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Steven Lamm, M.D., has reported extensively on a variety of medical issues on television and radio. A great communicator, Dr. Lamm has been the long-time medical correspondent for The View (ABC-TV) because of his ability to talk to women about their important health issues, and the health issues of the men they love. As a practicing Manhattan internist for over twenty-five years, Dr. Lamm has provided medical care and compassion to thousands of patients. Dr. Lamm has published four books that have explored the intersection of medicine, science, and health. |
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I’ve performed hundreds of EndoPAT tests in my practice over the course of the past few years, and I have come to view it as one of the most powerful diagnostic tools a doctor has in his arsenal today. You will see the role that EndoPAT played with my patient, Harvey. His situation best sums up the importance of the EndoPAT test and how it can be equally helpful to both doctor and patient alike. Having patients be compliant and take their medicine is a huge problem today. Studies show that for long-term drug therapy, the adherence rate drops off with time. It’s one thing for a person who is feeling miserable to remember to take a medicine that will relieve the pain, and quite another for someone who is feeling generally well to stick with a medication that is intended to prevent the future consequences of a chronic condition. |
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Statin therapy is the perfect example. Many scientific studies have demonstrated the benefits of statin drugs for preventing heart disease and extending the lives of people who already have heart problems. You get the most benefit from statins if you take them consistently for years. Even so, compliance studies have shown that, regardless of what the researchers say, people stop taking their cholesterol-lowering drugs as time goes by. For example, in a study of older patients in Ontario, Canada, only 40% of the people prescribed statins after a heart attack were still filling their prescriptions after two years. The track record was even worse for people taking statins to prevent heart disease: After two years, some 75% had stopped filling their prescriptions. |
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Harvey is my patient, and although he is not from Canada, he fits the profile of one of the Canadians in the study who was non-compliant with his medication regimen—and it almost cost him his life. Harvey is 68, slightly overweight, and the only exercise he performs is when he has to run to catch the downtown bus. I worried about this, just as I worried about his poor eating habits. Fast food was a noon-time staple at work, and meals at home (he is a bachelor) were generally ordered in from local restaurants. It was Harvey’s lifestyle that played a major role in his poor cardiovascular health. His cholesterol was high: 288 mg/dl, with an HDL of 39. At his previous visit with me, I had prescribed 10 mg of Crestor, a powerful statin medication, to be taken daily. I had also outlined a detailed nutrition and exercise program for him that would improve his health and help lower his cholesterol. Six months later, when Harvey came back to see me, I was not happy with his lab results, and I told him so. His cholesterol had gone up, not down, and his blood pressure was now an issue as well. “I started taking the statin,” Harvey said, “but then I sort of forgot about them after a while.” |
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Harvey had to turn his health around, I told him. Although his body was doing its best to fight off the inflammation caused by his poor eating habits and lack of exercise, it was starting to lose. His endothelium, the lining of his arteries, was being bombarded by free radicals, and plaque was building up in his arteries. Even though he felt fine, he wasn’t. The absence of illness does not mean that you are well, I told him. I explained how the EndoPAT test would give him a real picture of the current health of his arteries and he was intrigued. Twenty minutes later, he got his results. |
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His EndoScore was 1.58, which I told him was low. He was in the danger zone. It was his choice now. Take his medication and make changes in what he ate and how much he exercised, and his EndoScore would start to go up. Continue on the path he was now on, and he was only inviting trouble. Harvey agreed to take his medicine and come to see me in four months. He almost didn’t make the appointment. |
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Sitting in synagogue one Saturday morning, Harvey felt a crushing pain in his chest and then he started sweating profusely. He got up, took one step forward, and suddenly he was on the marble floor, staring up into a circle of faces. That’s all he remembered. As luck would have it, there was a cardiologist at the service and he quickly ran over to Harvey, who was not breathing; his heart had stopped. The doctor revived Harvey, got his heart going. Not once, but twice. Two weeks later, recovering from a major heart attack and after having three stents placed in his coronary artery, Harvey was sitting in my office. “I finally got religion, Doctor,” he told me. “You warned me about bad things to come. The EndoPAT predicted it. And now I’m finally a believer.” |
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