Thallium results

  I am 38 with a family history of heart disease. I had an angio done in 1996,
  and results were a "rough area" on one of my arteries. This is after 18
  years of a pack a dayand a lot of Big Macs.
  In Jan of 98 I had a Thallium stress done, due to some numbness in my left
  arm.My cardiologist said the problem was not my heart, I had good blood flow.
  My extrusion or etrusion (not sure) was 62%.
   For the past 2 years my diet has been low fat and I walk a lot at work.
  I also try to walk a mile every morning.My sitting heart rate is usually 60
  and BP is marginal at 140/90. I have cut back/quit smoking. I take
  Lotrel 5/10, Pravachol 10mg, aspirin 81mg and multivitamins.
  Nerve tests on my arm were negative.
  - How fast do blockages grow ?
  - Is 60 a good heart rate ?
  - Is the heart rate low for having high BP ?
  Thanks
  Roland

[CCF Cardio MD-SGM]

Dear Roland,
The negative thallium stress test results are reassuring, but I need to emphasize that few tests are perfect.  In evaluating patients with symptoms of coronary artery disease, the physician carefully considers the paitent's history and physical examination, integrating this information with results from various tests that might be performed.    The thallium test, in good hands, is fairly reliable.  It is approximaltely 85 percent sensitive in detecting flow-limiting coronary artery blockages.  That is to say that it will miss 15 percent of patients who do indeed have significant coronary disease.  Also, the thallium doesn't detect mild or moderate coronary disease.   So, it is very important that everyone, and especially patients with coronary disease,  tries to adopt lifestyles that lessen the risk of coronary disease, such as control of high blood pressure, cholesterol reduction, therapy of diabetes and smoking cessation.
Blockages in coronary artery grow.  This is a progressive, lifelong disease for which we have no cure.  However, the lifestyle changes that I mentioned will often significantly slow the progression of the disease.  Dramatic reduction of risk factors may halt the disease in some people.  Thus, the rate at which blockages grow depends greatly on how risk factors are being addressed, as well as genetic/hereditary influences that are difficult to circumvent.
The blood pressure you mentioned is still a bit high, especially on medical therapy.  You and your physician should shoot for a pressure of 120-130/80-85.  The heart rate you mentioned is fine-- quite normal-- with or without high blood pressure.  
Best of luck.  Information in the Heart Forum is for general purposes.  Specific diagnoses and therapies can only be provided by your physician.