Why Cardiovascular Screening Is Important
According to the Centers for Disease Control (CDC), heart disease is the leading cause of death for both men and women. The CDC website goes on to note: "About 610,000 people die of heart disease in the United States every year–that's 1 in every 4 deaths."
As such, cardiovascular screening is an important topic to discuss with your physician. Most patients are probably familiar with the lipid panel (or "lipid profile")—a blood test that checks lipids (fats), such as cholesterol and triglycerides. Increased amounts of bad fats (LDL cholesterol) in the bloodstream can lead to narrowing blood vessels and the onset of heart disease. Yet, 50% of patients who experience a heart attack have "normal" cholesterol levels.
Lipid Panel Screening
At PartnerMD, we believe in aggressive screening of cardiovascular health because our goal isn't merely to treat existing heart disease, but avoid it altogether whenever possible. This is why I recommend the NMR LipoProfile® to patients, since it gives more information than the standard lipid panel. (NMR stands for "nuclear magnetic resonance.")
Genetic Testing
Genetic testing can also offer additional insights, such as understanding what your cholesterol profile means in terms of your genetics. Your ApoE genotype reveals with more precision your unique risk for cardiovascular disease and can also affect how you respond to treatments of lifestyle changes. Click here for more information on the Apolipoprotein E and your risk for lipid abnormalities from the Cleveland HeartLab. Incidentally, the ApoE genotype has also been link to predicting the risk for Alzheimer’s disease.
Cardiovascular Screening and Insurance
Health insurance typically covers the NMR LipoProfile® when there's a diagnosis of hyperlipidemia, but genetic tests, such as the ApoE genotype, aren't usually covered. However, these are one-time tests (since your genes are your genes, meaning they won't change). So if a patient is on board with advanced screening for cardiovascular health, we recommend making the one-time investment. Note: we do advanced lipid screening as part of our Advanced Physicals and Executive Physicals
Preventing Cardiovascular Disease
In addition to advanced heart screenings, patients can do other things to improve their overall cardiovascular health:
- Monitor your blood pressure—and be aware that recommendations/guidelines can change. At the end of 2017, the American College of Cardiology lowered its definition of hypertension: "High blood pressure should be treated earlier with lifestyle changes and in some patients with medication – at 130/80 mm Hg rather than 140/90 – based on new ACC and American Heart Association (AHA) guidelines for the detection, prevention, management and treatment of high blood pressure."
- Consider a plant-based diet. The DASH Diet (Dietary Approaches to Stop Hypertension), which is a plant-focused diet, is a popular option. With certain patients with high blood pressure, I might advocate they become a vegetarian. That said, some people will have high blood pressure no matter what they do (this is where genetics can come in), so a diet change alone won't make a difference (although plant-based diets can help improve overall health).
- Know your family history (if possible) and share this information with your doctor. If a female family member (i.e. your mother, sister, or grandmother) had heart disease before 60, that means you have an increased incidence of premature heart disease. If a male family member (first- degree grandfather, father, brother) had heart disease before 50, you have a high instance of having premature heart disease. This would suggest you need to be more aggressive with your own cardiovascular health. Get information on how to record your family health history with templates.
Note: environmental factors play a role, and we pay attention to those in addition to your overall family history. For example, if your mother had a heart attack at the age of 59, that suggests you might be at risk for premature heart disease, but if your mother also had a high-stress job, smoked a lot, traveled a lot, didn't eat right—well, obviously, she had other issues beyond her genetics.
- Adopt other healthful lifestyle changes. Get regular exercise. Quit smoking (or don't start). Minimize stress levels. Maintain a healthy weight.
- Be an active participant in your overall health and wellness care. This is probably the most important thing any patient can do. To start…
- Educate yourself.
- Keep an ongoing dialogue with your physician.
- Follow the wellness plan you and your doctor develop together.
Speaking of a wellness plan, download our free how-to guide for healthy living.
