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Preventive Cardiology


The treatment of cardiovascular disease (CVD) has undergone tremendous changes over the last several decades. The first angioplasty procedure was performed in Switzerland in the 1970s. Clot busting drugs came into widespread use in the 1980s. Use of drug eluting stents started to be employed for the treatment of coronary artery disease in the late 1990s. At the same time, use of statins, aspirin, plavix, angiotensin converting inhibitors (ACE inhibitors), angiotensin receptor blockers (ARBs) and beta blockers, have significantly impacted the prevalence of CVD.

Despite these advances, CVD is the leading cause of death in the United States and the developing world. It accounts for more than 900,000 deaths annually. To put this into perspective, breast cancer, the most common cancer among women, accounts for 465,000 deaths annually.

While death rates from CVD have declined, clearly more needs to be done. The best way to effect change in this regard is through risk factor modification. With this in mind, 9 potentially modifiable risk factors have been identified. These include:

  1. Smoking
  2. Dyslipidemia (abnormal cholesterol profile)
  3. Hypertension
  4. Diabetes
  5. Abdominal obesity
  6. Psychosocial factors
  7. Daily consumption of fruits and vegetables
  8. Regular alcohol consumption
  9. Physical activity

It has been shown in large, well done studies such as the Nurses’ Health Study, that by controlling risk factors such as maintaining a desirable body weight, eating a healthy diet, getting regular exercise and not smoking could account for up to an 84% reduction in cardiovascular risk.

Taking this into consideration, your doctor’s goal will be to determine your risk of developing CVD. This is done by calculating your Framingham Risk. Based on your risk profile a strategy will be devised to reduce your risk. The succeeding articles in this section will outline a plan for reducing your risk of experiencing a new CVD event.

Mark A. Rothschild, MD, FACC