Stents, Bypasses or pills? How do i decide?

[@MarilynMayaMendoza]

Dear Dr. Gupta, you have helped me immensely throughout the years. I am 74 with stable peripheral artery disease. Thankfully, it was discovered by a nurse. After taking a small dose of statin every day, and because of you not getting overly anxious about my blood pressure, I am much more confident about my future. I also changed my diet to a Mediterranean one and even with severe arthritis, I exercise as much as I can. I recently found through a test that I have a genetic disposition to heart disease.Apa. But the cardiologist said the number wasn’t awfully high. In fact, the vascular surgeon said I don’t have to go back to see him. I suffer from an anxiety disorder and watching your videos and your calm demeanor really help me. You are doing a great service and I wish you the same peace you give your audience. Aloha from Hawaii.

[@mikenelson8351]

Once more, an intelligent and clear presentation. "Knowledge brings understanding". Thanks, and appreciated.

[@ivortreaise]

i have narrowing arteries and have been put on tablets ,your talk has reasured me a lot thanks

[@akumar7366]

Iam 60 with mild Angina , thank you Sir I found your advice reassuring. Iam on aspirin, statin and slow release nitarate tablet, last 10 months, things have improved. Your topic was the exact thing I was thinking about. Well done amazing Vlog.

[@richardwall2330]

Yes sounds very much like how my treatment is .I carry a GTM spray but never need it !

[@elizabethdumas4147]

I'm glad the decision was made for me. I'm two years post STEMI and stenting for 99% occluded LAD. Having that pain go away immediately was such a relief.

[@donaldcoder4510]

I went through this scenario and I received 4 stents in two days. I believe this was the proper treatment in my case. This was 6 years ago and I have not regretted that decision. Thank you for your videos. I always enjoy them.

[@frankpercy5419]

Been there and took advice to take route of tablets. Your message is brilliant and worth passing on as usual. Good Health to you, Doctor.

[@healerneeru6423]

Good to see your video, I wait for it..

[@juliegotshaw]

Very good advice. Thank you Dr.

[@GnanadesikanK]

Excellent and comprehensive explanation with clarity and great empathy

[@IanLad-r6v]

unstable angina led me to having a mild heart attack. got two stents and a balloon six weeks ago and doing ok so far..thank you for your video doctor and god bless.

[@mballer]

Treat with a diet change. Stents and bypasses will just clog again without change.

[@jna9888]

So I have heard from Dr Brewer. Nice to know since getting 6 stents 2 years ago. I had absolutely no symptoms, even after a sweaty day working in Florida. I did eat way too many Brazil nuts with too little water that day, and while waiting in the ER, I felt the uncomfortableness move right on down, but the staff insisted on checking me in, full stress test with no pain or out of breath, scan showed clogging, including LAD. Why didn't they try meds first? Well, now I have stents. Only med I take is baby aspirin. I quit all their meds. Two months of rosuvastatin almost ruined my left calf muscle. Two years now, following 95% carnivore, no smoking no alcohol, almost zero carbs, no starches, no sugars, no fruits just some blueberries. 80 years old, 5'7", 138#. Sorry, TMI!!

[@RC-tm8jo]

​@jna9888 if you can eat Brazil nuts, you can eat anything. I remember my one and only time trying a Brazil nut, and to this day, I have never eaten a single food in my life that tasted anywhere near as horrible as a Brazil nut. I like other nuts like pistachios, pecans, walnuts, etc., but Brazil nuts are the most awful tasting food I've ever tried 😂.

[@williamh5103]

Fascinating, I am 76 bmi 23, weight 140, 5’4” T2 diabetic, had pains in my chest, tropononin levels elevated but not a full blown heart attack. No consideration of alternatives such as medication first and see if that works. Would the pill approach have worked, do not know but would have willingly tried. I had the joy of watching the stents being placed all seven of them on this huge screen. This is Ireland, god knows how this works financially but I do not trust them. They are doing these stents on an industrial scale. It reminds me of the Monty Python Meaning of life with the skit of the machine that goes ping! No follow up that is over a year ago, sent home, my wife said I looked like a corpse! I am alive, I have gone strict keto , don’t drink, don’t smoke, never have, but with no advice from them. I am still cross and disgusted how those doctors/ the system behaved.

