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Joel Jamieson did everything right and was still walking around with a 50% blockage in his widowmaker artery. He’s a world-renowned cardiovascular expert who doesn't smoke, doesn't drink, sleeps well, manages stress, trains consistently, and has a VO2 max probably north of 55. He got screened at 40 and...

1,071,452 次观看 • 4 个月前 •via X (Twitter)

40 条评论

caleb 的头像
caleb4 个月前

I would not recommend that. Get a calcium score 1st (~$200) check your Alpha lipoprotein and cardiolipin A&B, look at your family history, and then get a CT angiocardiogram if any of those show risk. The risk of nephrotoxicity due to the contrast is real and the risk of radiation is real especially when young.

Brandon Ballinger 的头像
Brandon Ballinger4 个月前

I'd test these before a heart scan. They're cheaper, <$200, and show heart disease earlier:  - ApoB (more accurate than cholesterol)  - Lp(a) (strongest hereditary risk factor for heart disease)  - Inflammation (hs-CRP)  - eGFR (kidney health)  - A1c (metabolic health) Lots of great options including @EmpiricalHLTH.

Andy Galpin, PhD 的头像
Andy Galpin, PhD4 个月前

In Joel's case, this would have failed him. His full blood panel (including the markers you listed) looked great, and his first cardiologist told him there was no need for additional screening. He got the imaging done anyway, and it probably saved his life.

Brandon Ballinger 的头像
Brandon Ballinger4 个月前

In 99%* of cases, a heart attack is proceeded by a risk factor in a blood test. So most people are better served by getting the $200 blood test before they get the $1,000 CCTA. * actual stat from the medical literature, not just a figure of speech

Howard Luks MD 的头像
Howard Luks MD4 个月前

Well... tbh. If you have a significant family history, then that combined with ApoB, Lpa, hsCRP, Trigs, etc., should have led to far more aggressive lipid/lifestyle mgmt without the need for a CTA. If folks are on the fence about starting lipid-lowering meds/lifestyle changes, then perhaps CAC or CTA could help them... but those tests shouldn't be necessary for a cardiologist to initiate aggressive mgmt in his clinical scenario.

Andy Galpin, PhD 的头像
Andy Galpin, PhD4 个月前

Agreed, and I know Joel does as well. In Joel's specific case, he had worked with a cardiologist, who told him not to pursue any additional imaging or make any changes because his lifestyle was good. Had he not sought out a second opinion, things could have turned out very poorly.

Howard Luks MD 的头像
Howard Luks MD4 个月前

Agreed... it's terribly unfortunate that the only variables weighed to determine his risk profile were his lifestyle and physical activity.

Jesse Morse, M.D. 的头像
Jesse Morse, M.D.4 个月前

@AJA_Cortes What was his CAC? ApoB? LpA? HDL? HS CRP?

Dr. Eiman Jahangir 的头像
Dr. Eiman Jahangir4 个月前

The main issue is that a 50% blockage just means he needs aggressive guideline directed management of risk factors- blood pressure, lipids, diet and exercise…his family history , particularly with is brother, should have triggered that…

Jon Arnold 的头像
Jon Arnold4 个月前

At 54 I had a Ca score check even though my cardiologist said no. I got a devastating score of 927! An angiogram found 100% blockage of my Widowmaker. Endurance exercise saved my life due to extra arterial growth above the blockage. Exercise can protect from horrendous genetics.

DoctorTro 的头像
DoctorTro4 个月前

@grok is Andy a doctor and has he ever ordered a CCTA or interpreted a CCTA THANKS IN ADVANCE

Jonathan Watters 的头像
Jonathan Watters4 个月前

My father did not take good care of himself and made it to 87. My maternal gma made it to 96 not taking care of herself. My mom is fit as can be at 85 and does not take of herself. I take exquisite care. HypOtensive my whole life. No smoking. No drinking. I tried to raise my cholesterol because I was worried it was too low. Will I live forever?

Rakan I. Nazer راكان بن ابراهيم ناظر 的头像
Rakan I. Nazer راكان بن ابراهيم ناظر4 个月前

I wouldn’t recommend CT angiograms for all…this will open a pandora box of endless chaos. All those 40 and above, including very fit individuals, should get annual screening for hypertension, diabetes, and high LDL including a one time LPa measurement. Appropriate medical treatment should be started early and promptly. A healthy lifestyle is great but it wouldn’t make you immune to the no. 1 cause of death worldwide.

