Heart Disease: Needs not be silent, nor a killer
Preventing Heart Disease: Cutting-edge screening and steps for a Healthy Heart
Heart disease is a leading killer, but early detection and prevention can save lives. At Highbridge, we feel that heart disease is greatly under-diagnosed and that most heart attacks can be prevented. This post covers key screenings, advanced tests, and strategies to protect your heart. Consult your doctor or apply for a membership with Highbridge Medical for personalized advice.
Why Get a Coronary Calcium Score at Age 45
At age 45, everyone should consider a coronary artery calcium (CAC) score—a quick, low-radiation CT scan measuring calcified plaque in your arteries. Scores range from 0 (low risk) to over 400 (high risk). By mid-40s, plaque often builds silently, even in asymptomatic people. Guidelines recommend it for ages 40-75, especially intermediate-risk individuals. A zero score means low risk for 5-10 years, avoiding unneeded meds; higher scores (e.g., >100) signal aggressive prevention, predicting 2-4x higher event risk. It's affordable and non-invasive—your heart's early warning system.
For High-Risk Patients: CT Coronary Angiogram
If you have risks like diabetes, smoking, family history, or high CAC, discuss a CT coronary angiogram (CCTA) with your doctor. This contrast-enhanced scan reveals artery details, detecting hard and soft plaques. Soft, non-calcified plaques are "high-risk"—unstable, fatty, and rupture-prone, causing heart attacks via features like low-attenuation or napkin-ring signs. CCTA outperforms CAC for plaque composition and narrowing, guiding treatments like stents. It's not routine due to contrast/radiation but vital for symptomatic or high-risk cases.
Apolipoprotein B and Lp(a) in Routine Testing
Standard cholesterol tests miss nuances; add ApoB and Lp(a) for accuracy. ApoB counts harmful cholesterol-carrying particles (e.g., LDL), better predicting events than LDL alone, especially with normal LDL but high triglycerides/diabetes. Lp(a), genetically driven, independently raises risk (e.g., >50 mg/dL doubles/triples odds) for heart disease and valve issues. Test Lp(a) once if family history; both refine risk, supporting early interventions like statins.
Preventive Steps: Diet and Pharmaceuticals
Prevent plaque with diet and meds, reducing risk 30-50%. Adopt an organic, low carbohydrate diet: fruits, veggies, nuts, olive oil, fish; limit saturated fats, sodium (<2,300 mg/day), processed foods. Add omega-3s (walnuts, flax) and antioxidants (berries) to fight inflammation.
Pharmaceutically, statins lower cholesterol and stabilize plaques, cutting heart attack risk 20-30%. Consider PCSK9 inhibitors for high cholesterol or aspirin for antiplatelet effects. Combine with exercise (150 min/week), no smoking, stress management for plaque regression.
The Highbridge Approach:
1) As concierge doctors, we have the time to perform a thorough history and risk assessment including family history, environmental exposures, and retrospective nutritional assessment. 2) If appropriate, a coronary artery calcium score or CAT scan coronary angiogram with an advanced lipid panel. 3) Utilizing imaging and lab results, we develop a personalized prevention and treatment plan aimed at preventing cardiovascular disease. This includes profound nutritional counseling as well as the potential utilization of plaque-stabilizing medication. 4) We utilize serial imaging to gauge whether treatment is tangibly stabilizing coronary plaque burden.
Fairfield County Heart Health Resources
CAC (Heart Imaging):
Advanced Radiology Consultants- Provides coronary artery calcium scoring via CT scan. Locations in Stamford, Trumbull, Fairfield, and Stratford. Call 203-337-9729 to schedule.
Advanced Lab testing:
Request A Test- Affordable, same-day ApoB testing in Fairfield. Partnered with national labs for walk-ins.
Empirical Health: ApoB testing in Greenwich for $190, including lab visit and insights.
Westchester County Heart Health Resources
CAC (Heart Imaging)
Lenox Hill Radiology: Offers CT Cardiac Calcium Scoring, a non-invasive scan to detect calcified plaque in coronary arteries. Available at their Westchester locations, including Tuckahoe (115 Main St.), Hartsdale, and Yonkers (984 N Broadway).
East River Medical Imaging: Provides Cardiac CT with Coronary Artery Calcium Scoring to assess plaque. Located in White Plains (1133 Westchester Ave.), offering widebore MRI, PET/CT, and X-ray alongside cardiac services. They use advanced AI for detailed analysis of coronary artery disease.
Advanced Lab testing:
Empirical Health: ApoB testing in Greenwich for $190, including lab visit and insights.