The Most Reliable Way of Determining Heart Attack Risk?


by Mike Arnold

For those of you who are familiar with my previous writings, you’re probably already aware that I possess a passion for providing information that will—hopefully—help save others’ lives. In light of all the deaths we’ve seen over the last few years, never has there been a better time to address this issue, but my motivation for writing this article goes deeper than surface concern for strangers. You see, just a few weeks ago I was informed about the death of a personal friend. His name was Taylor Normandeau. Many of you may know him as the host of PED Radio, as well as from his wide range of contributions on the many forums that he used to frequent. Unlike most of the other bodybuilders that have passed away over the years, Taylor was not in his 50’s, 40’s, or even his 30’s. He did not abuse massive amounts of gear, nor did he use for a very long period of time. As a fairly well educated young man, he understood the importance of supplementation in the prevention of cardiovascular disease and made sure to include an abundance of clinically proven health products in his daily supplement regimen. By all accounts he was a loving father and planned on sticking around as long as possible.

Taylor died of a heart attack; the result of a complete cardiovascular blockage at just 28 years old. Although I never asked him personally, I feel confident in stating that if he were still alive today and someone asked him what he thought his chances were of experiencing an atherosclerosis-induced, life-ending heart attack within the next month, he would have said “extremely unlikely”. Sure, everyone harbors a certain degree of concern when living this lifestyle, but I doubt he would have guessed that his life was about to end so prematurely. Before I get someone saying “please, not another write-up about PED’s and cardiovascular health risk”, I want to make it clear that my intention is not to convince you of the potential dangers that these drugs present, but rather to inform you of your options. Not only could this information save your life, but it eliminates much of the guesswork that accompanies less reliable methods of assessing heart attack risk. This is what I want to talk about today.

Traditionally, bloodwork has been to go-to medical procedure for assessing cardiovascular health risk. It can provide us with cues, or signs that something is wrong and serves as an invaluable (I would say essential) tool for revealing what might be going on internally. Health markers such as cholesterol, triglycerides, hematocrit, hemoglobin, and various inflammatory markers like IL-6, TNFa and IL-10 are all important risk indicators in the development of cardiovascular disease. While these can be used to help predict the likelihood of experiencing an adverse cardiovascular event, they are only that—predictors. They don’t actually tell us to what degree atherosclerosis (clogged arteries) may be present, or even if it is present at all. They are suitable for exposing dysfunction and sending a warning, but that is about it. The reality is that even with bloodwork we are still largely left in the dark regarding the true state of our cardiovascular system and can only speculate as to what might be going on.

But what if there was a way to know—for sure—what our arteries actually looked like? What if we could look right inside of them, with a nearly risk-free, non-invasive procedure that allowed us to see exactly how much plaque had (or had not) accumulated? This would provide important information regarding our body’s ability to cope with the negative influence of AAS, as well as reveal exactly how much damage had been done from an atherosclerotic standpoint. Think about the following. How many of us, if we were informed that our coronary arteries were 90% blocked, would continue using drugs indiscriminately? My guess is that the vast majority would hastily discontinue use and immediately begin implementing whatever health measures they could in order to help improve their condition. After all, there is a big difference between someone thinking they might have a problem and knowing they have a problem. As risk-takers by nature, most PED using bodybuilders are at least somewhat aware of the risks associated with their chosen lifestyle, but instead of taking the conservative road, most accept these risks with an optimistic outlook and hope for the best. This is much more difficult to do when potentially life-destroying evidence is staring you in the face.

Obviously, atherosclerosis is only one of many potential cardiovascular problems associated with PED use, but as the #1 cause of heart attack worldwide, being able to accurately diagnose the condition would go a long way towards their prevention. In the past, the only way to accurately measure plaque build-up along the coronary artery walls was to subject oneself to a traditional coronary angiogram; an invasive procedure in which a catheter is inserted into an artery in your groin and threaded through your blood vessels all the way to your heart. Once the catheter is in place a dye is then ejected, which allows X-ray images of your heart to be taken, revealing potential blockages or areas of narrowing. Because of the potential risks involved, coronary angiograms are typically reserved only for those in whom the possibility of detecting a life-threatening blockage is moderate to high. As a side benefit, if a blockage is detected during the screening, the treating physician can begin performing what is known as an angioplasty right on the spot. This is an endovascular procedure used to widen narrowed or obstructed arteries/veins (i.e. clear blockages), with the goal of restoring normal blood flow.

When it comes to bodybuilders/strength athletes, few doctors are willing to perform traditional angiograms as part of a routine check-up, even when bloodwork indicates the presence of atherosclerotic risk factors (damaged lipid profile, elevated blood pressure, etc). Instead, you are more likely to receive a prescription for statins and antihypertensive medications. While these drugs can be beneficial under certain circumstances, in my opinion their use is rarely warranted in PED-using bodybuilders, especially when considering the wide range of equally effective (sometimes more effective) and safer OTC alternatives currently available. So where does that leave us? While preventative supplementation is an absolute must in my book (that is another conversation for another day), it is not a monitoring tool. Only by being able to see our arteries can we know where we stand in terms of atherosclerotic development. Fortunately, we do have a safe and effective way to measure plaque build-up. It is called Cardiac Computed Tomography Angiography (CCTA), or a CT angiogram for short.

Unlike traditional coronary angiograms, CT angiograms don’t require the use of a catheter. Instead, they rely on a powerful X-ray machine to produce images of your heart and blood vessels. While CT angiograms still involve the use of a dye injected intravenously through the hand or arm (to make your heart’s arteries visible on the CT scanner), those who have had the procedure done will usually tell you that it is no more traumatic than having your blood drawn. Due to its non-invasive nature, a CT angiogram doesn’t require any recovery time and is increasingly being used for people with a variety of heart conditions. However, traditional coronary angiograms are still preferable for those with a high probability of blockage, as an angioplasty cannot be performed with a CT angiogram. But when it comes to routine check-ups, CT angiograms are ideally suited for the majority of PED users. The procedure itself is a relatively simple process and takes about an hour to complete. It is usually conducted at the radiology department of a hospital or an outpatient imaging facility after being scheduled by your cardiovascular specialist.

If there is one thing we’ve learned over the last several years it is that no bodybuilder is immune to heart attack. Even when one appears to lack a genetic predisposition for developing cardiovascular disease (as demonstrated by their family history), we never know just how our body is going to respond to the negative effects of AAS. Taylor Normandeau may be the perfect example. While I am by no means inferring that steroids were the sole cause of Taylor’s death (we can’t know this information), it would be silly to discount their potential role when taking into consideration his family history, age, the use of preventative supplementation, and the relative absence of commonly accepted risk factors. It could very well be that his cardiovascular system simply wasn’t able to defend itself against the ill effects of AAS as well as most other PED users. This in itself would be an unrecognized genetic risk factor. If true, this means that any of us could be at risk, regardless of what steps we take to prevent it, or how resistant our family line appears to be to cardiovascular health problems.

Knowing this, it seems like common sense for all bodybuilders, especially those of us who have been using steroids for quite a few years, to begin including CT angiograms as part of our comprehensive monitoring and prevention program. As the only non-invasive means of directly monitoring plaque build-up in the coronary arteries, I can find no justifiable reason for neglecting this aspect of health care. If it can save even one bodybuilder’s life and spare his loved ones the suffering and grief that comes with losing a husband, father, or friend, it is well worth it.

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