{{ Carstensen noted that in the 20th century, Americans’ life expectancy nearly doubled from the century before. Trying to guess one’s own lifespan based on how long one’s parents lived is “no longer a good metric,” she said.
“This doubling of life expectancy is … allowing us to really rethink the way we live our whole lives,” such as how we work and for how long, Carstensen added.
To more deeply understand longevity, it’s important to appreciate the difference between aging and longevity, she said. Aging, the professor explained, is the fundamental, cellular, biological process of growing older, while longevity is a metric, which measures, for example, the longevity of a car or friendship.
“It’s an important distinction,” she said, “because a lot of people think longevity is just a euphemism for aging, but they’re not the same thing.”
Furthermore, Carstensen said not all Americans are living longer. Since the 1980s, all of the gains in life expectancy have gone to the college educated, she said. “We have not only a wealth divide, we have a longevity divide in our country,” Carstensen said. }}
The longevity of the working poor versus the upper middle class professional is gap of 15 years.
My parents circle of doctors and their spouses are mostly making it to over 90. The first exception just died at age 89. She had been very sick for a long time. She was not wealthy after her divorce but she had a much easier life than the hard drinking poor man. As a Scottish immigrant she may have gained 5 years. Immigrants on average live 5 years longer.
Just a note her alimony was tiny before you go there. The divorse was 40 years ago.
Sadly the next exception will be a dear friend, the youngest of the group, who has had been health for decades. She will be over 84 or more when she passes. She just had a major stroke. I won’t get into the details. Her meds for 6 decades were always things you would not want to take for years on end never mind decades.
I don’t think it’s that simple. If you have the heart disease genes, even a good lifestyle may not be much help. It seems some people are more prone to cancer than others. Is that genetic?
This. This is what they’ve been saying since my heart attack. Before the heart attack I had a NEGATIVE risk for heart disease. Well below “average.” Until I didn’t. People who think they can fiber their way or diet their way to semi-immortality and disease free are … uhh… wrong. But easily gullibbed by BS internet “studies show” nonsense easily blown up by simple life experience and an understanding of numbers.
Yep - I thought I was great, until I wasn’t. Fit. Thin. Lotsa exercise. Cruisin’ to long lived healthy 90 years. Until I got my Calcium CT score back. 500. W.T.H?
Lotsa testing later, Turns out I got bad genes. Now I control my Cholesterol quite aggressively with drugs. Frustrating. Scary. Disappointing. But there’s worse things. I’m just glad I caught it when I did.
The CAC score is only as meanful as the amount of actual plaque you have.
My score is 165 but the two cardiologists see no plaque. Both cardiologists have told me high calcium scores do not matter. Both looked at the CAC test and saw no plaque.
The other part of testing is the stress test. I have no problems there.
Hey, check this out. My heart attack saved my life. Yes. It was a right side plaque rupture. Pretty off-the-rack stuff. But once they got in there they found the two big arteries on the LEFT side (studies show that is the important side of your heart) were almost 100% blocked. Absent the heart attack I was all set up to die suddenly in my sleep at any moment in the preceding year or two. Or while doing push-ups. Or sit-ups. Or eating fiber. No symptoms. One yahoo MD said “Hey, all that exercise is probably what saved your life! Your heart was strong enough to withstand it.” I say all that exercise almost killed me. If I had not been “in such great shape” I’d have been having symptoms for months or years beforehand, gotten the stents and went on my way before losing 50% of my heart function and needing a pacemaker and defibrillator.
Eight months and 3 days before the heart attack the last doctor to examined me said not to worry about BP of 99/62 and 48 bpm heart rates. They are good signs. Heart is mighty mighty. Gave a listen and said “Good strong heart beat. No problems there.” So, I canceled plans for a treadmill test (age 62) and decided to do it at 65. With 2 arteries that far gone the treadmill would have flagged blockages of HOLY BOWL MOVEMENT! proportions and saved the day. But, how much of a hypo-chondriac does one have to be when you already have a negative risk profile for America’s favorite cause of death?
But hey, keep believing “studies show” and substituting it for actual stuff. To paraphrase Calvin Coolidge: There’s no sense of security like a false one and no knowledge like things you want to believe
Now I have my total cholesterol at 91, LDL at 14, HDL at 59. See a cardiologist every 6 months. Could maybe get more testing to see if I have an actual blockage.
My friends hear attack may have saved my life. The only reason I did it was because he was healthy as a horse and had a heart attack. I thought I would go see what might be going on in my chest. Wasn’t I surprised. Glad you survived your MI.
If you lack a medical diagnosis that predicts a lower life span, the only thing you have to go on are the “studies” of your cohort (i.e., college educated, born and grew up in New York vs. Mississippi, etc.)
