February is heart month, a time to think about the health of your and your loved ones’ arteries. If arteries get stressed by bad genes; bad habits (such as sedentary lifestyle, unhealthy diet, or smoking); or conditions such as obesity, hypertension, high cholesterol, diabetes, sleep apnea or inflammation, the endothelium that lines arteries thickens—an early sign of hardening of the arteries. Eventually plaque develops, and plaque rupture is the cause of heart attack and strokes.

Carotid IMT is an ultrasound test that measures endothelial thickness. It also picks up plaque, both calcified and uncalcified (“soft”). This FDA-approved imaging is offered at a discounted rate during February by Compass Peak Imaging in Glenwood, with no referral required.

Following are three stories from last February’s IMT screening–that patients agreed to share with readers–that demonstrate the value of IMT to assess arterial health.

Patient No. 1 was a man from Grand Junction who called after receiving his IMT report that showed substantial endothelial thickening. He was 59 years old but his endothelium was as thick as a typical 75-year-old American man. Even more alarming was that he had soft plaque on both sides—the type of plaque that’s most unstable and therefore most likely to rupture and cause a heart attack or stroke. He had central obesity (excess fat around his middle), indicative of prediabetes or diabetes. He had untreated high blood pressure and elevated cholesterol. Furthermore, he had a family history of early heart disease, including a brother who died in his late 30s from a heart attack.

This man had been in denial about his high risk for a heart attack and stroke, and the IMT result was a wakeup call. He didn’t have a PCP (primary care provider) but agreed to make an appointment to see one on an urgent basis. Hopefully he received counseling about lifestyle changes, and was given medication to get his cholesterol and blood pressure to goal. Due to his body habitus, he was advised to get screened for sleep apnea. He agreed to watch the documentary Forks Over Knives and read Dr. Esselstyn’s book “Prevent and Reverse Heart Disease,” and Dr. Michael Greger’s book “How Not to Die.”

Patient No. 2 was a 70 year-old woman with a family history of heart disease. She had high cholesterol but had muscle aching from statins in the past and quit taking them. She had a history of smoking when younger, normal blood pressure. In 2019, when she was 65, she had an IMT with mild endothelial thickening indicating vascular age of 70—plus a plaque burden of 8.4. Last year’s study showed increased endothelial thickening with a vascular age of 78. So, based on endothelial thickening her arteries were aging faster than her chronologic age. Furthermore, her plaque burden last year increased to 13.2, including a new area of dangerous soft plaque.

 She was advised about the importance of stabilizing her worsening atherosclerosis and hopefully reversing it. She agreed to see her PCP and to try a low dose of a statin every other day. She was also told about statin alternatives. Furthermore, she was given information about the one diet that has been shown to reverse heart diseases:  plant-based, unprocessed food with no salt, sugar, or added oil.

Patient No. 3 was an 81-year-old man from Aspen, who after reading Post Independent health columns about carotid IMT screening scheduled one at Compass. In addition to extensive endothelial thickening, his study showed marked atherosclerotic plaque in both the left and right carotid arteries, with obstruction to blood flow on the left–which when over 70 percent sometimes requires surgery. He was advised he needed aggressive medical detective work to determine where the inflammation was coming from that led to such extensive atherosclerosis, and agreed to see his PCP.

All three of these patients should have their IMT repeated this February to assess effectiveness of treatment. With appropriate treatment (diet, exercise, medications) endothelium should thin, soft plaque resolve or become calcified (stable), and calcified plaque burden should remain stable or lessen.

Bottom line:  Be proactive about your health and schedule the discounted carotid IMT screening this month (heart month).

Dr. Greg Feinsinger is a retired family physician who started the non-profit Center For Prevention and Treatment of Disease Through Nutrition. For questions or to schedule a free consultation about nutrition or heart attack prevention contact him at gfeinsinger@comcast.net or 970-379-5718.