Heart Disease
Coronary Stents and Reality; Did Your Cardiologist Come Clean?

Heart stents. Coronary Stents. Angioplasty. Angiogram. Percutaneous Coronary Intervention (PCI). Regardless of what you call it, over a half MILLION of them are done per year at a cost of around $18,000 each.
Sounds great. After all, we’re saving lives with these remarkable procedures that are far, far easier on the patient then cracking open the sternum and replumbing the coronary arteries.
Well yes. And no.
For emergency procedures, the research is pretty positive. The sooner you can get this procedure done in the middle of a heart attack, the better the outcomes. That’s where the clarity ends. In general, it is pretty well accepted (in the research, but not among cardiologists who do these procedures) that for non-emergency, elective procedures, the data on PCI crashes. To the tune of about 50% of them being done inappropriately.
These are some serious numbers, serious dollars and serious risks to the patients. And just in case the patient makes it through the procedure, they have usually earned a year or so on blood thinners. In coming years, the risk of the stent closing back up again is always brewing in the background.
But all of this is ok, because before you receive ANY medical care, there is something called informed consent. Under informed consent, it is the obligation of a physician to explain the procedure being done, the risks of the procedure, the risk of NOT getting the procedure and the alternatives. It would make sense that, as the procedure becomes more invasive, the obligation to fully inform the patient should grow as well.
After all, how can you, as the patient, truly make a decision about a procedure this important (or not) without being fully informed?? You really can not.
Which brings us to this particular study. In it, researchers reviewed We performed recorded 59 conversations by 23 cardiologists among adults with known or suspected stable coronary disease at outpatient cardiology practices. These conversations were evaluated for 7 accepted elements of informed constent when it comes to helping the patient make the decision to undergo angiography and possible stenting. Here’s what they found:
- A paltry TWO (3%) conversations included all 7 elements of informed decision making.
- Another eight conversations (14%) met a more limited definition of procedure, alternatives, and risks.
When the cardiologist was more forthcoming and honest about expectations of the procedure, the outcome of the visit was drastically different:
- If the cardiologist discussed clincially viable alternatives (i.e. medications, lifestyle changes, no treatment–the term for this in informed consent is “uncertainty “), the patient was 20.5 TIMES less likely to choose the procedure.
- If the cardiologist discussed the patient’s role in deciding about having the procedure done, they were 530% less likely to undergo PCI.
- If there was an exploration of alternatives the patient was 950% less likely to choose PCI.
- Neither the presence of chest pain (angina) nor severity of symptoms were associated with choosing angiography and possible PCI.
- Overall, better informed patients were 320% less likely to choose angiography and possible PCI.
Granted, this was a small subset of practicing cardiologists and maybe the bulk of cardiology practices do not follow the practices seen in this study. But, given how rushed many specialist offices tend to be, I’m afraid this is standard.
Overall, though, I think this reflects the disconnect between what patients perceive and what the reality is of the medical procedures that are performed with a high degree of regularity in modern medicine. The list of procedures and medications that have shown little benefit in the medical research but continue to be used is quite long.
And this is heart disease. Almost entirely preventable! For a long time now we’ve known that lifestyle changes produce better outcomes than PCI and yet this procedure is still done on an elective hundreds of thousands of times per year.
So, if YOU had a stent put in, do you feel that your cardiologist fully educated you on the risks, benefits and alternatives?
Diabetes and the Secret of Erectile Dysfunction – The Answer Lies Here

