Why you should get a CT heart scan

Found on: https://www.wheatbellyblog.com/2019/03/why-you-should-get-a-ct-heart-scan/

A CT heart scan is a crucial test to have done at low cost, relatively modest radiation exposure, that tells you whether or not you have coronary heart disease. It’s the only test that tells you with confidence whether or not you have atherosclerotic plaque in your heart’s arteries. It is quantitative and can be used to track progression, regression, or stabilization over the years.

Sadly, there is a lot of misinformation floating around about heart scans, so be armed with better information.


Hi, Doctor William Davis here, author of Wheat Belly and Undoctored books. I want to talk about why I think you should get a heart scan. Now I got involved with heart scanning over 20 years ago, when I brought Wisconsin’s first heart scan device to Milwaukee. I did that because my mom died of sudden cardiac death after a successful two-vessel coronary angioplasty she underwent in New Jersey.

I was practicing in Milwaukee, just starting out, and I was doing lots of heart procedures. My mom died, ironically, of the disease I dealt with, or I thought dealt with every day. That event shook me, and it made clear to me that we needed to do a better job of looking for heart disease years before something bad happens, like a heart attack, or sudden cardiac death. Well, how do you do that?

Can you look at your cholesterol and say “Oh, my cholesterol is 240. I must have heart disease.”? No, of course not — cholesterol is virtually worthless when it comes to predicting heart disease. I don’t even think we should bother measuring it. It’s stupid, but nonetheless, that’s the prevailing attitude.

Or you have a stress test. Well, stress tests are uniformly useless in people without symptoms. If you’re having chest pain, you can’t breathe, maybe a stress test in some form would be helpful. But if you’re just going to work, or going to school, feeling good, a stress test almost never tells you anything. Because stress tests become abnormal very late in the process, when you’re about to have a heart attack, or you have a very serious blockage in one of your arteries. But for the decades that precede a heart attack, a stress test will not detect it.

Some of my unscrupulous colleagues, of which there are many, would say things like “Well, we do the real test; a heart catheterization”, right? … an invasive procedure. Well, no; no. I’m talking about the people who are just going about their business, feeling fine, often exercising, right. They do not need an invasive procedure. You’d be shocked how often that’s done, though.

Okay ,what are we left with? You’re left with a CT heart scan. It’s just a CT (a CAT scan device), and it’s set in a specific way so that you get very low radiation exposure — it’s about 10 chest X-rays worth of radiation exposures — it’s come down over the years, and it’s trending downward, even now. But it’s about 10 chest X-rays equivalent.

You have to pay for it yourself in most cases, but you can typically get it for about $100-150. Any more than that, you can shop around. You might have to call some places that do heart scanning. Hospitals do it for cheap; you know why? They secretly hope you have a really high score, so that you “need” more procedures: a stress nuclear study (for $5,000), a heart catheterization (for $38,000), a bypass operations (for $150,000). That’s what they hope.

So they view the heart scan as a loss leader. But you don’t care about that. Don’t pay any attention to that, and do not let them up-sell you to a CT coronary angiogram, without a very thorough discussion of why, because that’s how they make money, you see. They try to tell “You have a high score” (that’s how heart scan results are reported) “You need a CT coronary angiogram”. Almost never should that be done, okay.

When you get a CT heart scan — very easy, it’s really fast. These devices are very fast nowadays. Then typically, in a couple of days or so, you’re given a score. What that score is, is the volume of calcium in your heart’s arteries. People go “Why are we measuring calcium?”

One, it’s easy to see on a CT scan, so is thereby easy to quantify. Think of it this way. My friend Dr. John Rumberger, when he was at Mayo Clinic, did much of this research — very brilliant research. Calcium occupies 20% of total atherosclerotic plaque volume. So it’s a gauge, a dipstick, for the amount of plaque you have in your arteries. It doesn’t tell you about blockage, okay, that’s different kind of perspective.

Think of it this way: think of your arteries as being a foot long iron pipe. A heart catheterization would tell you stuff like: there’s a blockage halfway down, that’s blocking 70 percent of flow. That’s kind of information you get on a heart catheterization. A heart scan tells you something like this: in this 1 foot long piece of iron pipe, there’s 273.85 cubic millimeters of rust — two different perspectives on the same disease.

A heart scan gives you a score, a calcium score. Normal is zero. The higher the score, the more plaque you have, and the more likely it is that can lead to heart attack and abnormal symptoms. There’s no specific cutoff. You can’t say “at a score of 500 you likely have a 70% block”. You can’t say things like that. Though, the higher it does go, it does indeed suggest greater potential for a blockage, that blocks flow.

But your primary concern here is not to detect blockage. It’s to quantify the amount of plaque, because the more plaque you have, the more likely it is to rupture. That’s what heart attacks are. It’s when plaque has inflammation in its walls, and it ruptures, and the exposure of the underlying contents of that plaque trigger blood clot formation. That’s what you’re looking for. But you want to know this years before that kind of stuff happens, right?

