Understanding Plaque and how to reverse it

you've heard about soft plaque and calcified plaque and hard plaque [Music] so this early stage is soft plaque and if you notice in that last segment the discoloration underneath is meant to show inflammation so there's inflammation in that soft plaque and it absolutely is possible a minimal plaque lesion to rupture because soft plaque is absolutely the most dangerous the most prone to plaque rupture as healing occurs so i said inflammation is the first stage towards healing part of healing is depositing calcium and the little white that flex in here are calcium and so you're transitioning even though the disease is progressing different segments are transitioning into calcified plaque which and they may have had plaque rupture events in the past but never big enough to cause the heart attack but certainly big enough to start damaging the downstream tiny blood vessels and so this progression from left to right is from soft partially calcified or heterogenous plaque and then if you make it through to healing without any intervention it is known that plaques can stabilize at this level not rupture become fully calcified and that's what shows up on most coronary calcium scoring arteries that have had this process so long and yes the inflammation in that segment has finally led to some healing but at what risk because i promise you those segments were having micro erosions small clots throughout the life of that plaque so david really good point we've done a couple of videos that deal with this issue was a review of a study the honda study where they actually compared people that had calcified plaque versus people that had soft plaque and a relatively small study but it was what a couple of years 100 in the soft black group 104 in the calcified black group and you had three or four events in the calcified group all of them happening very early so that was when the calcification was still getting locked in none later on and what was it ten times that amount of events and continued to happen over and over again in the soft black population the other thing i wanted to talk about is that by far my most popular video is my description of my own decrease in plaque from a 70 what 73 year old artery to 57 year old arteries and people still say that they watch it and they say hey doc i want to reverse my plaque you did it so let me do that it's uncommon to see that number one and number two it's not just me and david and a few other folks talking about that i've seen it in harvard health section from harvard health with meant for the public and what they talked about is it's uncommon but it's not impossible it's not rare and there are two places where we tend to see it people that have not been taking statins before they start taking statins so that brings up an issue about statins and inflammation which we've covered a couple of times over the past few weeks but most commonly you see it where people have lost a significant amount of weight they first started seeing that in prisoners of war who had been put on starvation diets lost 20 or 30 pounds they also saw that they had major decreases in plaque so i'm seeing that routinely over half of my new patients from the channel will come in have very solid plaque and then we start talking and it's like yeah i went through an episode where i had too much weight i've lost 30 pounds 50 pounds 150 pounds the last comment i wanted to make is the mechanism so if you consider this red stuff as a liquid including those immune cells that david's been talking about and you see in the pictures on our course on this if you'll go back david if you consider this red stuff as the inflammation part and the yellowish stuff is a little bit more like the ldl itself the small dense ldl you can see if you start removing this red stuff you're going to get a significant decrease in this space between the media layer in the intimate layer so a cimt will pick that up as a quote decrease in our arterial age or quote reversal of plot so one thing that people need to remember and think about is quite often reversal of plaque is not quite so much just removal of ldl as it is just decreasing all of that fluid that's packed between those segments of ldl and all of that are evidence of stabilization of plaque correct when we decrease inflammation we actually stabilize the plaque allow healing to finish and decrease events so one question that i'd like to address is in terms of symptoms of soft plaque well guess what they're the same as hard plaque usually none there are usually no symptoms until plaque rupture occurs and so in soft plaque you're going to pass stress tests most of the time 99 of the time carotid ultrasounds that are not looking at the arterial wall will tell you that you're okay so soft plaque is silent and deadly a hard plaque that more often will have symptoms but it's just as deadly so if you acknowledge the point as almost all doctors do now that heart attacks are caused by disruption of a plaque then go back and think about the symptoms what are the symptoms that tell people they're getting ready to have a heart attack there are none this slide is really just a recapitulation that you have to have both plaque and inflammation to have this very ugly event called plaque rupture and you can see clot in the wall of the artery you can see clot in the channel of the artery and this person actually died from their heart attack and at the time of autopsy that entire channel was full of that clot and you can easily see how that clot is friable and easily breaks notice in the upper left-hand part of this picture in that arterial walls another rust-colored thing well guess what that was plaque rupture years ago that probably was silent and yet the injury to this person's arterial system continued so they started building new plaque on top of that and you'll see these concentric layers of deposition and plaque growth and plaque is very dynamic it's always doing something it's either getting more dangerous or less dangerous and unless you're doing something about it it's getting more dangerous this is a critical piece of information and i'm sure if you've watched this channel you've seen something similar and this is why we do see imts and just briefly they looked at 10 000 people that had no symptoms had normal blood pressure normal blood sugar normal cholesterol and they took a cimt of their carotid artery and their femoral artery and they took a one-time picture and then followed these people for a decade this study started in the late 80s finished up in the late 90s long before we had many of the therapies that are in vogue now and so there was no there was no treatment possible in these folks so it was an observational study and they found out that if you had blockage meaning at least a 70 narrowing in one of those two arteries and you just watched it over the next decade 80 percent of those people were hospitalized or died because of arterial disease if you had any plaque in any artery and didn't do anything about it over a decade 40 of those people were hospitalized or died from an arterial event and then lastly and very importantly if it was just thickening if it was in the early stages of aging and you didn't do anything about it but doc i don't have any plaque what do you mean i need to be on a prevention program you just said my artery was getting thicker no it's the early stages of disease if we don't do something one out of 11 of those people are going to be hospitalized or dead over the next decade my colleagues focused on the far right hand picture the 80 i mean those people were at high risk so justifiably they said let's figure out how to open up or fix or bypass somehow prevent that death from happening but what got ignored is the other two channels of this where plaques present or in the earliest stages and it was ignored we're not ignoring it anymore don't you ignore it anymore don't let your doctor say you only have a little bit of plaque if you've had a bypass surgery don't let them tell you we fixed the problem plaque is deadly it's the cause of this pandemic and it's preventable it's curable we can fix this so why is this not easily done in a seven or eight minute visit well on the left of the screen here are all the sorts of things that impact the arterial health the lining of the artery these are the sources of injury and on the right are all the sorts of things that ford and craig and i look for in terms of what's going on what's the damage doing to my patient and here's how they're related it is a spider web of interrelational things think back to one of the first slides i showed you that said that our nutrition our diet is the number one cause of death that's why i put nutrition at the top of this and movement second but if i only address your nutrition if i only remove those threads from this web i haven't fixed the problem there has to be a solution for each of these areas so some of the folks have said i don't want to be on a statin what can i do well you need to do all of these things but there are definitely times where a statin drug is an appropriate decision people that don't have high cholesterol sometimes need a statin drug and it's not because of their cholesterol it's because of their inflammation [Music] you

Channel: Dr. Ford Brewer

Views: 129,557

Keywords: prevmedheartrisk, ford brewer prevmed, drfordbrewer, prevmed, how to prevent stroke and heart attack, preventive medicine, yt:cc=on, Understanding Plaque and how to reverse it, heart disease prevention, heart disease treatment, coronary artery disease, heart disease symptoms, arterial plaque buildup, arterial plaque reversal, arterial plaque reduction, how to reverse arterial plaque, how to reduce arterial plaque naturally, dissolve plaque in arteries, calcified plaque

Id: poEZ8zTtUH8

Length: 10min 27sec (627 seconds)

Published: Fri Jun 10 2022