Let’s face it, erectile dysfunction, or ED as it is known in the radio commercials, is not a good thing.
For us men, back in the late teens, twenties or thirties there could be few things less desirable. For some reason, though, as we age it becomes almost acceptable for erectile dysfunction. Maybe it’s because, along with the ED comes a lack of sexual desire, making the ED really a secondary problem.
If you listen to the commercials (which I can no longer do since I threw the radio out the window in frustration) about erectile dysfunction you will be convinced that testosterone deficiency, or low T syndrome, is the cause of ED.
Here’s the real truth.
Erectile dysfunction is cardiovascular disease. Period. An erection is all about controlling blood flow. If blood flow is poor an erection is not going to happen.
This can be due to poor vascular reactivity (aka endothelial dysfunction) where the blood vessels cannot open and close when needed or it can be more advanced where the blood vessels that are supposed to fill the penis with blood are full of plaque (atherosclerosis).
This means that both the short and long term answer for ED needs to focus on the health of your blood vessels (aka vascular health).
Considering that diabetes is so incredibly bad for your blood vessels, the findings of this particular study looking at the relationship between ED and diabetes should come as no surprise. In it, researchers looked at 220 Type 2 diabetic to see how common erectile dysfunction was and whether depression or anxiety played any additional role.
The questionnaires used were the IIEF (International Index of Erectile Function), SAS (self-rating anxiety scale) and SDS (self-rating depression scale) to assess whether and how much these situations were present. Here’s what they found:
- 52.9% of the patients were affected by erectile dysfunction.
- In those diabetics who spent less time with their HbA1c levels below 7% (indicating that they were better controlled) over a two year period had a lower likelihood of ED. The reverse was also true.
- Patients with ED had higher levels of triglycerides and fasting insulin.
- Resistin (a hormone released by the abdominal fat that has been linked to prediabetes and diabetes) levels were higher in patients with ED.
- Free testosterone was lower in patients affected by ED (remember that this is just ONE other problem and NOT the cause of the ED).
- Depression and anxiety were not related to the risk of ED.
Over half of the diabetic patients had erectile dysfunction. Half.
There are VERY few diabetic patients who cannot drastically improve their health with the right dietary choices, exercise program and attention to simple things like drinking out of plastic water bottles. Many of the diabetics I come across knowingly and willingly make less-than-ideal choices.
If it was me, I would have to balance these lifestyle choices against the risk of developing ED. Can’t say not exercising on a regular basis or eating that 2nd serving at dinner would win out.
If you’re really interested in learning about how you can make better choices, I would strongly suggest checking out my Diabetes eBook by clicking here.
High Intensity Exercise and Heart Damage
IS THERE SUCH A THING AS TOO MUCH EXERCISE?
As a martial artist for many years now, I’ve never been a big fan of long distance running. I’d much rather go the interval route like fighting in the boxing ring. I’ve also encouraged patients to follow more of a modified interval type training designed to increase cardiac function and resiliency. And, quite frankly, I don’t think humans were designed for long distance aerobic activity.
Seriously–think of a single animal we would have stalked or been stalked by that would’ve taken an hour to accomplish? Think you can outrun a tiger for an hour? Chase an antelope for an hour? I’m thinking not…
So this study looked at ventricular function in normally trained and endurance trained athletes after a short bouts (14, 1 minute) of all out running. They found that, in the endurance trained athletes there was a reduction in heart function that wasn’t present in the normally trained athletes. So why is this? I have spoken to runner’s groups about the amount of oxidative stress generated during endurance events. It is highly likely that these endurance athletes may be in a chronic state of oxidative stress, leading to rapid reduction in cardiac function with high levels of intense exercise.
Are You Giving Your Kids this Vitamin?

You take your vitamins religiously. You exercise and watch what you eat. But your kids? You send them to school with a Twinkie and fruit juice and don’t think twice about vitamins for them.
It’s not that you don’t care about your kids, it’s just that we don’t really think of them as having the problem. We think of kids being more resilient and the choices that they make not having a long term impact. But we just now that this isn’t true. There is a long list of things that happen to children that have effects decades later as an adult. These can include:
- Childhood maltreatment (physical, emotional, nutritional, sexual)
- Exposure to parents who smoke
- Antibiotic exposure as an infant
The point is that things that happen in childhood DO matter. These things can play a huge role in the health challenges your child will or will not have to deal with as an adult.
That’s a pretty strong responsibility as a parent.
Luckily some things are easier to implement. Which brings us to this particular study looking at the relationship to vitamin D levels in children and the health of their blood vessels 27 years later (as measured by carotid artery intima media thickness, or IMT). Here’s what they found:
- Children with the lowest levels of 25-OH vitamin D (<40 nmol/L or 16 ng/ml–a very low number) were 70% more likely to have high-risk IMT.
- These same low-level vitamin D kids were 80% more likely to have risk factors for heart disease as an adult.
This is a very simple addition to your child’s routine. With Keegan (9 years old), he gets 6,000 IU of vitamin D per week. That’s only 3 drops per week of the Biotics Bio-D-mulsion Forte formula that I recommend here in the office. I will usually add another drop of Biotics Bio-Ae-mulsion Forte as well (vitamin A 12,500 IU) to help support immune function.
This combination has seemed to keep his immune system humming at top efficiency and according to this study, may be protecting his blood vessels at this very moment…
Are You a Smoking Parent? Shocking Info You Need to Know

