Many topics might be considered sexier than writing or reading about the risk of heart disease. I’m sure you would prefer to read about how a vacation in the Maldives can help lower your risk of heart disease, and I’m certain there is a strong case to be made. But nothing is sexier than helping you stay alive which is precisely what this article is intended to support. More specifically this article aims to raise awareness of your risk for heart disease by providing an overview of the various online and offline solutions available that will provide insight into your risk. Once you understand your risk you will be better equipped to manage it through conversations with your doctor proactively, and through changes in your lifestyle.
It’s important to note that the starting point for your medical diagnosis and treatment should be your primary care provider. Discuss your risk factors, ensure that they are testing for the full range of biomarkers that can indicate the potential for heart disease, and discuss the potential for a coronary artery calcium (CAC) test, and other advanced screenings such as a CT coronary angiogram that your doctor may suggest based on your risk factor. It’s a good idea to educate yourself on what to ask for, especially if you have a family history or have any other risk factors (high blood pressure, overweight, smoke, etc.); longevity expert Dr. Peter Attia, goes in-depth in his book Outlive (highly recommended!) on some of the labs and diagnostic tests that can help detect heart disease, a summary of which you can find here and which you should discuss with your healthcare provider.
Taking Your Health Into Your Own Hands
As I mentioned in my profile, my aneurysm was found somewhat by chance. I went to my doctor for a routine physical, my doctor happened to do an EKG which indicated some irregularities that led to him identifying an aneurysm which then led to a CT scan which more precisely confirmed the initial findings. I could have very easily not had a physical. In fact, roughly only one in three adults receive an annual physical and some medical professionals are actively lobbying against the annual physical since in many cases the annual physical is not “evidence-based,” meaning that for the average healthy person annual physicals do not reduce the risk of death from heart disease, cancer, or other causes. They also argue that annual physicals, particularly for healthy patients, take time away from doctors seeing patients with more urgent needs.
My mission with WellTree is that you and others won’t leave the discovery of your potential heart condition to chance. Regardless of age or how great of shape you are in, it’s important to understand your risk and to have a conversation with your doctor. It is not always the case that your doctor will run the right tests, especially if you are asymptomatic, so understanding your options and some of the things to look out for, and having proactive conversations with your doctor is key. This is particularly important if you have a family history as I did. The solutions below can provide some insight into your potential risk. Armed with this information you will be better equipped to talk to your doctor about the appropriate course of action for you, if any.
Online Screening Tools
The easiest place to begin to understand your risk for heart disease is to look online. Two of the most commonly referenced online tools to help assess your risk for heart disease include:
- American College of Cardiology ASCVD Risk Estimator Plus – assesses the chances of a person ages 40 to 79 developing heart disease over the next 10 years.
- Reynolds Risk Score – assesses the risk of death over the next 10 years for people up to 80 years as a result of cardiovascular disease.
- American Heart Association My Heart Check – while not a clinical solution, this assessment looks at various aspects of your health and well-being to provide a “heart score” and recommend lifestyle changes that can help prevent heart disease.
These calculators factor in various inputs including age, race, blood pressure, cholesterol, use of certain medications, and smoking history to provide insight into your 10-year risk based on statistical models. These should be used solely to gain a baseline understanding of your risk which can be used to have a conversation with your doctor. More importantly, if a calculator suggests that you have moderate or high risk, it will hopefully prompt you to seek the input of a doctor more quickly than you otherwise would have. Your doctor should have final authority when it comes to understanding your risk for heart disease and subsequent treatment. That said, being educated will allow you to have more informed conversations with your medical provider. Note that according to the Cleveland Clinic, these online risk assessments are only useful if you have not had a heart event.
Offline Screening Services
Another option some may consider are heart screening service providers that use imaging technology to look at your heart and provide insight into your potential risk of cardiovascular disease. One such provider is Life Line Screening. For $159 (January, 2024) they provide a cardiovascular and stroke disease risk screening that consists of:
- Carotid Artery Scan – check for plaque build-up in the carotid artery; plaque build-up can lead to a stroke
- PAD Arterial Disease Test – check for peripheral artery disease (PAD) is where arteries in the legs are narrowed or blocked due to atherosclerosis, or hardening of the arteries
- Abdominal Aortic Aneurysm Test – uses ultrasound to check for abnormalities that might require further examination
- Atrial Fibrillation Test – uses a 6-lead EKG to test for irregular heartbeat, also known as AFib
There is some debate as to the usefulness of services such as these where patients go outside of their primary medical provider for tests that may or may not be useful. Some suggest that such services rely on fearmongering and can lead to false positive test results, anxiety, and unnecessary medical interventions. Life Line Screening tackles those arguments head-on suggesting that they perform non-invasive tests and that it is up to your doctor to determine a treatment plan. I fall somewhere in the middle. If I felt that my doctor wasn’t taking my potential risk seriously based on family history or other risk factors, I think a cost-effective test could provide peace of mind. I think back to my mother’s stroke. She had a physical not long before; I’m not aware of any advanced screening that was done to evaluate her risk. Had we taken advantage of such a service, I wonder if we could have prevented what ended up being a catastrophic stroke. As the saying goes, hindsight is 20/20. And if you do take advantage of such a service, always work with your primary care physician on a treatment plan or to conduct further testing as necessary. These services should complement, not replace your primary care.
Conclusion
The best way to prevent heart disease is to maintain a healthy lifestyle – diet, exercise, nutrition, sleep, etc. Maintain a healthy blood pressure, and minimize stress, saturated fats, inflammation, and other factors that are known to contribute to heart disease. However, even the healthiest person cannot control for genetics of family history. Taking advantage of online and offline tools to provide insight into heart disease risk, in combination with working closely with your healthcare provider, will ensure you are covering your bases to proactively prevent and treat heart disease as necessary. Stay healthy!