This is the best goddamned channel on YT. The wealth of medical insights found here, and free, no less, is unmatched.

I worked in a cath lab in the 1980s, 10 years, back when the exams were “analog”: minimally invasive, a catheter in the femoral artery, threaded up to the carotid or the coronaries, contrast media (“dye”) injected, x-ray film movies.  You could also see it real time on the fluoroscopy screen during the injection and filming.  Of course this was only done in symptomatic patients, and at the time, everyone who came to our lab either was at the time or had been a smoker, and. no one was negative (all had very significant plaque, which you would expect as they were symptomatic).  Femoral arteries usually pretty clean, but popliteal (behind the knee), no. And if you have any significant plaque in your legs you would have pain upon walking a block or less.  Unfortunately that’s pretty far advanced so it’s not reliable as to the start of or mild plaque formation.  That ABI at home test he shows is so inaccurate as to be meaningless.  Those blood pressure cuffs are not meant for your ankles so you will not get a meaningful number and in fact you need to read and follow the instructions that come with as using the left arm and the right arm have different protocol.  Mainly the tests we did were for people who were to get CABG surgery, or for cerebral, to identify carotid or vertebral blockages related to stroke or weakness etc.  The dr can listen for a bruit (.”brooey”, rushing sound) in the neck with a stethoscope which of course is not specific, but a very strong clue.  The procedure to clean that out is a carotid endarterectomy.  Your ophthalmologist can see the arteries in the back of your eyes and could in theory see how relatively clean or twisted with plaque they are, which is a good indication of one’s systemic situation, but they don’t make a habit of reporting, unfortunately. Since it is completely non-invasive.  If they told younger people that they could see the arteries were clean (as one told me once), people might take pains to keep them so and go for an annual eye exam to keep up with it.  But sadly, no.

Wish we had this info when I was younger

A Dr. on YT has been advocating for CIMTs for at least a decade.

I wish i had thought about stuff like this when I was 20....or 30....or 40...😂

One thing I found fascinating here is the idea that a “clean” heart doesn’t necessarily mean the disease process hasn’t started — it may simply be showing up somewhere else first. It really changes the way you think about atherosclerosis: less as a problem that suddenly appears in the heart, and more as a process developing quietly throughout the vascular system for years. Really interesting study.

Dr Greger from nutrition facts talked about this years ago. He said that silent artherosclerosis begins in your teen years. So this new study give us more details about the places were plaque builds up.

Amazing video!

GREAT podcast! Especially the ABI explanation.

Atherosclerosis is always been known to be a SYSTEMIC disease rather than a localized heart issue. This paper maybe makes a case for screening for PAD (either in carotid or femoral vessels) earlier

Interesting research showing that heart disease can be more complex than what routine imaging alone reveals, reinforcing the importance of looking at multiple risk factors together. ❤🔬

So much for the idea that plaque mostly develops in the cardiac arteries due to turbulence

Just  took my ABI.  It was 1.23.  Cool hack!🎉

So what do you do with the information if they find something?

They did this very thing in the Vietnam war.  An American surgeon was finding plaque in the bodies of deceased soldiers in their 20s, up to an average of 55% blockages (it might have been up to 58%).

Years ago, Dr. Greger was talking about how plaque is in young people, 10 years old, etc.

This matches why ED is one of the first symptoms of HD. I wonder where assumption that plaque only accumulates in the coronary artery came from in the first place. ApoB and stress are present across the entire body.
Nothing that the plant-based community didn't already know. Dr Greger has been talking about this for a long time. There have been several studies looking at autopsies of "healthy" young individuals that died from war and whatnot. Men in their twenties already had significant atherosclerotic plaque, and children can have signs of disease as early as 9 years old.

Great video, thank you!

In med school in 1976 I was taught that young Korean war vets undergoing autopsy nearly all had large vessel atherosclerosis. The subtle age progression you outlined is new data, but I was aware of the general concept for my whole medical career.

Another good one Gill. Great information. Thank you from Australia. 🙂

thanks for the video