I grew up in a household with two smoking parents. I was the one hanging my head out the car window with the dog.
I can’t go back and change the fact that my parents smoked. Luckily, their smoking did not influence me to begin my own life-draining habit. So I escaped the damage.
Or so I thought.
I’m pretty sure the days of parents blowing smoke directly into their children’s faces for laughs are pretty much over. These days, this same act would almost certainly be accompanied by a visit from child protective services. But even the most conscientious of smokers can’t protect their children from damage. This is because few smokers seem to be aware of the concept of third-hand smoke. Sure, we all know about secondary smoke and passive smoking. And if you do your best to not smoke around your kids and not smoke in the car you’re going to fully insulate your kids from your bad habits.
Not true.
Cotinine is a compound that shows up in the blood of those who have been exposed to cigarette smoke. This includes both smokers and the children of smokers. The higher to cotinine levels, the higher the exposure. With that in mind, if you are a smoker and you care about your child or children’s health (which I’m sure you do), then you need to pay attention to this particular study.
In it, researchers looked at the carotid arteries of adults who had been exposed to cigarette smoke TWENTY-SIX YEARS earlier. Here’s what they found:
- The percentage of children without any cotinine in their blood levels was highest in non-smoking households (84%), followed by one smoking parent (62%) and households where both parents smoked (43%).
- Two and a half decades later, the adults who were raised in a smoking household were 70% more likely to have hardening of their carotid arteries.
This is not good news. This means that the damage to the blood vessels begin as a child as a result of this early exposure to indirect smoke. And, in all likelihood, it is an ongoing process. The hardening of the arteries does not happen as a child, but rather is the end result of a decades-long progression of the damage that started way back when.
But it gets worse:
- Even in those households were parents were conscientious about not exposing their children (referred to as good “smoking hygiene”) and whose children had no detectable blood levels of cotinine there was still a 60% higher risk of hardening of the arteries.
- For those children who parents really didn’t focus on protecting their children (poor smoking hygiene–the children had detectable blood cotinine levels) there was a whopping 400% increased risk of hardening of the arteries in the carotid arteries of the neck.
400%.
If you are a parent who smokes, you need to take a hard look at just how much of an effect this is going to have on your kids. And it’s not an IF, it’s a HOW MUCH. And we can see that, even it you do not directly expose your kids to cigarette smoke, they are suffering the damage of your lifestyle choices.
Period.
Calcium Supplements and Heart Disease
Think You’re Not at Risk for Heart Disease? Take This Test and Find Out

Heart disease is not something that we need to educate the public on. Everyone’s got ideas on how to prevent heart disease.
But, apparently, there’s some massive disconnect between what we need to do and what we are doing. A recently study revealed that not a single person out of 1,731 were living a lifestyle that included Life’s Simple 7 established by the American Heart Association. Not a single one.
But I’m confident that not a single person out of the 1,731 actually wanted to have a heart attack or leave his or her family with the untimely death of a loved one.
So why the disconnect? This particular study may help give you some insight as to why YOU haven’t adopted at least the Simple 7.
In it, researchers looked at a group of 5,863 patients and asked about his or her individual perception of risk of heart disease based on established risk factors. The patient’s perceived risk was then compared to his or her ACTUAL risk based on established risk factors.
Individuals were asked to rate his or her heart disease risk for the next years as low, intermediate or high. Based on these responses, they were classified as hypo-perceivers (the patient’s perceived his or her risk of heart disease as lower than it actually was) and normo-perceivers (the patient’s perceived risk was on par with his or her actual risk). Here’s what they found:
- Cardiovascular risk was intermediate in 45.7% and high in 54.3% of individuals as estimated by the Lifetime Risk Score (LRS).
- Shockingly, 83.9% were hypo-perceivers, thinking that they were at a lower risk than they actually were.
- A mere 16.1% estimated their risk correctly.
Talk about a massive disconnect. First of all, EVERYONE in the study had at least an intermediate risk for heart disease. This is a sad reflection on the overall state of health. But how could so many of these patients be so unaware at how great his or her risk is??
The rest of the study may give us some insight into just how much our “take a pill to fix it” society has screwed up our perceptions:
- Smokers were 204% more likely to underestimate their risk.
- Those with cholesterol problems were 121% more likely to underestimate risk.
- Sedentary people were 167% more likely.
- Those who took meds? A whopping 350% more likely to underestimate his or her risk.
- On the flip side, those with a higher BMI (64%), high blood pressure (43%), depression (54%) and stress (60%) were at a lower risk of hypo-perception.
I have said this time and time and time again. Taking medications to “fix” your problems does no such thing. In almost every situation, medications give you a false sense of security. Even though your blood pressure, cholesterol or blood sugar has gotten better on the meds, it translates very weakly into actually changing your risk of the things you are really worried about like heart attacks, stroke or death.
In other words, you will die with better numbers, but you WILL STILL DIE.
While this is a strong statement, we have seen it play out over and over in the medical literature. This study just reinforces the fact that our drug-oriented medical approach is creating a society that BELIEVES it is at a lower risk for heart disease, when in reality, it is not. There is a very high likelihood that you have some degree of risk for heart disease, unless you have adopted at least Life’s Simple 7 (click here for more info on the Simple 7 and see where you stand….personally I’m at a 9.4/10 because my BMI suggests I should lose 4 pounds, but my actual body fat percentage is where I want it to be).
Take the test yourself and let me know how you scored in the comments section!