Tuesday, November 18, 2008


This is the first in series of thrice weekly explorations on health. This will allow you to sort out what you would like to know about maintaining your philosophy of strategic health and getting a value for the money well spent.

This is part of the concept of strategic health – finding disease or lacking health without any symptoms. This enables an attack on something that will be wrong if something isn’t done early. This is a new concept in health; avoiding disease.

What can you test; evaluate for the best value for health? One of our most important tests, the CVProfiler has no charge with the initial visit. But I’m very concerned when someone who comes in for a follow up visit feels that the abnormal test need not be rechecked. The treatment of the abnormality is simple, relatively inexpensive and should be done.

When I discovered I had the arteries of 80 year old when I was 37 yeas of age, I had no knowledge of the CVProfiler. When I rechecked my inside to see if the plaque had changed I used the same technology – the CT scan – to learn that I had completely reversed my atherosclerosis! This concept of Strategic health is really cool.

All testing in the office if you come in for the testing alone is reduced to $100 a test when you just come in for the tests alone. We still prefer that it be Wednesday afternoon if you can so we can balance the staff but when ever you can come is fine. Our Christmas giving program would include those prices as well. The Christmas giving is to acknowledge the gift of health for a consultation for health or any other testing can be arranged can be arranged by emailing office @ endocrinemetabolic.com. It’s your time.

Although these are times when all of us regularly think about scrimping on costs for your health, the waveform analysis of your blood pressure and vascular tree is not a good place to start.

We have 2 systems for this, the CVProfiler and the BPro. The latter is being sold so fast to other physicians and health practitioners that except for testing the units when they briefly come through the door I am not using the BPro right now. This is the “son of CVProfiler” so I will concentrate on the CVProfiler.

The concept of wave form analysis originated in the modern sense some time in the last Century for measurement of physical properties in natural sense. The Mayo Clinic worked with the concept in the 1950s and the device I use was developed at the U. of Minnesota in 1980.

Some time elapsed prior to clinical use since research was needed to gather data from 200 world wide centers focusing on what’s normal for those with cardiovascular disease, medications, diabetes, family history of cardiovascular disease, sex differentials, smoking and ethnicity.

The initial device cost was $800,000. The introduction of the personal computer to do calculations allowed a dramatic price decrease and introduction into many physician offices in 1998. This was also the year that Nobel Prize in medicine was given to the three physicians who demonstrated that l-arginine was capable of reversing atherosclerosis.

This is what the device measures with regard to blood pressure and what it means to you.
• The accuracy is unexcelled.
• The blood pressure is measured while lying down flat on your back (supine). We spend up to 8 hours asleep daily so if the blood pressure goes up while lying down, that is very abnormal. This is why most strokes occur in the morning just before awakening.
• Eventually we now follow the systolic (high number) blood pressure to lower, safer levels.
• The diastolic (low number) can be followed to lower target levels to assess competence of heart valves, particularly the aortic valve.
• The mean (think average) arterial blood pressure previously was only measured in the Intensive care units of hospitals or research labs. It gives a hint of other vascular problems such as pulmonary hypertension (high blood pressure in arteries of the lung).
• The pulse pressure is the difference between your systolic and diastolic blood pressures. May help predict heart disease risk.
• Pulse rate determines heart stress intrinsic to the heart and secondarily from other systemic diseases influencing the heart.

This is what the device measures with regard to flexibility of the blood vessels.
• C1 – Large Artery Elasticity Index tests the thickness of the arterial wall which in this case means the muscularis, the anatomic middle of arteries. This is the most important of the problems of arteriosclerosis which is hardening or inflexibility of the arteries, not atherosclerosis. These arteries are so small you need a microscope to see them.
• C – 2 – Small Artery Elasticity Index is even smaller and microscopic. These arteries are almost capillary in size, the smallest vessel in the body. This is the most important part of the artery system in the body because it is here that all diseases begin and all the therapy does too.

The total length of this “vascular tree” is 100,000 miles and the area is that of 7 tennis courts. The inner lining, or endothelium, is the biggest organ in the body and only one cell thick. When the endothelium goes down the whole body follows. The feeling of good health or feeling “really good” comes when you have turned your endothelium into that of teenager.

On the back of the report you can see how well you compare to those in your situation. In the past, we were so pleased to have patients become “normal” or in a state where “people like me” have the same testing values. Wrong.

John Cooke, MD Professor of Medicine and Director of the Program in Vascular Biology and Medicine at Stanford U. Medical Center, when I told him I was normal, asked me “does that mean you are just like all the other 71 year olds”. No,” I replied, “I’m 15 years old inside.” YES!

We have done well at avoiding vascular disease from any etiology. Recently we have uncovered the reasons several excellent academic institutions failed in their NHI funded studies. The answer lies in part in the treatments we use for sure but we learned how to use this noninvasive waveform technology to know how to change treatment. Additionally, our concentration now is anti aging. I’m so pleased at how well we doing in that field I will have to devote a full newsletter to that subject.

This is so import to health; we give the first CVP away with each first consultation. We check the value every 3 months because we know that 60% of people can quit all Rx for blood pressure at 3 months and stay just on the ProArgi9 plus. At 6 months 96% of the remainder can do that too. Here is some good science if you wish, and click on the last link for all 291 articles. It’s your time.

Grey, E.; Bratteli, C.; Glasser, S.P.; Alinder, C.; Finkelstein, S.M.; Lindgren, B.R.; and Cohn, J.N.
“Reduced Small Artery but not Large Artery Elasticity is an Independent Risk Marker for
Cardiovascular Events.” AMERICAN JOURNAL of HYPERTENSION 16:(No. 4), 265-269, 2003.

Syeda, B.; Gotsauner-Wolf, M.; Denk, S.; Pichler, P.; Khorsand, A.; Glogar, D. “Arterial Compliance: A
Diagnostic Marker for Atherosclerotic Plaque Burden?” AMERICAN JOURNAL of HYPERTENSION
16:356-362, 2003.

Cohn, J.N.; Hoke, L.; Whitwam, W.; Sommers, P.; Taylor, A.; Duprez, D.; Roessler, R.; Florea, N.
“Screening for Early Detection of Cardiovascular Disease in Asymptomatic Individuals.” AMERICAN
HEART JOURNAL 146(No.4), 679-685, 2003.

Duprez, D.A.; Somasundaram, P.E.; Sigurdsson, G.; Hoke, L.; Florea, N.; and Cohn, J.N. “Relationship
Between C-Reactive Protein and Arterial Stiffness in an Asymptomatic Population.” JOURNAL of
HUMAN HYPERTENSION 19: 515-519, May 2005.

Takeuchi, K.; Ideishi, M.; Tashiro, T.; Morishige, N.; Yamada, T.; Saku, K.; and Urata, H. “Higher Small
Arterial Elasticity in Hypertensive Patients Treated With Angiotensin II Receptor Blockers.”
HYPERTENSION RESEARCH 28 (No. 8): 639-644, August 2005.

Giles, T.D.; Berk, B.C.; Black, H.R.; Cohn, J.N.; Kostis, J.B.; Izzo, J.L.; Weber, M.A. “Expanding the
Definition and Classification of Hypertension.” THE JOURNAL of CLINICAL HYPERTENSION 7 (No.
9), September 2005.

Winer, N.; and Sowers, J.R. “Diabetes and Arterial Stiffening.” ADVANCES in CARDIOLOGY 44:245-
251, 2007.


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