Q: I am 47 years old and in reasonably good health. Currently I work out 4 days a week in the gym, a habit, which I have for over 9 years. I am told that a certain amount of plaque build up is unavoidable as one ages. Is it safe for me to jog on the treadmill at moderate speeds? What is the best way to find out the condition of my blood vessels vis a vis plaque?

A:It is safe to go on the treadmill but one has to build up the exercise tolerance gradually over a period of months. At the age of 47 it is safe to assume that there will be plaques in the vascular tree. To be safe one should develop age related exercise schedule. The fact is exercise is the best way to rehabilitate the patient with heart disease and other vascular diseases, like plaques in the legs. Current thinking is that a supervised exercise schedule is best way to ward-off future problems. Regarding finding out the status of plaques in the blood vessels the safest way is to undergo Echo Doppler examination. This can be done for all vital organs like heart, brain, kidney and of course legs. One should also combine with that blood biochemistry and clinical examination by a physician. If all this comes as normal or near normal then it can be safely concluded that plaque formation is insignificant and is not life threatening. Should these tests show that there is abnormality then one can be investigated further and, if need be, subjected to angiography. There is a word of caution regarding angiography, as it is an invasive procedure it should be restricted to persons who are needing further treatment like angioplasty/stenting or surgery.