Heart Disease Deaths Are Rising – Here's a Solution
Middle-aged Americans are dropping dead from heart attacks and strokes at an alarming rate. After bottoming in 2011, the cardiovascular disease death rate for people aged 45-64 has crept upwards by 0.9 percent each year, according to a new report from the Centers for Disease Control and Prevention.
Deaths are rising, in large part, because people don't realize they're at risk. There's an enormous amount of misinformation floating around. For instance, many people believe that only elderly patients, or only those with high cholesterol, need to worry. In reality, the majority of people who die from preventable heart disease and strokes are younger than 65. And many victims have normal cholesterol levels based on current guidelines.
It's up to doctors like me to help prevent these deaths. Better educating patients about cardiovascular disease and screening them for all the risk factors – not just high blood pressure and cholesterol – could save hundreds of thousands of lives annually.
Cardiovascular disease kills more than 840,000 Americans each year, according to the American Heart Association. That's more than all forms of cancer and chronic lower respiratory disease combined.
Despite its prevalence, patients fail to grasp the severity of this threat. Research company Ipsos and MDVIP, the concierge physician network with whom I'm affiliated, recently asked Americans a series of basic questions about heart disease – and more than 60 percent failed the quiz. Three in four respondents weren't aware that most heart attacks occur in people with normal cholesterol levels. Another 75 percent didn't know that heart attacks happen when blood clots form over plaque in the arteries.
In my experience, patients almost always underestimate their personal risk – and are gobsmacked when I tell them.
Physicians can help combat this complacency by encouraging patients to undergo wellness evaluations and treat cardiovascular risk assessments just as seriously as mammograms or colonoscopies.
Of course, educating patients is only part of the solution. It's up to doctors to offer a more comprehensive range of screenings to look for a patient’s hidden risk.
People with elevated inflammatory markers have a significantly higher risk of developing heart disease, even if their cholesterol levels are normal. A simple test can help detect such inflammation in seemingly fit and healthy patients, giving them an opportunity to make changes necessary that contribute to a longer, healthier life.
Doctors can also identify genetic markers, run blood particle tests, and even perform ultrasounds on arteries – all of which paint a fuller picture of patients' heart health than cholesterol and blood pressure tests alone.
I am fortunate to be affiliated with MDVIP, a network of primary care doctors that emphasizes personalized prevention and care. I only see approximately 13 patients a day, compared to 20 or more for the average primary care provider.
Having a smaller practice enables me to go beyond the basics and conduct lipid particle, insulin resistance, and inflammatory marker testing to all patients annually. I also assess body mass index, blood pressure, family history, smoking history, exercise habits, diet quality, and other risk factors to understand each patient's personal risk.
Such comprehensive assessments allow doctors to deliver more proactive, preventive care that can lengthen and improve patients' lives.
Every day, about 4,000 Americans suffer heart attacks or strokes. Sadly, about half of them never get a second chance to improve their cardiovascular health.
It doesn't have to be this way. We have more ways to assist with identifying cardiovascular risk than ever before. It's up to physicians to educate patients about these tools and encourage them to seek treatment.
Shep Dunlevie, M.D., is an MDVIP internal medicine physician in Atlanta.