Thor Torrens 的头像
Thor Torrens4 个月前

Did everything right is subjective and your omitting many other factors and variables besides genetics Like certain foods or supplements he took to contribute to his disease

RWC 的头像
RWC4 个月前

What about a calcium CT for $100?

Senior Fitness Athlete 的头像
Senior Fitness Athlete4 个月前

This hits home - at 49 I was having issues - just not feeling right, Docs never got it right, eventually 1.5 year later - a cardiologist did the CT, damn the room said - 95%. Doc said I did everything right, was just my DNA. I am now better than 95% of my gen pop peers -vo2max.

exfatloss🥛 的头像
exfatloss🥛4 个月前

Probably ate a lot of seed oils?

Dan Mehmet 的头像
Dan Mehmet4 个月前

Joel Jamieson the MMA conditioning coach?

Andy Galpin, PhD 的头像
Andy Galpin, PhD4 个月前

Yes.

Dr. Robert Barrett 的头像
Dr. Robert Barrett4 个月前

Great post. Reminds me of Jim Fixx, who wrote The Complete Book of Running, and died at 52. Family history.

Andrew Talbot 的头像
Andrew Talbot4 个月前

Would you recommend a CAC test first to determine if atherosclerosis has started? Then, if yes, prioritize this test? Would one give insight into the other, given it's significantly cheaper?

𝕸y_n🂡me_Is_☡ 的头像
𝕸y_n🂡me_Is_☡4 个月前

39 just had a heart attack. Fit the bill you described to a tee. Had a 100% clogged artery, surgery and stent. One week ago

JPowell's Printer 的头像
JPowell's Printer4 个月前

"Did everything right" How much sunlight was he getting. How much blue light was he avoiding? I thought so.

CyberinTexas 的头像
CyberinTexas4 个月前

Is he COVID vaxxed? That seems to make a difference these days. It is an important data point.

Omar Saleem 的头像
Omar Saleem4 个月前

for south asians who have even higher earlier risk than the general population, early screening is vital. But important to differentiate what is the best route.

SLT Media 的头像
SLT Media4 个月前

Would love to know his take on diet and what he considered “heart healthy”

AftDel 的头像
AftDel4 个月前

Lpa is the culprit in most, not all, of these genetic family history stories.

Andy Galpin, PhD 的头像
Andy Galpin, PhD4 个月前

Certainly a very important thing to take a look at.

Tom Bibby 的头像
Tom Bibby4 个月前

💯 agree. Just got a Coronary Computed Tomography Angiography (CCTA) done to be safe. I'm assuming it's the same??

Tony Scott 🧄(🦆🐓🐵🧪🧬🪪)❌=↑🧄🧄🧄🥩🥚🧀↓👽👾🤖 的头像
Tony Scott 🧄(🦆🐓🐵🧪🧬🪪)❌=↑🧄🧄🧄🥩🥚🧀↓👽👾🤖4 个月前

He didn't do it right then.

Odie D 的头像
Odie D4 个月前

Let me guess. Avoids animal fats/protein, consumes heart healthy seed oils, refined grains, fibre and copious amounts of fruit and veggies.

Drgabrielpirjol 的头像
Drgabrielpirjol4 个月前

Please tell us his LDL burden for the last 20 years.

Leonardo Cashinci 的头像
Leonardo Cashinci4 个月前

Is there an instance where this blockage isn’t a big deal? In isolation may not be an issue. What if he was developing his own arterial cross collateralization? Is occlusion with aging more normal than we realize?

∞ 的头像
∞4 个月前

@clvyevolved “did everything right”

Michael Byrne 的头像
Michael Byrne4 个月前

“Half the arterial flow in my body is blocked; the trouble is I don’t know which half.” John Wanamaker (1838-1922)

Yalla Papi 的头像
Yalla Papi4 个月前

Noticed you didn’t say he eats healthy

Johanna 🇺🇸🇮🇱☦️ 的头像
Johanna 🇺🇸🇮🇱☦️4 个月前

@AJA_Cortes Also check Lp(a)

Andrew Morcheles, CSCS 的头像
Andrew Morcheles, CSCS4 个月前

Wild to assume that someone with a high VO2 max would just be healthy.

Jason Wachob 的头像
Jason Wachob4 个月前

💪🙏

Brilliant_minds 的头像
Brilliant_minds4 个月前

I thought of the huge difference any supplement could make would be life changing. Tomato loads of it! Astronomical levels probably wouldn't work. Thoughtful effects of Lycopeen ?

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