Being Proactive

[erijon]

About me, as I said I am 54 years old. I went through a series of heart tests back in 2005, 2006 & 2007 for what ended up being a gallbladder issue which has been resolved. When I first saw a cardiologist at an ER in 2005 for some chest pain I was experiencing, I weighed 348 pounds, had a BP of 140/85 and my cholesterol was slightly elevated at 219. I went through thallium stress tests and echos all three years, all normal.

I started lifestyle changes in 2005 and started exercising daily and managed my diet. As of today, I am 260 pounds so I have 70 more to go, but I have lost the weight slowly by exercising and watching what I put in my mouth. My BP has dropped to my current 90 day average of 111/67, to which my family doctor wants me to come off the ARB I take for hypertension. My resting heart rate has dropped from the mid 70's to the mid to upper 50's with very good tolerance for exercise. I cycle 12-15 miles per day (I have only missed 2 days since 1/1/2010) and I have peak runs up to 10-12 mets with a heart rate around 160 BPM at peak. My heart recovery rate is between 35 - 45 beats in the first minute from peak. Also, my cholesterol has been well controlled since my first round of testing in 2005 and has not exceeded 170 in total with an LDL between 58 and 80, currently 74 with normal HDL levels. My only bad number is my TGL's tend to run around 250 (down from 400).

Given this long winded introduction, a couple questions;

1. What else should I be doing to protect myself from developing CAD?

2. How concerning are the PVC's for my future?

3. Does my exercise tolerance indicate good cardiovascular health free of CAD?

4. Are my resting heart rate and heart rate recovery numbers OK?

Again, thanks for your time,

Jon

[jrbon]

What your cardiac problems are? Only hypertension?

1) Personally I will not stop the ARB medication, your BP of 111/67 it does not seem low to me but just perfect.... so why to alter it by changing the medication.

2) Because your RA, I guess that from time to time you will need some medicaments to alleviate pain and most of them increase BP. So ARB it is a sort of insurance for that.

3) Because your RA, I think your main concern should be, not cholesterol but inflammation, of course the hs-CRP test, will not be significant as diagnose in your case, but can be important to track it to see the trend. The same applies to IL-6, alfa tumoral factor and homocisteine.

4) Because we are speaking about immune problems and Vitamin D is a well known regulator of it, I would get it tested and try to get a very good level of it in serum.

Jesus

[ed34]

I'm not a Doctor but your post is interesting and I commend you for your lifestyle changes.
1. You are watching your cholesterol, your blood pressure, diet and exercising. You are hopefully not smoking and this just leaves one last thing to consider, stress. People who are prone to feel stressed are much more likely to contract heart disease. The laid back type of person who isn't much bothered by things is much less likely.
2. what pvc's?
3. Well it does show your heart is getting sufficient oxygen but it doesn't disprove CAD.
    For example you could have small lesions, or very good collateral development.      However, your heart is coping very well.
4. How long does it take your heart to drop to 90 or less? 5 mins or so?

You do know that latest research shows that losing weight is much quicker if you exercise one day, then take it easy the next? The body burns much more stored energy (fat) during the rest phase. As soon as you start exercising again, your body switches back to carbs. Fats are a much slower source of energy which is why they burn more efficiently at rest.
So exercising tue-thurs-sat and resting the other days would really accelerate weight loss.
Obviously watch the calorie intake during the rest days.