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I'd like to start a series of conversations here on what I've learned over more than 30 years of dealing with CT heart scans and coronary calcium scores because these is so this is so important for getting control over cardiovascular risk. So many people think that just addressing cholesterol is all you need to do when addressing cholesterol is just close to useless. And that's why maybe your local hospital added an $80 million wing on their hospital for cardiovascular care because it remains heart disease remains the number one money maker for health care. It's also remains the number one killer of men and women uh in the US and and much of the world. So and 80 million Americans now take a statin cholesterol drug. Yet it has had virtually no meaningful impact on reducing cardiovascular events. So the status quo has been maintained and of course your hospital, your doctors like your cardiologists, health care systems all make a lot of money by maintaining this deeply flawed status quo.
Well, let me tell you how I got started in this whole conversation about CT heart scans and coronary calcium scores. So many years ago, about 35 years ago, my mom living in New Jersey, I I was living in the Midwest, had went to the hospital and had two coronary vessels, two coronary arteries in her heart. Angoplasty opened because of a severe blockage. Went home and four months later was found uh dead of sudden cardiac death in her in her bedroom.
Well, I asked myself, you know, what could I have done ahead of time to have warned my mom in some way? Was there something I could do that could have provided her with a warning, say a month, three months, six months, a year, five years ahead of such a catastrophe? Well, most doctors would say cholesterol would do that, which is an absurd concept. If I said your total cholesterol is 240 milligrams or your LDL cholesterol is 160 milligrams, does that tell you you're going to have a heart attack or die in a month, 6 months, a year, five years? Never. It tells you nothing. And there's a whole lot of uh there's a long list of reasons why cholesterol is an outdated and useless concept. See my other videos, see my many books that discuss this, my wheat belly series, undoed series, super gut, super body. All right, discuss a lot of these issues at length as well as my thousands of blog posts, williamdavismd.com blog and of course uh my YouTube channel where I discuss why we should have discarded cholesterol testing decades ago and there are better methods of course.
Well, what could I have done for my mom before this all happened? One of the tests that was available, though only uh in certain areas back 35 years ago was a heart scan that generated a coronary calcium score. Now, this was so long ago. Now, we use CT devices or what's called multi- detector CT scanners. Back then, we used the technology that preceded the multi- detector technology. And that was called electron beam CT scanners or EBCT. We said this was a very elegant technology invented in San Francisco by an engineer and he used magnetic fields to focus the X-ray beam. It didn't involve a low dose of X-ray but this became a real plus a real advantage in situations for instance like children or infants. If a child needed a CT scan it's hard to get a child to sit still, right? And back then, conventional CT scanners required two seconds for each um cross-sectional slice, and typically 30 slices or so were needed. And so, how do you make a child sit still? They they can't. And breathing involves motion, right? Just the motion of the lungs, of the diaphragm, of the chest. Uh and just fidgeting. It's hard for people to sit still for any length of time. So, this new technology, EBCT, was very rapid. It cut scan time by about 90% to about 0.2 seconds per cross-sectional slice. So this became a real plus in imaging the heart because if we want to image things that are fractions of a millimeter in the heart arteries because the heart heart arteries are very small. Typical diameter is about 3 millimeters. You need a you need a device that moves very quickly to acquire images because the heart beats and it beats with multiple phases of motion. The top of the heart, the atria beats differently than the ventricles below and there's other forms of motion in the heart. So the heart is a moving a rapidly moving object and you need very rapid scan. Well, this EBCT did it and it gave us exquisite images.
Now around the same time, Dr. Dr. John Rberger, who's become a friend, was at the Mayo Clinic and he did something extraordinary. He took the hearts of people who had died, car accidents, cancer, heart attacks, all different causes, and studied their coronary arteries, their hearts, arteries, specifically looking at of the atheroscllerotic plaque that these people had. And by the way, it's very common even in your 20s to have athoscorotic plaque. Not a lot perhaps, but you still have the start of it. And of course, older people have lots more. Well, he studied that athosceric plaque and found that 20% of the total volume of that plaque was occupied by calcium, that hard substance calcium. So in other words, if there was 10 cubic millimeters of total athosic plaque, you could count on having two cubic millimeters of calcium. So it provided kind of a dipstick or a guide or a or a measure of total athosclloric plaque in all three arteries. Well, that's well and good, but how do you put that to use in a living human? Well, became clear that these new EBCT devices could do that. And then Dr. Arthur Agston, who you whose name you may recognize because he was the author of the South Beach diet many years ago, well, he also created something called the Agston scoring system. It was a way to score the calcium so that you compare the calcium in one person to another person or you could track it over time as a indirect way to quantify the volume of aththeroscllic plaque in the coronary arteries.