[@riverpud]

interesting comment,because of a failed stress test was due to go for angiogram but slow to do so refused as its invasive and might be quick to stent etc.Opted instead at the min to do ct angiogram and see what happens if anything shows fair enough ill prob have to have regular angiogram and take it from there i,m 59

[@keithharrison1453]

Possibly a viable alternative strategy may have been to check Insulin Resistance, to see if there are inflammatory issues driving the blockages that would benefit from a better diet. Such as cutting out all sugar and seed oils, plus reducing carbohydrates down to the absolute minimum, preferably to zero. Start with fatty red meat and lamb, salt and water, and work up from there. Certainly works for me.

[@Mariagianni2918]

Thank you so much Dr. 🙏🏻

[@MariaVasquez-hr6kk]

Thank you for this information.

[@christianmollo3239]

Best Heart Doctor ever ! Love these videos and now at 60 yrs old my Job finally gave me good health insurance 🥳 I live in Long Island but I’d love to visit for a consult/ check up. I’m heavy 260lbs 5’10 but I feel great… no diabetes no history of heart problems and I only have high Blood pressure when I go to the doctor 😀 Go figure ? 134/72 at home 155/98 at the doctor’s office. Believe it or not I also run 2 miles a day 4 or 5 days a week. But I’m dieting and would like to run the 1/2 LI marathon this May, I did it in 2012 at 190lbs. Anyway thank you doctor ! This channel is an absolute blessing

[@Vacaiable]

A 50 year old man needs a study that spans 30 years plus. I would take this study with a pinch of salt if I were this patient.

[@jmc8076]

He did say it ‘could be’ useful. Sounds like studies for length vs quality of life (his patient’s focus) for very similar situation are lacking. Hopefully more in future.

[@marshbox]

Surely what is needed following either an invasive procedure or meds or both are CT scans for patients at least annually. This is the most accurate method of monitoring further narrowing to determine future potential treatments.

[@gillsimpson4976]

Thank you very much. Very interesting and informative video.

[@jamesblevins7115]

Great podcast Dr Gupta. Been a big follower for awhile and I always appreciate you for explaining things that I can understand Best Wishes😊

[@mac2658]

Thanks doc, exactly what I needed to take a decision for myself now.

[@MsFishingdog]

Great video. Thanks

[@kholi1240]

Nice explanation

[@ibrahimswiss8714]

That was very helpful, thank you 🙏🏼

[@bistms]

Am 55 year with stable angina and my doctor has advised medications with which am feeling much better. Also have changed my lifestyle and reduced stress. Medications prescribed as Ecosprin, Atorvastin, Ramipril and Bisporol on low doses. Blessed to have advised by Doctor who is genuine like you.

[@Allah-f2r]

Best cardio❤

[@chicagomike]

I had a 95 percent block no symptoms. I said I did to get this checked and a stent put in. Medicare won’t pay for it. Unless you have pain.

[@annehaughton3968]

What about the 1 in 5 who the angiogram shows 90pc blockage and stress tests show issues but they don’t feel angina?

[@mplt6151]

I am 59 and have a very similar history as your patient and got similar recommendations as you gave to him. However, I decided to get stents and as for me it was the right choice. No more pain or other discomfort and taking only one baby aspirin daily but no more beta blockers as they were causing ed.

[@christinacutlass1694]

Thank you!

[@momienmohamed7752]

Thunks my best information .God bless u .❤❤❤❤i

[@AquilaTheHun]

I'm really surprised. While seeing the point in favour of the only medical treatment, 70-80 % lesions well fall into the significant category. And he has 3 of these! And he'll probably carry on with his stressful lifestyle which will - sooner or later - lead to further worsening of the coronariography results. Plus the family predisposition. I am not a doctor. But in the past 10 years (I'm 55) have got 6 stents in my main arteries (LM-LAD-RCX T-stenting, distal LAD and RCA stents). My expert level interventional cardiologist didn't think twice, given my family history and all the rest. It is a risky decision by both the doctor and the patient. Total lifestyle changes may (?) reverse atherosclerosis (but 80 % blockage is too risky anyway, isn't it?) but what if not? With stenting all these lesions AND total lifestyle (including mindset) change it is safer I think. As a layman who has read and undergone a lot in the topic.

[@jmc8076]

I think the basis of choice was length of life vs quality. Sounds like this changes approach.

[@AquilaTheHun]

@jmc8076 Every single case must (should) be assessed individually. The biggest issue with "protocols" is that they don't do this. They treat the individual as a statistical data. This is a huge problem in my opinion.