Let’s say you have a score of 500, what now? Well, those of you who have been following along my programs, know that all the things that I do: the Wheat Belly Total Health program, the Undoctored Wild-Naked-Unwashed program — all those programs, the prescriptive part of the programs, came from my efforts to reduce heart scan scores, or at least stop them from increasing.

Because if we do nothing, if you have a heart scan score, say, of 500, and you do nothing, the score goes up
25% per year.
It’s horrifying. If you allow that to happen, you’re getting closer and closer and closer to death, heart attack, those things.

What if you take a statin drug, an aspirin, and cut the fat in your diet — cut the saturated fat, and exercise? How fast does your heart scan score go up?
25% per year
… does nothing. Those conventional solutions do nothing to prevent plaque from growing.

So what do you do you do? You do the programs, okay — Wheat Belly Total Health, or now the Undoctored Wild-Naked-Unwashed program. Those strategies that I put together over the years, and we showed that you could reduce heart scan scores, or at least put a stop to the continual rise. But it’s not uncommon for heart scan score of say, 700, to drop to 300, 400, something like that.

You can actually see on the heart scan images, you see can see the plaque has shrunk (at least the calcium part of it has shrunk). Now some people say “aren’t you measuring only hard plaque?” No, the calcium score is an index of total plaque and all its varied components: calcium, fibrous tissue, inflammatory cells, soft plaque, everything. It’s an index of total plaque.

So don’t let my colleagues — who often don’t understand heart scans, because they don’t care about prevention; they care about heart catheterizations and defibrillators, and those kinds of high ticket items — if they say “that’s a stupid test”. No. It’s been over 20 years, this test is actually good. It took a long time to gain acceptance among most of my colleagues, but it has happened. Now if it was $10,000 a scan, and the professional fee was $3,000, you bet they’d recommend heart scans. But they’re $100 or so, and there’s virtually no professional fee — there might be a few dollars for a reading of the scan, but hardly worth their time, so they call it stupid.

That’s how health care operates nowadays. It’s based on money, and revenue returned on your effort. So if you have a positive heart scan score, you engage in the program. That’s that’s as good as it gets. There is no other program that reduces your heart scan score. So, Wheat Belly Total Health | Undoctored program.

What’s better than one heart scan score?
two heart scan scores
Let me tell you why.

Let’s say you have a score of 500, and the report says your risk for heart attack is about 7-8% per year, and it’s gonna go higher as your score grows, right? Well, what if you engaged in the program, the Undoctored program, the Wheat Belly Total Health program a year ago, and your score a year ago was 700, and it’s been reduced to 500? Well, your risk for heart attack is not 7 or 8%. It’s zero, because you reduced. Now, you won’t know that, because you didn’t have a score perhaps a year ago.

What if the score a year ago was 300, and now it’s 500? Now your heart attack risk is higher than 7%.

So you get the point. Better than one score is two scores. It gives you an index, a rate of change. We can actually calculate the annual rate of change. But you want it to do this {declining trend gesture}. You do that by engaging in all my programs.

So if you, or someone close to you, is at risk for heart disease — now this [CT] is typically offered to men 40 and over, women 50 and over, but that’s kind of a soft cut off, depending on your mix of risk factors for heart disease. If you’re, let’s say, a guy, and your dad had a heart attack at 37, don’t wait till you’re 40. Or if you’re a woman, and your mom had heart failure and sudden cardiac death at age 43, don’t wait till age 50, right? Go probably in your 30s. Be aware of those kinds of modifying effects on when you should get a heart scan.

If you have a heart scan score of zero — if you’re lucky enough to have a heart scan score of zero, don’t get it done for at least 5 years. If you have another zero in 5 or 6, 7 years, your lifetime risk for heart disease approaches zero. That’s really good news. And by the way, if you have a heart scan score zero, do not let your doctor talk you into a stupid statin drug. Because your risk for heart disease is virtually zero. You can’t reduce it any further with a statin drug.

And also, if you have a positive score, whether it’s 14, 500, or 1500, don’t let the cardiologist or your primary care talk you into a statin drug. It does not have an effect. The only thing that a statin drug does is prevent plaque rupture — reduce the likelihood about 1% (not 36%, not 50%, like my colleagues quote; that’s BS; that’s statistical manipulation; it’s very deceptive), it reduces risk for plaque rupture about 1% over several years. That’s it. And those are in people who are doing nothing else, right. Going on a low-fat diet, and taking aspirin, hardly does anything.

It’s the program — the program, the Undoctored program, Wheat Belly Total Health. We eliminate the expression of small LDL particles. We raise HDL, reduce triglycerides, reduce blood sugar, reduce insulin resistance, reduce inflammation. We use high-dose fish oil. We use vitamin D restoration, iodine and thyroid optimization, magnesium, cultivation of bowel flora. Those are the strategies that have dramatic effects, so much so that you can reduce your heart scan store. Aspirin doesn’t do that. Statins don’t do that. A low-fat diet most certainly does not do that. So, know what a heart scan is. Use it properly, and it can be part, a crucial part, of a very powerful heart disease prevention program.

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