Your cholesterol levels may be great . . . but that doesn’t mean there isn’t real danger brewing deep within your arteries. As shared in my last issue, conventional testing is not the end-all to detecting coronary heart events (i.e. heart attack/stroke).

Most of those who died from a heart attack or stroke didn’t even present symptoms or have blood-flow limitations. They may even have passed a stress test prior to the event or other heart testing.

What they should have done? Had a more inclusive test— the Carotid Intima-Media Thickness (CIMT) test with a high-resolution B-mode ultrasound.

This test not only measures the thickness of your carotid artery, but can actually reveal the true age and health of your arteries.

The CIMT uses sophisticated ultrasound technology, assessing the carotid artery’s first two layers—in the neck and groin (femoral). Both locations are sites of initial blood-flow-blocking plaque development.

With that, this life-saving ultrasound can reclassify patients at intermediate risk, identify prevalent coronary heart disease and predict major adverse heart disease events.

Having an abnormal intima-media thickness means soft plaque has taken up squatting rights and created endothelial malfunction. That thickness is determined by average values for your gender, age, smoker/ non-smoker, diabetic/nondiabetic, other risk factors.

Typically, your carotid intima-media thickness grows at a rate of 0.014 mm per year.

A faster rate indicates a more rapid build-up of soft plaque—and a true target for a cardiovascular event.

Proof is in the imaging. Research of 715 healthy subjects—ages 20-85—who had CIMT testing revealed this: 32.8% of the women and 40.5% of the men had plaque. Of those 65 years and older, 62% of the women and 70% of the men had plaque.

The alarming fact: 40% of them would have been missed without that CIMT (femoral) ultrasound.

Why CIMT imaging outranks other tests. Although there is a fast-computed tomography test (i.e. CT heart scan directly of coronary arteries) to measure coronary artery calcium (calcified plaque) and evaluate subclinical vascular disease, the CIMT ultrasound clearly is a far better diagnostic:

• No exposure to ionizing radiation (CT heart scan uses a sizable dose)
• Can identify the all-important soft plaque in addition to the calcified

• Helps determine actual arterial age
• Becomes a baseline measurement to classify risk in both women and younger men (both of which have a high tendency toward a zero calcium score)
• Forms a window into how well your medical approach (i.e. healthier living, weight loss, blood pressure control, cholesterol therapy, stress management, etc.) is reducing your heart attack/stroke risks

B- versus M-mode imaging. The “M-mode” may offer a better temporal resolution, but it delivers a “single point thickness.”

That is a concern since thickening of the carotid wall is anything but uniform and can cover a wide range.

Also doing perpendicular imaging is often an issue with M-mode as well as the level of precision with regards to the pixel size. Just 1 digital pix—an extremely small difference—can classify a patient in a different risk category.

The technique. The test is noninvasive, done as an outpatient procedure and lasts only 15 to 20 minutes.

• Using a software program, a sonographer measures your IMT mean and maximum with precision.
• Also measured is any soft plaque buildup in diseased vessel segments that may not be readily apparent.
• An expert must interpret those measurements.
•  Those interpreted values will determine a course of customized, preventive therapy and help your physician track the progress of that therapy going forward.

Are you a candidate?

• Men in their 40s and beyond
• Women in their 40s-50s
• Any man with erectile dysfunction
• Anyone with a family history of premature coronary heart disease (i.e. early age of 50 or 60), especially heart attacks, strokes or bypass surgery
• Anyone younger than 60 with severe abnormalities in a single risk factor
• Women younger than 60 with at least two coronary heart disease risk factors
• Anyone with rheumatoid arthritis, psoriasis, inflammatory or autoimmune diseases
• Anyone with elevated homocysteine levels
• Anyone with a history of cigarette smoking
• Anyone with high LDL/low HDL levels, high triglyceride levels, high blood pressure, diabetes, etc.
• Anyone who is overweight
• Anyone with metabolic syndrome
• Everyone wanting to learn the true health and age of their arteries

Much of your heart health can be steered with the right medical approach. But that starts with the right testing. Call my office today to learn more about CIMT imaging, cardiac blood tests and healthier aging therapy.