the shoveling actually substitutes for the

usual stairclimbing workout.

Maybe it will kill me some day, but I'm of the attitude that there's a such

thing as excess timidity vis-a-vis the safety proscriptions involving the

" dangerous " business of actually moving our bodies at a level of vigor that

nature apparently " intended " .

Al

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