What is my life expectancy?

What is my life expectancy? (statistically) I'm a 71 yo male ophthalmologist, had a single stent in the midportion of my left anterior descending coronary artery 6/20/08 for angina with marked exertion, some other vessels are 50-60 % stenosed, no diabetes or hypertension, height 5 ft 7 inches, weight 135, athletic (15 marathons), blood lipids and cholesterol always good( cholesterol 153, HDL 56, LDL 85, triglycerides 59), currently cholesterol 106, HDL 54, LDL 45, triglycerides 36 on Lipitor 20 mgm qd; CRP 2.4, Hemoglobin A1C 6.1, never smoked, mother died of stroke (carotid artery) age 89 and father died of CA age 89 (had small MI at 85); looks like I have cardiovascular disease without any risk factors.(mother's brother died of MI at 58 and her father died of stroke age 65, but I'm told not to go beyond immediate family for risk factors)

[Lee Kirksey, MD]

Hello Dr
In general, predicting ones life expectancey is a difficult proposition. And I believe that no accurate method of doing this exists. I can present some facts that may help .

The CDC publishes statistics regarding life expectancies based upon race, gender and state of residence. They are as follows:

Black male: 69.8 years
White male: 75.7 years
Black female: 76.5 years
White female: 80.8 years

The number one cause of death for Americans is cardiovascular disease including strokes and heart attacks. Clearly, you have some degree of this process given your recent stent placement for exertional angina.  It is interesting that your level of activity seems quite high and you appear to have minimal medical risk factors for CAD including no hypertension, borderline glucose intolerance with A1C 6.1 and relatively good lipid profile aside from the borderline HDL. Of note, a more extensive detailed lipid panel is available that provides segmentation of your lipid profile. In your case it might shed more light on why in the face of relatively normal results, you had severe CAD. Briefly, different subtypes of particles, for instance LDL can lead to CAD. With LDL, there are small particles and large particles. The small particles are more harmful because they seem to penetrate the blood vessel wall more easily. So your total LDL can be normal, but if you have a greater percentage of small particles, you are probably at higher risk  (see post http://optimalhealthtoday.com/New%20Cardiac%20Risk%20Profile%20Testing.htm )

This profile might guide therapy to be more aggressive for you although it seems like that is being done anyway.

Cardiovascular disease is a more common cause of death than the next 5 causes combined. Those causes include various types of cancer including colon, lung and prostate for a male. Fortunately these can be screened for rather effectively and you dont sound like a smoker.

So, I would guess that your life expectancy, under a proper disease surveillance program which includes aggressive prevention of worsening cardiovascular disease, should be at least the average of 76 years. Given your level of activity, I think that's a safe expectation.

PS. I would also have a carotid screening ultrasound exam

Best of health.
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