Studies show that coronary artery disease (CAD) causes roughly 1.2 million heart attacks each year and more than 40% of those who suffer these events will die. Fortunately, physicians are more informed than ever before and are able to keep a close eye on their patients’ heart attack risk. They can prescribe proper medications and offer lifestyle changes that are tailored to each person’s needs. At the same time, new advancements—including next-generation diagnostic reports—are available to help physicians empower patients to better understand and improve their heart health.
Published research has identified several key risk factors for heart disease that fall outside the realm of what patients can control, but the good news is many risk factors for heart disease are controllable. The key is to use the resources we have to identify modifiable risk factors early. Such actionable items include efforts to quit smoking, control blood pressure and cholesterol levels, and manage diabetes, among others.
Recent advancements in cholesterol testing are enabling physicians to look beyond standard lipid levels and helping provide patients with a more detailed picture of their heart health. Testing that measures the small particle of lipoproteins—for example, Apo B, LP(a) and mapping of HDL to assure the quality of HDL particles—have revolutionized risk factor modification. Additionally, it is now known that inflammatory markers, such as lipoprotein-associated phospholipase A2 and myeloperoxidase, are directly correlated to arterial intima inflammation and an increased risk of CAD. Furthermore, measuring insulin resistance and insulin levels could identify prediabetes early and possibly prevent the development of CAD.
Additional diagnostic advancements include genotype testing for sensitivity to statins. This can ensure that patients can tolerate statin therapy when they are put on a specific formulation, which in turn may improve adherence rates. We also now have testing that directly measures the major cholesterol production and absorption markers that are associated with circulating total cholesterol. This can help clinicians understand why patients have abnormal cholesterol levels and provide information on how to treat it. Advances have also been made by personalizing data and engaging diagnostic reports with easy-to-understand language and graphics. These recent advances can help patients understand why and how to take a bigger role in adhering to simple lifestyle changes.
The recent wave of modern diagnostic tools to help manage heart disease are enabling physicians to assess risk factors earlier, empower patients to take a more active part in their heart health, and prevent or modify the course of their disease. Rather than treating heart disease at the end stages, we should be proactive about using these tools throughout care to increase our heart disease prevention efforts.
Readings & Resources (click to view)
Pearson TA, Mensah GA, Alexander RW, et al. Centers for Disease Control and Prevention and American Heart Association. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107:499-511.
Greenland P, Alpert JS, Beller GA, et al. American College of Cardiology Foundation; American Heart Association. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2010;56:e50-e103.
Stone NJ, Robinson JG, Lichtenstein AH., et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63:2889-2934.
JN, Caglar T, Stockl KM, Lew HC., et al. Impact of the new ACC/AHA guidelines on the treatment of high blood cholesterol in a managed care setting. Am Health Drug Benefits. 2014;7:426-439.