Plaque is the stuff of coronary heart disease. It is CONTROLLABLE, it is STOPPABLE, it is REVERSIBLE.
But you must be equipped with the right information on diet, nutritional supplements, and hopefully the avoidance of medication.
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I hope I’m not getting my hopes up prematurely, but I believe that I’ve seen it once again: Dramatic reversal of aortic valve disease.
This 64-year old man came to me because of a heart scan score of 212. Jack proved to have small LDL, lipoprotein(a), and pre-diabetes. But there was a wrench in the works: Because of a new murmur, we obtain an echocardiogram that revealed a mildly stiff (“stenotic”) aortic valve, one of the heart valves within the heart that can develop abnormal stiffness with time.
You can think of aortic valve disease as something like arthritis–a phenomenon of “wear and tear” that progresses over time, but doesn’t just go away. In fact, the usual history is that, once detected, we expect it to get worse over the next few years. The stiff aortic valve eventually causes symptoms like chest pains, breathlessness, lightheadedness, and in very severe cases, passing out. For this reason, when symptoms appear, most cardiologists recommend surgical aortic valve replacement with a mechanical or a bio-prosthetic (“pig”) valve.
Now, Jack’s first aortic valve area (the parameter we follow by echocardiogram representing the effective area of the valve opening when viewed end on) was 1.6 cm2. A year later: 1.4 cm2. One year later again: 1.1 cm2.
In other words, progressive deterioration and a shrinking valve area. Most people begin to develop symptoms when they drop below 1.0 cm2.
Resigned to a new valve sometime in the next year or two, Jack underwent yet another echocardiogram: Valve area 1.8 cm2.
Is this for real? I had Jack come into the office. Lo and behold, to my shock and amazement, the prominent heart murmur he had all along was now barely audible.
I’m quite excited. However, it remains too early to get carried away. I’ve now seen this in a handful of people, all with aortic valve disease.
Aortic valve stenosis is generally regarded as a progressive disease that must eventually be corrected with surgery–period. The only other strategy that has proven to be of any benefit is Crestor 40 mg per day, an intolerable dose in my experience.
If the vitamin D effect on aortic valve disease proves consistent in future, even in a percentage of people, then hallelujah! We will be tracking this experience in future.
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Hi Dr. Davis (apologies for the previous mistake),
I wanted to point out that I enjoy your Blog and I share your interest in a nutritional basis for the prevention of cardiovascular disease. However, you allude in your various blogs to several of the unanswered issues behind our understanding of a highly complex topic. Salt reduction, resveratrol, caloric restriction and the enormous array of vitamins provide clear benefits for some people and yet seem to have almost no effect (or, when combined carelessly, even a detrimental effect) on others.
Based on your last response, I have a final comment on this "more on aortic valve disease and vitamin D" post on your 'blog – not advice'. Then you can choose to be incensed by it, or take it as it is meant – a comment from a concerned cardiovascular research scientist who would dearly like to see these alternative approaches brought into the mainstream.
Whether you accept responsibility for it or not, it is clear that some people read your postings and act on your "musings". You are, after all, a cardiologist and seen as an expert in medical matters. Further, you and I both know that the vast majority of people neither have access to nor the potential to understand the scientific literature, so the internet has become a frequently dangerous tool by which millions get their information and advice.
In this thread alone, there are people asking for (and receiving) specific advice on the type of vitamin D to acquire (gel caps) and the purported optimum dosage (anywhere from 4000-8000 units per day). Further, while you don't actually tell him to, William Ball was clearly following what he perceives as 'Doctor's advice' when he "decided to try Dr. Davis's idea".
His subsequent decline was then 'diagnosed' by you as likely being a "natural progression", even though he states that his vitamin D levels were "normal". This was apparently after taking 10,000 IU per day? Perhaps Mr. Ball would have been interested to know that 10,000 IU is the figure proposed by Hathcock et al., in 2007 as being the upper tolerance limit for humans [Am. J. Clin. Nutr. 85 (1): 6–18] – and should perhaps raise alarm bells.
There were several opportunities for you to make more clear that this is just "a blog" and should not be used as an alternative for sound medical advice. There is a lot still unknown about this topic and while "not your problem" (and to use your words) there are plenty of people "stupid enough to make more of" your post that you might wish.
I have several friends for whom I have great concerns because they follow potentially dangerous alternative health approaches based on the "knowledge" they glean from the internet. One friend takes potentially toxic doses of the cyanide compound 'vitamin' B17 to prevent cancer. I have family members who have not vaccinated their children because they KNOW vaccines cause autism. Another refuses to use toothpaste and spends a fortune on bottled water because fluoride will reduce his IQ and give him cancer.
Big Pharma is now seen almost universally as demonic and conspiracy theories abound. According to such theories, without the influence of doctors, scientists and pharmaceutical companies, we would already be living in a world without cancer and cardiovascular disease – but we are hiding the answers for the sake of profit. While you clearly hold some cynical views about the profitability of the 'conventional treatment' of heart disease, most doctors are doing the best they can under hugely difficult circumstances (and in the face of patients refusing to change bad behavior). We can only hope that the future is brighter as a result of the research being conducted on the alternative preventive measures to which you subscribe.
In the meantime, as a doctor, you should perhaps be more aware of your influence and how blindly some people will follow your advice, whether you think you have given it or otherwise.
Aortic valve stenosis is generally regarded as a progressive disease that must eventually be corrected with surgery–period. The only other strategy that has proven to be of any benefit is Crestor 40 mg per day, an intolerable dose in my experience.