Impressively low LDL, @Volucris …. I’ve been toggling around the low 30s with a combo of Lipitor, Repatha, and, of course, those fashionably healthy “Lifestyle Choices” (which I blame for producing complacency in my healthcare providers).
My decision to ask for more advanced lipid testing (Lp(a) and Apo-b) along with a CAC scan…..which was pretty unequivocal at 700 and change. Of course, this is just a measure of the amount of calcified plaque, and in and of itself gives no clue of where any blockages are or if the disease is ongoing (reasonable to assume it it, I reckon, with an eye popping Agatson score like that) Subsequently saw the guy who’s now my intervention cardiologist and he suggested a CT coronary angiography with a FFRct (measures the flow rate) That was even more of a shock….greater than 85% occlusion of the Left Anterior Descending, Left Circumflex, and Right Coronary Arteries….and loads more besides….with a flow rate you’d expect.
That test result arrived by email Sunday evening and I was due to see my man on the Wednesday. Let me tell you, I almost had a heart attack just thinking about it….especially since these numbers are the sort of thing that would’ve earned me stent placements just a few years ago. Dr M actually called me on the Monday morning….surprised that the results had been ready so soon after the CTA on Friday and a bit miffed that news like this should’ve hit me the way it did without context. Anyways it seems that these PCSK9 inhibitors are absolute game changers and can get LDL levels down to near neonate levels…..not just stopping new plaque deposition in its tracks (good enough for me!) but actually causes a steady regression.
Fortunately, my daughter hasn’t inherited the predisposition to high Lp(a) and her Apo-b is well within normal limits, so that’s one thing I haven’t passed along.
For sure, personalized vs population based medical decision making is the wave of the future. When I mentioned how I felt like such an anomaly, my intervention guy replied that all his patients are anomalies.
When it comes to longevity, you and the study may both be right. Wealthier, better educated people not only live longer on average because of better diet and exercise habits, they also receive better healthcare. You, VeeEnn and fcorelli all seem to have improved your longevity prognosis because of your access to, and ability to take advantage of good healthcare.
Up to a point…depending upon what your definition of longevity is, and whether we have made a meaningful difference to the future course of events.
In the same way that you’ve read comments like “At the end of the day, we’re all dead anyway “ or implications that attempts at proactive decision-making denotes a fear of dying….or some such twaddle, folk have actually made similar comments in real life. For all the world as if one is aiming for immortality. As if. Given the fact that, for all my long standing self care, I haven’t succeeded in preventing the most common cause of premature death. Granted, I haven’t suffered any symptoms, yet…but, still. As my intervention cardiologist admitted….someone should’ve said something before now.
Longevity is about more than how long you live. How well you live is also a big factor. Especially in those “marginal years” …. the run up to the day the Grim Reaper comes a calling. My mum died at 78 of the consequences of ASCVD….severe congestive heart failure. If that happens to be my lot in death (or maybe sudden cardiac death) I would want it to be after a period of “compressed morbidity”. Not much more than a few months but preferably a few seconds of awareness that things were going pear shaped. Definitely not like my mum…..who, starting in her very early 60s had the first of her strokes, developed severe intermittent claudication, very difficult to manage high BP (secondary to renal artery stenosis) and a plethora of other symptoms that made her life something of a burden to her. At 73, I’m ahead of the game.
However, it’s tremendously irksome that the medical professionals I’ve chosen over the past couple of decades had been apparently bamboozled by the steady stream of examples of craptaculous lifestyle adopters clogging up their appointment books. To the extent that it took what I think might’ve been perceived as hypochondriasis, or attempts at biohacking to get a straightforward diagnosis of a somewhat preventable disease at a point when it was actually more preventable.
Access to good healthcare didn’t do much for me…..because I didn’t get it. As I’ve mentioned before…the Curse of Healthy Lifestyle Choices.
An interesting response at my PCP practice (well, I like to think that folk take notice of such things) seems to be more proactively around advanced lipid testing etc. The practice is one of the few that is trying to remain independent of the corporate snatch and grab that’s going on in these parts. One manifestation is a periodic newsletter with reminders for vaccines and other healthcare tips. The very next issue had a reasonable article on the value of CAC scans in joint decision making with treatment of “high cholesterol”.
You are mistaken……at least outside of “concierge medicine”, and as far as proactive diagnostics for folk who’re apparently healthy and following the Righteous Lifestyle path.
Again you’re mistaken. If you have a non zero Agatson score, you have an objective measurement of calcified plaque. A measurement of some degree of ASCVD. That score does not tell you if you have ongoing disease (or that you don’t, either, of course). A CAC scan is not designed to identify “soft” plaque. It’s certainly possible to spot it with modern equipment…..if you’re lucky…..but, to quote the adage “Absence of evidence is not evidence of absence “
Certainly, early detection beats waiting for the usual signs and symptoms…..but it’s a stretch to call it preemptive when the disease is already present