BaleDoneen Method
Specialtycardiology

The BaleDoneen Method is a risk assessment and treatment protocol aimed at preventing heart attack and stroke. The method also seeks to prevent or reduce the effects of type 2 diabetes. The method was developed by Bradley Field Bale and Amy Doneen.

Description

Similar to other protocols, the method tests for cholesterol levels, blood pressure, and diabetes mellitus, as well as factors not included in other current protocols, including systemic inflammation, vitamin D deficiency, insulin resistance, elevated levels of lipoprotein(a), and genetic risks, to identify potential root causes of arterial plaque.[1][2]

Testing for plaque includes a carotid intima-media thickness test, (CIMT), which measures blood flow through the arteries and the thickness of the arteries.[2][3] Physician Dr. Jeff Emery wrote that the test "allows us to identify if you are at future risk for a heart attack or stroke."[4] The American Heart Association has recommended CIMT as "a safe, non-invasive and relatively inexpensive means of assessing subclinical atherosclerosis. The technique is valid and reliable."[5] The method also uses the coronary artery calcium score (CAC),[5] a measurement of the amount of calcium in the walls of the arteries that supply the heart muscle, using a coronary CT calcium scan of the heart.[6][7] CAC has been shown to be an independent marker of risk for cardiac events, cardiac mortality, and all-cause mortality.[8]

The method uses urine and blood tests to check inflammatory markers, such as a high-sensitivity C-reactive protein test (CRP) measuring CRP, a protein in found in blood that indicates inflammation throughout the body.[9] In 2017, results of the CANTOS trial demonstrated that anti-inflammatory therapies reduce risk for heart attack, stroke, other cardiovascular events[10] and cancer by up to 50%.

The method ties results of this testing to considerations of lifestyle, diet, sleep disorders, stress levels, genetic factors, and dental care, and personalized treatment targets are set to reduce patients' cardiovascular risk.[9][11] In some cases, these goals exceed those set by standard care. A common protocol for blood pressure indicates that an adult male with a reading of 130/85 is not at risk for a heart attack if the patient is being treated for high blood pressure. However the American Heart Association[12] and the BaleDoneen Method define safe levels as being below 120/80.

Effectiveness

In a retrospective study that analyzed data from patients who had received cardiovascular risk reduction treatments that included lipid-lowering medications, lifestyle modification, and additional therapies for those with insulin resistance, type 2 diabetes, hypertension, metabolic syndrome, and other cardiovascular risks.[13] The following outcomes were reported during the first year of treatment with the BaleDoneen Method, compared to baseline: 50% decrease in the size of carotid artery plaque deposits, 30% drop in triglycerides, 25% drop in LDL cholesterol, and 6% rise in HDL cholesterol.

A retrospective study of patients treated with the BaleDoneen Method,[14] reported statistically significant reductions in CIMT measurements, plaque burden, fasting blood sugar, LDL cholesterol and inflammation over an eight-year period. Limitations of the study include lack of diversity in the study subjects, nearly all of whom were Caucasian, and lack of a comparison group. Randomized controlled clinical trials are needed to compare the effect of the method with standard treatment protocols.

Treatments

For the treatment of arterial disease, the method uses pharmaceuticals such as statins, baby aspirin (low dose aspirin), renin–angiotensin–aldosterone system inhibitors (RAAS inhibitors), and other drugs that are common tools for most physicians, as well as vitamins,[15] supplements, lifestyle modification, and a diet based on the patient's DNA.[7] The method also recommends significant attention to dental care[16] to improve heart and circulatory system health, including brushing and flossing teeth twice a day.[7]

References

  1. ↑ Walton-Shirley M (March 2011). "The Bale/Doneen method of heart attack and stroke prevention: So you have a better idea?". MedScape Diabetes & Endocrinology.
  2. 1 2 Kahn J (2015-11-10). "Heart Attack and Stroke Prevention Specialists: The Time Is Now". HuffPost. Retrieved 2019-01-18.
  3. ↑ O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK (January 1999). "Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group". The New England Journal of Medicine. 340 (1): 14–22. doi:10.1056/NEJM199901073400103. PMID 9878640.
  4. ↑ Doneen AL, Bale BF (March 2013). "Carotid intima-media thickness testing as an asymptomatic cardiovascular disease identifier and method for making therapeutic decisions". Postgraduate Medicine. 125 (2): 108–23. doi:10.3810/pgm.2013.03.2645. PMID 23816777. S2CID 30487153.
  5. 1 2 Greenland P, Abrams J, Aurigemma GP, Bond MG, Clark LT, Criqui MH, et al. (January 2000). "Prevention Conference V: Beyond secondary prevention: identifying the high-risk patient for primary prevention: noninvasive tests of atherosclerotic burden: Writing Group III". Circulation. 101 (1): E16–22. doi:10.1161/01.CIR.101.1.e16. PMID 10618318. S2CID 36769082.
  6. ↑ "Coronary Artery Calcium Scoring". InsideRadiology. 2016-09-13. Retrieved 2019-01-18.
  7. 1 2 3 Bale B, Doneen A, Cool LC (2013-04-15). Beat the heart attack gene : the revolutionary plan to prevent heart disease, stroke, and diabetes. New York, NY. ISBN 9781118454299. OCLC 852763580.{{cite book}}: CS1 maint: location missing publisher (link)
  8. ↑ Neves PO, Andrade J, Monção H (2017). "Coronary artery calcium score: current status". Radiologia Brasileira. 50 (3): 182–189. doi:10.1590/0100-3984.2015.0235. PMC 5487233. PMID 28670030.
  9. 1 2 "C-reactive protein test". Mayo Clinic. Retrieved 2019-01-18.
  10. ↑ Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, et al. (September 2017). "Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease" (PDF). The New England Journal of Medicine. 377 (12): 1119–1131. doi:10.1056/NEJMoa1707914. PMID 28845751. S2CID 205102333.
  11. ↑ Barville J (February 2014). "Studies have linked gum disease to cardiovascular disease". The Spokesman-Review.
  12. ↑ "Understanding Blood Pressure Readings". American Heart Association. Retrieved 2019-01-18.
  13. ↑ Cheng HG, Patel BS, Martin SS, Blaha M, Doneen A, Bale B, Jones SR (August 2016). "Effect of comprehensive cardiovascular disease risk management on longitudinal changes in carotid artery intima-media thickness in a community-based prevention clinic". Archives of Medical Science. 12 (4): 728–35. doi:10.5114/aoms.2016.60955. PMC 4947619. PMID 27478452.
  14. ↑ Feng D, Esperat MC, Doneen AL, Bale B, Song H, Green AE (2015-07-01). "Eight-year outcomes of a program for early prevention of cardiovascular events: a growth-curve analysis". The Journal of Cardiovascular Nursing. 30 (4): 281–91. doi:10.1097/JCN.0000000000000141. PMID 24717191. S2CID 205705257.
  15. ↑ Mason CM, Doneen AL (2012). "Niacin-a critical component to the management of atherosclerosis: contemporary management of dyslipidemia to prevent, reduce, or reverse atherosclerotic cardiovascular disease". The Journal of Cardiovascular Nursing. 27 (4): 303–16. doi:10.1097/JCN.0b013e31821bf93f. PMID 21804401. S2CID 8868384.
  16. ↑ Levine JB (2017-07-13). "This New, Treatable Cause of Heart Disease is Bridging the Gap Between Doctors and Dentists". Huffington Post. Retrieved 2019-01-18.
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