[@richardwall2330]

Thank you sir ! 12+years on from stents well medicated (asprin monomill,statins,ramapril )regular exercise weight control eating really well (femented veg leafy greens restricted meat )&following your excellent guidance seems to be working rather wellMany thanks keep up the good work

[@DCGreenZone]

The Evaporate trial, Hearts Trial, showing massive progression of soft plaque with statins and reduction of soft plaque and even calcified plaque iirc with 3 plus grams of EPA/DHA would indicate (To me at least) that Omega 3s are the smart choice.

[@frankdooley12]

65 year old , received two stents recently. Had arrhythmia and highish BP only of late, definitely post Covid re-infection issue but nobody wants to discuss this. Blockage discovered during angiogram just lucky I guess, on blood thinners, statin and beta blockers. Very hard to be totally confident in medical treatment after the Covid disgrace. Thank you Doc, I reckon I could trust you at least.

[@404_unfound]

It’s great to see you doing these videos again. Can you please do a video on taking vitamin D3 4000IU with 200ug vitamin K2. K2 is reported to facilitate taking the calcium out of the blood stream into the bones. Without the K2 blockages build up, and it’s reported that taking K2 can or does reverse the build up of plaques. Do you advise patients to take K2 and D3, or might you give it a try?

[@deannewise3320]

Unless you have a deficiency 1000iu vit D3 is enough. Too much is not better.

[@404_unfound]

@ 1 IU of vitamin D3 is defined as the daily amount of D3 needed to keep a 10gram mouse in good health. Mice are quite a good model for human biology so using a mouse model the average 80kg human should be ingesting 8000 IU. But humans are not mice. Now we need to define what is deficient for humans. The latest figure is a blood serum level of 120 nmol/L. Check Dr Phillip McMillan video about a week ago and Dr John Campbell. So get your levels checked as I and my wife has. Prior to her test she took 4000UI daily and serum level was 120. I took 6000UI and my result was 220 nmol/L so I have dropped to 4000UI daily too. The deficiency level has now been agreed by those professionals who are investigate immunity (not GPs), so test and adjust intake to suit.

[@sdjohnston67]

I wonder if this 52 yo man has a high amount of visceral fat (to include pericardial fat)? Thin people can still be loaded with this fat which is pro-inflammatory. Endurance runners tend to have large amounts of visceral fat.

[@lulu1369]

Clinical trials are nice if not controlled by the stint makers and pharmaceutical company. But what do you see with your own eyes❓

[@Vacaiable]

That is a brilliant question.

[@marylynch951]

Well said and I agree

[@100youron]

I would find it very useful to see the differences in the various outcomes and not just stating that they are "statistically" significant. Using a three year period is not very useful unless mortality was quite high. Another very useful piece of information would have been to compare the outcomes to a group taking no action. And lastly, the NNT, as you often refer to, would add substance to the findings.

[@DCGreenZone]

A significant reduction in the thickness of the carotid artery intima-media and the size of the carotid plaque was observed. The improvement rates ranged from 66.5 to 95.4%. NK was found to be ineffective in lowering lipids and suppressing atherosclerosis progression at a dose of 3,600 FU/day. The lipid-lowering effect of NK was more prominent in subjects who smoked, drank alcohol, and subjects with higher BMI. Regular exercise further improved the effects of NK. Co-administration of vitamin K2 and aspirin with NK produced a synergetic effect. No noticeable adverse effects associated with the use of NK were recorded. In conclusion, our data demonstrate that atherosclerosis progression and hyperlipidemia can be effectively managed with NK at a dose of 10,800 FU/day. The lower dose of 3,600 FU per day is ineffective. The dose of 10,800 FU/day is safe and well tolerated. Some lifestyle factors and the coadministration of vitamin K2 and aspirin lead to improved outcomes in the use of NK. Our findings provide clinical evidence on the effective dose of NK in the management of cardiovascular disease and challenge the recommended dose of 2,000 FU per day.

[@chicagomike]

I was not given a chance to decide. I was given a stent. My artery was 95% blocked.

[@tukomi6304]

Pills not cure my angina i ended up in a cabgx4..im 8 months post operation

[@barbaraberwick8993]

It seems that we don’t treat the cause. Iwould not be pacified if i were that man.

[@captquest1]

How can an 80% blockage in one of three of my 16 month old BP graphs disappear in just 7 days?? This just happened to me. I have just retuned from St. Joseph Hospital here in Tampa after an attempt to install a stent, for blockage that was no longer there and stent not needed. A CC determined the blockage just one week ago.

[@CYndibabI]

💭💭 happy to see your face 🩵 💭💭 watching video now 🩵

[@vince1229]

Berberine removes arterial plaque.

