There are four types of people who need a Cardiologist.
Unfortunately either they don’t know it, don’t understand how everything in their bodies is linked to everything else, or have some other reason for ignoring their risks of heart disease.
However, seeing a Cardiologist before heart disease develops can save your life.
The “sit and wait” approach is just not good enough when it comes to heart health.
In fact, it directly contradicts the physician’s oath which states “First Do No Harm.”
To me, that means: Also prevent harm.
Historically, doctors and patients have monitored slow-growing risk factors such as blood sugar and cholesterol and waited to act until the numbers are “bad.”
➡ I suggest that, instead, we should think ahead when our patients have known risk factors or things that predispose them to heart disease.
➡ Our goal needs to be to keep the good health most of us are born with, instead of settling for test results that are “OK” or “borderline.”
No One Is Immune From Heart Disease. No One.
There are four types of people who need a Cardiologist and should seek preventive care, due to known predisposing factors.
1. People with a strong family history of heart disease
People in this group may have genetic issues (from birth) that increase their risk of a heart attack, even if they eat right and exercise regularly.
In some cases, we do genetic testing for specifically heritable cholesterol disorders.
➡ This is especially true if their parents and/or siblings have heart disease.
➡ This group should also be screened using advanced blood tests.
➡ If necessary, they should be screened with imaging tests of the blood vessels, such as with a coronary artery calcium scan, to determine if they have inherited the same pattern as their family member(s) with heart disease.
Too often, people in this group do not receive adequate screening or education. Then by the time they visit a Cardiologist they have been over or undertreated for their condition.
Their primary care doctor may have assured them that they had nothing to worry about because their cholesterol and blood pressure were in the normal range.
➡ But what if their family members also had normal blood pressure and cholesterol and still had heart attacks, as is often the case when there’s a strong family history?
➡ Unfortunately, although people in this category are usually aware of their family history of heart disease, they may think the risk doesn’t apply to them.
But it does. If you are in this category, I urge you to see a Cardiologist.
The opposite may also be true:
➡ What if the doctor orders multiple tests, and the results of one out of 10 are abnormal, so the doctor tells the patient something is terribly wrong, which may not be the case?
If we screen for and discover a genetic mutation before the disease develops, we can cut the patient’s risk and the risk of other people in the family who may also carry the mutation.
In fact, some hospitals across the country partner with Pediatric Cardiologists to make sure kids who carry these mutations are set up with the tools to lead heart-healthy lifestyles.
We can help you decide which tests are really needed and set up a treatment plan, including lifestyle changes, and potentially prescribe medications that can cut your risk of heart attack, strokes, and other heart-related conditions.
2. The second in the group of four types of people who need a Cardiologist have a personal history of early age heart disease.
➡ Having a heart attack or stroke at a young age is unusual. We shouldn’t see heart attacks in people younger than their mid-60’s.
Still, we see many people in their 30’s, 40’s, and 50’s who have heart disease. And, as mentioned above, these people usually have an established history of heart disease in their families.
With young patients, we have to think outside the box to prevent further heart disease and damage.
The causes of heart disease can vary greatly, so the approach to treatment should be specific to each patient.
The “usual” approach to heart disease management (standard treatments and testing) is not good enough because their heart diseases don’t follow the usual pattern.
➡ Early age heart disease patients usually need more aggressive care.
➡ Sometimes they need to be screened for other factors and need further testing to determine the cause of their disease.
New treatments are often used following emerging concepts for risk factor management, based on the latest science and research.
For example, one of the newest and most potent cholesterol treatments was partly developed through research at UT Southwestern, with clinical studies involving several of their patients.
➡ If someone has a heart attack or stroke before the age of 55 for men, or younger than 65 for women, their family members should consider seeing a cardiologist as well.
We can assess their heart disease risk, then offer a plan for regular screening and risk reduction.
3. People with significant cholesterol disorders
People in this group often have extremely high cholesterol that can’t be lowered by lifestyle or diet changes.
➡ There’s almost always a genetic cause for this, and we have to get to the bottom of it before we can find a treatment that works for them.
One particularly challenging cholesterol problem is a genetic disorder called Familial Hypercholesterolemia (FH).
➡ People who have FH have a mutation that causes extremely high cholesterol and early age heart attacks.
Two UT Southwestern doctors, Joseph L. Goldstein, M.D., and Michael S. Brown, M.D., won the Nobel Prize for the discovery of this mutation and their research surrounding it.
➡ A specialist’s experience with cholesterol disorders allows them to offer a different approach to care that these types of patients would find elsewhere.
➡ We can give earlier and more aggressive treatment with access to new drugs as they are developed.
4. Finally, the last of the four types of people who need a cardiologist are people with multiple uncontrolled risk factors:
This last group has the typical risk factors for heart disease:
- Uncontrolled high blood pressure
- High blood sugar or Diabetes
- Unhealthy diets
- Lack of exercise
Each of these traits is a risk factor on its own, but when they come together (as they often do), it makes preventing and controlling heart disease more complicated for patients.
➡ People with multiple heart disease risk factors need a team of physicians to help them make all the required changes.
➡ One physical exam a year isn’t enough, and one doctor alone can’t manage all these changes.
➡ Patients need real-time support and feedback to turn their habits and risk factors around.
The right type of Doctor, in the correct specialty, can help you stick to your plan and improve your heart health.
One of the key ways we do this is by monitoring your heart health numbers, helping you understand what they mean (for YOU specifically) and giving you the right tools to meet your goals.
If you’ve seen a primary care doctor or even another cardiologist before, one or both have likely given you the “know your numbers” talk. This refers to the key risk factors for heart disease, which include:
BMI: Your body mass index is the ratio between your weight and your height.
➡ This measurement isn’t an end-all, be-all, because it doesn’t account for muscle mass, but it’s important to pay attention to it.
➡ High BMI’s are linked to increased risk for heart disease and other diseases, including 11 types of cancer.
A reading of 140/90 is considered high, but remember that for most people, lower than 120/80 is ideal.
➡ High blood sugar:
Diabetes is one of the most common and most important risk factors for heart disease.
- High cholesterol:
Your low-density lipoprotein (LDL, or bad cholesterol) level should be lower than 100.
If yours is 128, you may think it’s OK because it’s below that 130 line which is considered “borderline.” But 128 is on the high side of normal, so it’s not necessarily healthy.
Think of it this way – when you’re born, your LDL is less than 70!
- Waist circumference:
This is the measurement around the waist at belly button level. Waist circumference is a risk factor for Metabolic Syndrome, which is related to heart disease. (Click here for more information on Metabolic Syndrome).
- The “normal” measurements are less than 35 inches for women and less than 40 inches for men.
If you test on the high side for any of these numbers, you will benefit from seeing a Cardiologist – even if your regular doctor says you’re in a normal range and it’s fine, and especially if you have a personal or family history of heart disease or heart attack.
A Cardiologist can help decipher your test results and find your and your family members’ heart disease risk. And we’ll help you and your family get the right tests to find a treatment plan for you if you need it.
Heart disease is the No. 1 killer in the United States. Seeking care from a Cardiologist before heart disease develops can help you lower the risk and pay off in huge health benefits later.