You CAN’T Outrun Your Own Genetics
Some medical professors teach the most common symptom of atherosclerotic heart disease is sudden death. Atherosclerosis is the leading cause of death with sometimes little or no warning. For women, 10 times more die of heart disease than breast cancer. Every year we hear a story of someone “who was very fit “and having a heart attack in a triathlon or marathon”. In 1977, Jim Fixx wrote The Complete Book Of Running. He was a competitive marathon runner, but he died during a run at age 52 of heart disease. He had a significant family history and an early life of weight issues and smoking. Alberto Salazaar, a well-known professional marathoner had a heart attack at age 48. Despite all the research and what’s scientifically known, we are losing the war against this nemesis. Young and old people are going undetected and dying of heart disease.
Similar to screening for cancer, heart disease has specific tests to follow the risk. Historically, Cholesterol bloodwork including HDL, LDL, VLDL, and triglycerides is checked ApoB, which is associated with LDL is also a critical marker. Look carefully at your numbers. Your result may say ” normal”, but your values may be at the very upper end. Higher values should be treated to get in the mid or low range of normal. Heart CT scans can show calcium deposits in the heart vessels giving a calcium score. This calcium score will show historical and present damage. This number can be a predictor of future heart disease. Body Weight, smoking, diabetes, and activity levels are patient-controlled risk factors; however, family history or genetics are inescapable.
Our circulatory system carries blood, oxygen, and nutrients throughout the body. This system also carries waste and cholesterol. Cholesterol is a compound that is required in the body to make cell membranes and hormones. Cholesterol is synthesized in the liver and consumed with your diet. Cholesterol is carried around the blood in compounds consisting of cholesterol and special proteins. HDL, the “good” cholesterol, has less cholesterol and more protein. LDL, the “bad” cholesterol, has more cholesterol and less protein. The protein associated with LDL is ApoB, therefore this becomes a critical marker to evaluate risk. Damage to the lining of the circulatory system from inflammation or hypertension can lead to the LDL/APO B collecting in the lining of the vessel This collection of cholesterol can lead to a calcification or plaque that can block or impede the blood flow to the heart muscle. This buildup is a slow progressive process that if untreated will lead to occlusion of the vessel and myocardial ischemia or heart attack.
My father died last fall of heart disease. When he passed, the cardiologist said his heart was “full of calcium deposits”. He had severe heart disease. My dad was a physical freak. He ran marathons including Boston for many years. He spent his final years farming the hillsides of western North Carolina. Except for his love of my mom’s fried chicken, he should have been low-risk. His father died of heart disease. He was also a great athlete. He was a semi-pro pitcher and lived aggressively. Family history matters. You can’t change this risk by losing weight, exercising, living clean, and not smoking. You can’t outrun bad genetics.
Because of these deaths, I asked my primary care to order ApoB and a cardiac CT. My only risk factor is family history. I eat relatively well, my sugar level is great, and I exercise to an excessive level. My LDL and ApoB were slightly high. My cardiac CT number was slightly high. Despite what my mother told me, I’m not special. These numbers tell me I have a mild to moderate risk of developing heart disease if untreated. Now I must consider treatment to slow this process. I do not think I can change my diet or exercise much more so I may have to consider medicine. The idea is long-term health requires early detection and treatment. Cardiac CT and Apo B can be early detection.
Health Insurance companies rarely pay for ApoB or a cardiac CT. I paid about $40 for the lab and $160 for the CT scan. Insurance companies will not pay for a cardiac CT for early detection for prevention, but they will pay big for a cardiac stent or open heart surgery. If you have a family history, I encourage you to get these tests with your normal cholesterol screening. Early detection from screening and then treatment can decrease life-changing cardiac events.