[@shellbell6919]

Please advise ..... ...End of August I was diagnosed with HF.... I have severe tricuspid regurgitation with complete loss of coaptation of leaflets plus moderate mitral regurgitation. I also have left & right ventricle damage with enlarged heart, Atrial Fibrillation & an EF of just 23%. I'm a female aged 59 5ft 5 inches tall weighing 11 stone so I know I'm two stone overweight but so exhausted I'm unable to exercise. I was admitted to hospital on the 30th of August where I lost a stone & a half in fluid weight after being fed diuretics intravenously. I had an MRI scan with adenosine stress test at Papworth on the 22nd of October but still have no results. My anxiety levels are through the roof. Haven't seen a cardiologist since being discharged from hospital on the 11th of September. Out of breath & sweating just getting a shower which tires me out. ..Feel very low in mood, frightened & anxious. Feel as though I'm going to lose my life but suffer In the meantime.

[@sridharkrishnan3563]

Why don't you talk on EECP? Isn't it the best to get over the problems of narrowing arteries?

[@sasharamirez2335]

slim, fit, a non-smoker means jacksquat, TOFI peeps are thin_outside_fat_inside, and can be hiding serious amounts of visceral, and deep visceral fat, runners can be as metabollicaly broken as a couch potato, especially older runners with high insulin levels, low muscle mass, and pounding the fruit

[@markwi007]

i had 4 stents in a100% blocked LAD,still had mild angina after the procedure. dr put me on monomil,statins,amlodipine and asprin which made me feel even worse. i have decided to take matters into my own hands and have studied the subject for the past 4 years. im off all the medications except asprin,i take nattokinase,citruline,k2 and im total carnivore. all symptoms gone,work out most days,all metabolic markers excellent.

[@marshbox]

Its still worth booking to have a CT scan at least annually. This is the only sure-fire method to check & monitor the condition of your arteries.

[@markwi007]

@@marshbox without symptoms its not possible in the uk unfortunately.

[@heywhotsgoinon8286]

I have just very recently had a mild heart attack, ecg, ultrasound, all came back normal . However my troponins were slightly raised, 45>75. Had an angiogram showing no blockages. ( i do have 3 stents but are ok) the only extra med i have been prescribed is a beta blocker. I havent smoked for over 2 years ( vape). I exercise at least 3 times per week. If I'd had a concrete reason for my 3rd H/A eg need another stent or bypass, i could deal with that, but to not know what caused the H/A is very difficult for me to deal with mentally at the moment.

[@craigmilne-e3s]

update cortisone was 96 so I guess that needs to come down somehow

[@jmc8076]

TY for calm among a world storm. Can you cover recent 10 yr outcome reviews/ reports on stents etc vs oral meds? Surprising? Why is simple heart calcium CT scan not used more? Quick search gives info/sites. Yrs ago w/husb’s new PR’s OK he stopped cholesterol rx and aspirin (nose bleeds.) Tweaked lifestyle incl foods for natural aspirin and NO (nitric oxide). At 70 is healthy except for sml back issue from sports. Key markers (thx Dr G) done 1-2x per yr. I know this maybe not best for everyone. Wishing Dr Gupta and all of us incl furry companions peace and health for 2025. ✨🥂

[@ichthus1890]

Dear Doc. Early Oct., just prior to my 70'th birthday, I experienced a clot in my groin artery, then next day felt it move to my calf. After extensive testing my Cardiologist learned today that I've not taken the prescribed statin's, blood thinners, aspirin, but rather opted for berberine, niacin and other home remedies. Due to a Lipoprotein a score of 208 nmol he recommended twice monthly injections of Repatha and more heart tests due to aorta narrowing. I told him I'm working out and walking every day and since starting the berberine I can walk an extra half mile per day, that I didn't want any more dye injected in me and I'd think about the Repatha. After he said goodbye I felt relieved that I'd escaped Big Pharma's clutches once again. What do you think?

[@harvinderbhasin5534]

Hello Doc.. I am 68 years old and just got stenting done. Now I have 15 stents in total. I am mainting my colosterol to 150 .. blood pressure is maintained and taking thinners.. my parents died of heart problems… any suggestions please… thank you

[@michaelketley1252]

I wonder if this might be choice made by cost?

[@homomorphic]

No, no and no. I am 60 yrs with an a1c of 4.9, ALT of 16, crp of 0.9 and an IMT of 0.68. never going near statins or any mechanical interventions. Any doctor that tries to do any of these things to you is not your friend.

