Thursday, September 15, 2016

Trump's release of medical records is a great teaching lesson

Donald Trump did a great service by releasing his medical records.

Here is what a billionaire gets for his health care.

CAC calcium score.  98.
 "Not bad" Dr. Oz says.
Zero would be better.
98 means he has plaque which can rupture and cause death.
Tim Russert had a CAC score of 200 and a normal nuclear stress test one month before his sudden death episode.

LDLc is 94 which I believe Dr. Oz said was good.
Tim Russert had a LDLc of 68 just before he died.

We need to teach patients and Doctors that LDLc is a poor predictor of risk in comparison to non-HDL cholesterol and LDLp or apoB.

There is often discordance between the LDLc and the LDLp or non-HDLc.
Tim Russert had it and apparently it was not noticed?
Dr. Oz unfortunately did not talk about non-HDL cholesterol.
It would have been easy.
169 (TC) minus 63 (HDLc) equals 103.

I think Mr Trump's Non-HDLc should be less than 80 and I would advise more medication to lower it.

However, before I did that I would get a Liposcience lipoprofile to determine his LDLp.  It may not be covered by insurance and cost him $100 but he is a billionaire and it may save his life as it may have saved Tim Russet's life.

Mr Trump's MESA risk calculation is 7% for a CHD event over 10 years.  It is only 6.4 % without using the calcium score.  To my surprise this is much lower than the co-hort calculator below?

2 comments:

  1. Zero could also mean he could have non-calcified plaque which could rupture. Only 20% of men his age have 0. I'd be more worried by his metabolic syndrome build. But my dad had that all his adult life and lived to 96. I've a theory why heavier people appear to live longer, Brian. It's preserved muscle mass from lugging themselves around.. What do you think of that?

    ReplyDelete
  2. Sorry I missed your comment. Some people smoke till 90's also. We just don't known why.

    ReplyDelete

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