Now this was revolutionary. A lot of my colleagues objected to it because they continued to think that the only important measure was percent blockage. They wanted to find things like, oh, there's a 95% blockage in the left anterior descending, the we say the L, the major artery in front of the heart because that's what leads to anga, chest pain symptoms. That's what they thought led to heart attack and that's what justifies doing things like in stent implantation to open that blockage or bypass surgery to bypass that blockage. What they fail to recognize is the most heart attacks and other cardiovascular events like sudden cardiac death are not driven by that progressive worsening of blockage. You know, 30 50 70 95 100%. Here's how most heart attacks work. You have what would be regarded as a minor plaque. Maybe it doesn't reduce the diameter of an artery more than 30%. But that's active tissue. That atheroscotic plaque is active tissue. And because it's inflamed and there's enzymes chewing away at it inside of it, it ruptures and exposes its internal contents to the blood flowing past it. And that is we say thrombogenic. It provokes formation of a blood clot. So 30% blockage or some other minor blockage ruptures and within minutes you have complete closure of the artery from a blood clot. That's why back 25 30 years ago we used to use something called thrombolytics. These were drugs introvenous drugs that uh in many case could dissolve the the uh blood clot and it worked maybe 80 90% of the time but it also was dangerous because thrombolytic agents also cause hemorrhage in place like the brain. So that practice has fallen out of favor. But point being vast majority of heart attacks don't occur from a 95% blockage or something like that. It occurs from what we would regard as a minor plaque that's metabolically active and then ruptures. And so that's why getting a coronary calcium score is so powerful because it gives you a gauge of total athletic plaque lining all three arteries.
Now the lesson I want to focus on today is vitamin D. Let me tell you why. So let's say you had a scan, right? So maybe an old EBCT scanner, maybe one of the more modern MDCT. And why, by the way, why did multi-detector technology take over? Because General Electric, the company that was pioneering some of the MDCT technology, didn't like this competitive technology, EBCT. So GE literally bought the intellectual property, bought the company, Imatron, locked it up. So even if you wanted it, you can't get it. So that allowed the proliferation success of the competitive multi-detector CT technology. So if you have a heart scan today, it's always a multi- detector device. So let's say you had a score, right? So we're going to quantify the calcium in your arteries as a means to gauge total athoscotic plaque. So a normal score is zero, no calcium, thereby little to no athoscotic plaque. And then the scores can go up to the thousands. And the higher the score the greater the risk the greater the legit such that a score of a thousand say which is very high. There's about a 10 to 15% chance per year that you die have a heart attack or develop anga that leads you down the path of procedures. So if it's 10 to 15% per year you can imagine over five six sevenyear period it's virtually guaranteed that something bad will happen if you take no action. So let's say your score is 400. What if you did nothing which is not smart right? What if you did nothing? How fast will that carnio calcium score and thereby the athoscotic plaque grow? It will grow 25% per year. It's horrifying, right? Imagine your money grow 25%. It'd be fantastic, right? You'd be hanging out at the country club with Bill Gates, but it's plaque. It's going to be growing at 25% per year. What if you went on a high dose of a statin cholesterol drug like 40 milligrams of Lipur and cut the saturated fat and cholesterol and total fat in your diet? Exercise, took a baby aspirin, maybe added other things like a beta blocker. How fast will that score increase? The science is very clear, 25% per year. that those what my colleagues to this day have the nerve to call that optimal medical therapy. Optimal medical therapy has no impact on progression of a coronary calcium score and thereby the progression of uh afterard plaque. There may be modest benefits of statin drugs wildly exaggerated by many of my colleagues in the pharmaceutical industry. there's very little benefit uh to taking a statin drug and there but the real tragedy of all that is that it took everybody's focus of attention off the real causes of heart disease which you can identify readily and address readily and you know what to be honest you don't even need the doctor to do it you can do it on your own another conversation for a conversation for another time so let's say your score is 400 and unfortunately this causes many people to panic when they see that 400 a year later 500 a year later is 625 and they're getting closer and closer to bad things happening. Right? So unfortunately many of my colleagues many of whom sadly are not the most honest interested more in money than science or someone's welfare will tell you let's do the real test a heart catheterization and see if you need a stent implanted or a bypass operation. of course procedures that yield thousands and thousands of dollars for the cardiologist, for the health care system, for the hospital, etc. Even though the evidence is quite clear, if you're a person going about your business, you're going to the office, you're going to work, you're going to school, whatever, you're riding your bike, you're doing things with no symptoms, there is no benefit to those procedures, yet they're done all the time because the financial incentive is irresistible, sadly, for my colleagues. So you'll see unnecessary procedures. Ask anybody you know who works in a kath lab where we do those angiograms of the heart and ask how often do you see unnecessary we say revascularization procedures, stances, angoplasty, atherctomy, bypass surgery. They'll tell you um all the time. It's very common. It's a frequent thing and it's widely known but almost nothing done about it. It's widely known that many procedures are unnecessary because they pay so well.
