Prevention Of Cardio Disease Cutting-Edge Methods

By Husna R. Baksh, MD

Healthy Steps

. http://www.myhealthysteps.net/

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Prevention Of Cardio Disease Cutting-Edge Methods

Would you be surprised to know 64% of women and 50% of men who died suddenly had no previous symptoms? In this day and age, we must be doing something terribly wrong. Fortunately, with the right tools, heart disease can be readily identified before onset of symptoms and is reversible.

Cardiopulmonary Exercise Testing (CPET)

CPET (bike stress test) assesses heart and lung function in real time during exercise and is able to detect abnormal cardiac function years before a cardiac event or symptoms. The test quantifies peak exercise capacity (VO2max), which is the single most important parameter that determines cardiovascular deaths as well as death from all causes. As VO2max decreases, death rates increase as a linear function.

Early stages of heart disease are marked by impaired circulation in the small blood vessels throughout the body. This process accrues over years and is governed by genetics, activity levels and diet. CPET accurately detects small vessel disease once it is physiologically significant.

If we are successful in reversing small vessel disease with appropriate risk factor modification (lifestyle and medical changes), then microcirculation improves and VO2max increases from baseline. We are, for the first time, able to track progression and regression of heart disease on an individual basis.

Advanced Lipid Testing

To rapidly optimize risk factors, many doctors are using advanced lipid testing to develop care plans. For instance, someone may have a normal LDL (used in the past to determine cholesterol treatment) but still have risk for blood vessel problems, which may lead to a heart attack or stroke. Particle numbers such as LDL-P, and small LDL-P along with Lipoprotein a, LpPLA2, CRP, HDL subsets etc. give us another idea of risk at the microvascular level.

The goal is to improve blood flow in the small vessels. If the small vessels are clean, then so are the large vessels that cause heart attacks and strokes. Calcium scores can also be used to detect large vessel disease but do not detect small vessel flow and cannot be used to track disease regression with therapy.

Corus Technology

Finally, a recent test that has come to my attention is the Corus score. This score gives your probability of risk for obstructive coronary heart disease.

A heart attack and stroke prevention program consists of looking at risk based on multiple types of data. After 25 years of practicing medicine, it is refreshing to see patients now following recommendations to prevent heart attacks and strokes. Why this change? Patients can now get a personalized medical regimen, an exercise prescription and specific fitness targets to achieve to show improvement.

Cardiovascular disease can not be reversed overnight. Team working with patients, to review their treatment plans and tracking their improvements, has been highly rewarding. Patientengagement in their health outcomes has been phenomenal.