Living Life Free From Heart Disease

What is my risk of heart disease?

The development of heart disease is dependent on your unique genetics and lifestyle; however, the process typically takes many years to several decades to transpire. Several factors affect an individual’s progression to cardiovascular disease: high blood pressure, cholesterol, chronically elevated inflammatory markers, high stress levels, chronic diseases, and liver or kidney problems.

How do doctors calculate future risk of heart disease?

Doctors use online tools such as the ASCVD (Atheroscelortic Cardiovascular Disease) or PREVENT score calculators. The ASCVD score was introduced in 2013 and is one of the most popular and widely accepted risk calculators in the United States. The PREVENT score calculator is relatively new and was created by a team of Northwestern physicians in 2023. These calculators are fairly limited and only consider factors such as a basic lipid panel, presence of diabetes and/or hypertension. Patients with pre-diabetes or pre-hypertension do not receive any points using this system.

While these tools are widely adapted in the United States, other countries around the world have come up with their own risk calculators. These calculators are fairly extensive. For example, in the UK, the QRISK3 calculator is employed to estimate future risk of heart disease. QRISK3 scoring takes into consideration factors such as autoimmune disease (i.e. rheumatoid arthritis and systemic lupus erythematosus), atrial fibrillation, migraines, mental diseases and use of antipsychotic or steroid medications. These factors have been shown in studies to correlate with an increased risk of heart disease. 

What are some limitations of these online risk calculators?

While some of these international tools are more comprehensive, there are several factors that are still missing. These include chronically elevated inflammatory markers (e.g. ESR, hsCRP), insulin resistance, chronic diseases, and a sedentary lifestyle. Another limitation is the absence of markers such as ApoB, which correlates more closely with heart disease than a routine LDL. These calculators also do not consider atherogenic particles such as Lp(a), which is present in approximately 20% of the US population and significantly increases the risk of heart disease. At Chicago Direct Primary Care, we use a comprehensive approach to assess your risk of heart disease. Our approach encompasses your unique personal and family history, a lifestyle assessment, comprehensive blood panel, expanded lipid screening, coronary artery imaging, and cardiopulmonary fitness testing (VO2 max test). 

Is heart disease preventable?

Heart disease is the number one cause of mortality worldwide. Approximately 1.5 million heart attacks and strokes occur each year in the United States. The Center for Disease Control and Prevention (CDC) attributes 320 billion dollars annually to healthcare costs and lost productivity due to cardiovascular disease.

Cardiovascular disease is a common preventable cause of morbidity and mortality. Early assessment of lifetime risk allows us to intervene and take charge of your health. Some of our preventative strategies include lowering your cholesterol levels early, treating high blood pressure, lowering inflammatory markers by eliminating their root cause, and dietary and lifestyle modifications. 

Is it possible to avoid cardiovascular disease?

Using the tools of modern medicine aka “Medicine 3.0” and early intervention, it is absolutely possible to significantly delay and/or avoid cardiovascular disease altogether. This is our mission at Chicago DPC! We work with individuals of all backgrounds and health statuses to optimize their cardiovascular health. We believe in early detection and intervention, rather than waiting for heart disease to happen.  We’d love to chat with you!

References

https://www.cdcfoundation.org/pr/2015/heart-disease-and-stroke-cost-america-nearly-1-billion-day-medical-costs-lost-productivity#:~:text=%E2%80%9CAmericans%20suffer%201.5%20million%20heart,Heart%20Disease%20and%20Stroke%20Prevention. 

https://www.qrisk.org/

https://professional.heart.org/en/guidelines-and-statements/prevent-calculator

https://clincalc.com/Cardiology/ASCVD/PooledCohort.aspx

https://www.cdc.gov/genomics/disease/lipoprotein_a.htm#:~:text=High%20levels%20of%20lipoprotein%20(a,made%20of%20protein%20and%20fat.