[@WilliamGK1924]

Can you do a video on how to avoid bacterial infections after having ascending aortic root and valve replacement. I have a synthetic root and mechanical valve. Unfortunately in the past 3-1/2 years I’ve gotten a staph infection that went septic and now a streptococcus bacteria infection . The staph almost killed me ended up 6 months antibiotics then 5:01 2nd heart surgery followed by 6 more months antibiotics. This second one I’m still fighting today, I think I might be ok on this one but there has to be away to stop these bacteria from entering? Thank you for all the work you have done .

[@Seek_Him]

Maybe oil of oregano? It helps treat staph resistance. Clove oil & cinnamon? Crushed raw garlic.... All natural infection killers. (Bacteria ect.)

[@photosmithy]

Hi, cardiologists talk about NSTEMI and STEMI. But little information is found on TSTEMI ( transient). Are there any good videos or documents to read ( not mega scientific) for me to look at. thank you

[@MK-jz5ym]

Follow the money!

[@katherineking3174]

Do the tablets OPEN the arteries!?

[@craigmilne-e3s]

hi i am 61 and on three BP meds losartan felodipine and bisoprolol my BP is 208/99 the specialist at the hospital done my bloods and ECG and said for my size and fitness he has no problem with these readings .Said he would be happy to get it down by 20 i have adhd so he said its probly always been high .What do you think

[@vince1229]

Potassium citrate.

[@erikjanse3994]

What tablets did they use in the study?

[@dmantamp]

On a long run is there any side effects of takingtablets

[@saikrupa8651]

Hi sir is heartbeat varying from one hour to hour when i see in smart watch is it common in everyone

[@Unknown-hu4gf]

Doctor, if you had a choice between Empagliflozin or Dapagliflozin to treat HFrEF which would you choose? I've heard that Empagliflozin increases ejection fraction (EF) so should that be a deciding factor or not? Thank you ahead of time for your consideration!

[@catitude4]

None of the above. Chances are it's calcium build up. Better to address the cause than use these band aids that don't help why it happened in the first place.

[@DrProfX]

Angina?

[@sezwo5774]

The question is how can one trust the studies when all are sponsored with grants by various financial interests. Of course a study sponsored by interests wanting to save money on interventions will find them not worthy while studies sponsored by opposing interests will find intervention worthwhile. What is the point besides youtube clicks of parroting "scientific" studies?

[@sayjen123]

Helo Doctor.. Am on flecanide for last 2 years will it harm the liver?

[@stevelanghorn1407]

Thankyou for this. Perfectly (and very rationally!) explained, as ever.

[@fyrish100]

How about a plant based diet , stop eating artery clogging crap ie animal fat & animals cholesterol and apparently the arteries clean up avoiding the scalpel

[@PeterTebby]

Iodine and eating Natto is a better option

[@PeterTebby]

@kathy.7475 yes its why the japanese have low heart problems the natto removers plaques, natto over time removes the plaques from the blood vessel walls and iodine is super beneficial to the thyroid, heart and blood vessels. 95 percent of the UK are deficient in iodine. We desperately need research doing but the Japanese have lower heart problems and massively lower cancers rates than the UK. It's the Natto, Vitamin K2, selenium and Iodine.

[@raff23able]

Great advice. I’ve read the studies after being diagnosed with 50-70% stenosis of the LAD. I’m currently on a strict diet and take my medications. I have no other symptoms. It is scary as I was diagnosed at 48 years old. My liver enzymes are elevated on the statin and I’m going to talk to my GP about Pcsk9 injections.

[@SachinGaikwad-bc6zs]

Hello Dr. What is your opinion/observation regarding impact of complete/mostly plant based diet on stopping, if not reversing, atherosclerosis process in the body...Thank You...

[@briangriffin2905]

Get yourself checked for lipoprotein (a) .

[@bballah9969]

What these doctors do is absolutely criminal! 💯

[@dawgdrum]

?

[@ericcraig8205]

What this man does is wonderful,like having god to ask questions on religion, non of us get out alive in the end.

[@chicagomike]

They saved my life arse.

[@toushifahmed2331]

Doctor my father is a post necrotising pancreatitis patient and yesterday he had a heart attack, our doctor suggested an angiography and it shows he had 3 blockages and at 90 percent , our doctor is suggesting for a bypass surgery in future , can you please suggest me something ,please reply me , I am really scared right now

[@dr.amitabhamukherjee3601]

Totally worthless study and an utterly useless video.

[@annehaughton3968]

What about the 1 in 5 who the angiogram shows 90pc blockage and stress tests show issues but they don’t feel angina?