So what what what did I do though? I have people I I so back then I held open then an EBCT scan center and we were scanning people left and right and you uncover heart disease everywhere. So what do you do if someone's on lipid baby aspirin low-fat diet and yet their disease is progressing? Well, we had to find new ways to deal with this. And up till then, doing everything we can think of back then it was omega-3 fatty acids, uh, statin drug, nasin, fibrate drugs, larginine, the amino acid, all kinds of things we tried and we did manage to slow the progression down from the expected 25% per year down towards maybe 12 15% per year. So slower but still pretty bad. Right. Right. Once again, if it was money, it'd be great, but it's plaque growing at a rapid rate.
Now, I'm doing this in a northern climate where vitamin D deficiency is quite severe. A typical blood level of vitamin D at 25 hydroxy vitamin D for this area would be something like 15 or 17 nanogs. We're trying to aim for an ideal level 60 to 70 nanogs uh per milliliter. So when I put people on vitamin D oilbased gel caps only to assure absorption, not capsules with powder, not tablets, they can be absorbed, but they're erratically absorbed. They're unreliable. So uh oilbased gel caps, inexpensive, widely available. A typical dose would be 8,000 units, but also then adjusted over time to your body size race. There are other factors that influence how well you process vitamin D. But a common dose would be 8,000 units of based gel cap per day to achieve. So let's say somebody start with a 25 hydroxy vitamin D level of 12. We put them on say 8,000 units or 10,000 units. We check it three months later. It takes that long for the vitamin D level to stabilize and maybe now it's 68 nanogram. Right on target. That's what we want.
When I started doing this in hundreds and then thousands of people, it was the first time I saw those cardio calcium scores drop. The first time this happened, this is many years ago, of course, someone had a score about 680 or thereabouts and went dropped into the 400s. I thought, "No, this is not right. This is impossible." So, I pulled up the original scan and the more recent scan. And yes, indeed, the calcium, you could see clearly had shrunk considerably. Now people say you can't see the softer elements like fibrous tissue and inflammatory tissue and and fatty. Yes, you can. You just can't quantify it precisely. At least back then you couldn't because the technology was insufficient to quantify threedimensional space voxels. It's like a pixel in three dimension. Back then we didn't have the technology. I tried to do it but couldn't do it. Now you can do it and that's a conversation another day. But back then we couldn't do it. But you could still see it. you could still see the softer elements and indeed not only had the calcium shrunk but the softer elements had also shrunk. So it became clear that one of the most crucial things you can do to gain control over heart disease risk but specifically cardiac calcification score is to address vitamin D to get your 25 hydroxy vitamin D blood level to I I would advocate 60 to 70 nanogs per mill.
Now that vitamin D also has other great benefits. It also reduces insulin resistance. It induces arterial relaxation because diseased arteries are constrictive. It raises HDL, reduces triglycerides, reduces blood glucose, reduces blood pressure a little bit. It improves your emotional state, improves your mental focus. In other words, huge benefits uh from vitamin D that include giving you back control over the progression of coronary artery calcification.
Now, let this conversation be the start of a series of conversations I'll be providing that recounts I suppose I should have done this years ago, but uh I'll be recounting many of the lessons learned from this 30 plus year experience with CT heart scans and coronary calcium scores. Now, if these conversations interest you, you want to go further, I invite you to see my books where I talk a lot about these things, the Wheat Belly series of books, wheat belly revised and expanded, the undoceded book, issues more focused on the microbiome, super gut, and then issues relevant to body composition, my new super body book. Or if you want to talk with me and other people about these kinds of things, I have a membership website, the inner circle.drdavisinfinitealth.com. Dr. Davisinfinitealth.com where you talk about these things and you can even do such things as post some of your laboratory values like your lipoprotein a lot of us get uh what's called NMR lipoprotein analysis which deals a lot of data or maybe your microbiome analysis and you can share it with us for instance in our forum we have a very busy discussion forum and you can get feedback from other members from me from other people on my staff and we give you feedback so that you are not impaired prepared because the ignorance of the doctor or the doctor who continues to believe silly things like cholesterol is all you need to address for heart disease risk.