It is time for Americans and their physicians to learn that there is more to do to prevent heart attacks and strokes.
Everyone must learn the difference between LDL-C and LDL-P and non-HDL cholesterol (The Tubby Factor).
Everyone must learn what a calcium score and a carotid intima thickness ultrasound does to detect subclinical atherosclerosis.
My book, The Tubby Theory from Topeka teaches the above and demonstrates how I used the above tests to prevent heart disease and stroke and to also regress plaque in the arteries in my medical practice in Topeka for the last two years.
My goal is to change the Paradigm of preventive medicine in America. The new paradigm is to find subclinical atherosclerosis early with a calcium score and a CIMT to then treat it to stabilize the vulnerable plaque from inflammation and rupture.
Rupture of the plaque causes sudden death.
In 1 of 3 patients, SUDDEN DEATH is the first sign of heart disease.
Reference: Lipoprotein Management in Patients with Cardiometabolic Risk, Brunzell et al, JACC. 2008; 51: 1513
Tim Russert died one year ago of sudden death. The media reported nothing more could have been done for him. Non-HDL cholesterol goal of < 100 was not met. This was never reported. It was reported that his LDL-C was to goal 68 and his nuclear stress test was normal one month before his death.
It has been more than a year since Mr. Russert died. I hope my new term that I coined, The Tubby Factor, will bring attention to the above facts.
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Most Helpful Customer Reviews
Horrible book. Dont waste your time. Not enough scientific back up. Its a waste of time and money.
In my practice I gave up starting high dose or moderate dose statin in the statin naive patient. I have received too many referrals to see patients who are convinced that they can't take statins because of muscle pain with starting high dose statin. I usually give samples of crestor 5 mg a day or every other day. In six weeks I check their LDL-P or their non-HDL cholesterol depending on their insurance. As Dr. D has demonstrated in his case studies and I have found in my practice, individual patients respond very differently to statins and the first dose often has an amazing effect. In six weeks the patient is not at goal. What next? In practice I have found that Niacin is the second drug of choice. Why? 1- Arbiter 6, 3 and 2 CIMT studies 2- Coronary Drug Project - decreased Total Mortality by 11% after 15 years. 3-Clas I and Clas II Angio studies 4- FATS First major study to document regression with Angios 5- HATS SUSTAINED RELEASE NIACIN 1,000 MG BID USED IN THIS STUDY- CIMT study 6-Compell study - only 1,000 mg of niacin needed with crestor. 7-FDA indication for regression of plaque in combination with clofibrate 8-Stockholm Ischemic Trial- Positive primary and secondary trial with clofibrate ADA/ACC Consensus statement April 2008 p818 "The preferred agent to use in combination with a statin is nicotinic acid because there is somewhat better evidence for reduction in CVD event with niacin, as monotherapy or in combination, than there is for fibrates." I was extolling the virtues of niacin with statin to a cardiologist when he told me it made him nauseous to hear it because he could never get his patients to ever stay on niaspan because of side effects. I told him I had the same experience until I began using OTC sustained release niacin. I only use 500 mg bid with a low dose statin to avoid side-effects. With a total nicotinic acid of 1,000 mg the patient gets the best bang for the buck with HDL-C. At this dose elevated HgbA1C rarely occurs even in diabetic patients. Liver enzyme elevation is quite rare. The Compell trial showed Crestor 40 mg lowered ApoB by 39%, while Crestor 20/Niacin ER 1,000 lowered ApoB by 42%. The Seacoast trial also shows a better benefit adding niacin than doubling the statin. I have given hundreds of patients Endur-acin 500 mg BID with meals. Less than five patients stopped this drug due to flush. No one was taken off because of LFT's or elevated Hgb AIC. Slo-niacin is another option to Endur-acin but I have had better luck with Endur-acin in terms of the flushing. Why take Niaspan when Endur-acin costs only $70 for !,000 tablets when purchased over the internet. I never have needed to switch to Niaspan to use high dose nicotinic acid because I will use zetia as a third drug rather than risk flushing with high dose Niaspan. Patients often come back to tell me they can't afford the crestor. I put them on simvastatin 10 to 40 mg for only $10 for 3 months therapy. Thus many of my patients have done very well on simvastatin/endur-acin for $90 a year. This is documented in spreadsheets in my book: The Tubby Theory from Topeka.