The point of preventive cardiology is to inform people they’re on a path toward developing heart disease and other cardiovascular problems—so that they can change their lifestyle and delay or prevent the onset of any issues. And recent advances in cardiology are helping doctors detect heart health risks earlier than ever before. New screening tools include Abbott’s High-Sensitivity Troponin-I test, which Medcan has become the first in Canada to introduce in a preventive setting.
Cardiovascular-related diseases like stroke and heart attack are the number one cause of death in Canada. They’re also eminently preventable. According to Dr. Beth Abramson, Medcan’s director of cardiology, prevention of heart disease begins with a healthy lifestyle. In fact, 80 per cent of risk factors are under our control. We can significantly cut our risk if we maintain a healthy body weight, exercise daily, follow a healthy diet and avoid smoking.
Heading into February’s Heart Month, Medcan’s chief medical officer, Dr. Peter Nord, met virtually with Dr. Beth Abramson to discuss some of the most exciting early-prevention tools in cardiology.
Using a simple blood sample, Abbott’s High Sensitivity Troponin-I test measures the concentration of troponin, a type of protein integral to muscle contractions in the body. The protein also is associated with stress on the heart muscle. A form of the troponin test has been used for years to detect whether an emergency room patient has had a heart attack. More recently, large studies that have followed tens of thousands of healthy participants over time have discovered an association between troponin levels and the participants’ likelihood to ever experience major vascular events. Consequently, the troponin test has begun to be used to predict risk of future heart disease even in healthy people who do not have any symptoms or signs of a cardiac condition. Incorporated into Medcan’s Annual Health Assessment, the new test helps practitioners to more accurately determine risk level—allowing doctor and patient to identify the right preventive treatments and lifestyle choices in advance with the hope of ensuring that a heart condition never materializes.
The carotid arteries are located on either side of the neck and carry oxygen-rich blood from the heart to the brain—and they play a key role in one of the most interesting ways to assess cardiovascular health. In a carotid intima-media thickness (CIMT) test, an ultrasound tech uses audio waves to measure the thickness of the neck artery. When compared against average values for people of a similar age, the results of the CIMT scan are able to indicate the presence of atherosclerosis, or narrowing and thickening of the blood vessels, and help doctors determine cardiovascular disease (CVD) risk. The fact that it’s safe, painless and non-invasive round out the advantages of this early-detection tool.
For years, people with elevated risk of developing cardiovascular disease have been told to avoid eating red meat. But doctors didn’t fully understand the pathway that connected beef, pork and the like with later heart disease and stroke. Then came a flurry of recent studies around TMAO, or trimethylamine N-oxide—a metabolite, or a substance created by the digestive process. Specifically, TMAO is created after you eat choline, which is found in foods like red meat. The studies associated higher blood levels of TMAO with elevated risk for CVD. In fact, according to the Journal of the American Medical Association, one of the studies found elevated TMAO concentrations in the blood were associated with more than twice the risk of heart attack, stroke and other cardiovascular problems, compared to people with lower levels. “It’s really interesting science to see that we are what we eat in many ways,” Dr. Abramson said. “Picking up a TMAO blood test, and saying it’s abnormal, has a lot of information for us.”
We’re all accustomed to doctors checking our cholesterol levels, and many of us also know the difference between good HDL cholesterol and bad LDL cholesterol. Another form of lesser-known cholesterol test screens for lipoprotein (a), or Lp(a). A doctor may order this type of cholesterol screening if a patient with a strong family history of heart disease has mostly normal blood work. Elevated levels of Lp(a) would indicate elevated risk for CVD, providing additional motivation to consider pursuing a healthy lifestyle. Learning that early enough can spur lifestyle changes that may help decrease your risks. In people with a family history of heart disease, Dr. Abramson says, “if that Lp(a) is high, I know they’re at genetic risk, and I know I’m going to have to treat them regardless of that cholesterol level that, at first glance, does not look that abnormal. So Lp(a) is something that we’re starting to use more and more of.”
With a healthy diet and regular exercise, CVD prevention is in your hands. Take care of your heart every day by gifting your body with daily exercise and healthy foods. And know that with the help of new technology, you may be able to prevent potential heart disease from occurring in the first place.