Lee Kirksey, MD
Lee Kirksey, MD
Male
Philadelphia - PA
Specialties: Peripheral Arterial Disease, PAD, Cardiovascular Disease, stroke, treatment, angioplasty, spider veins, laser ablation, wound treatment, surgery, leg pain, Prevention, Varicose veins
Interests: vascular, specialist, treatment options, diagnosis, spider veins, stroke, Prevention, Varicose veins
Male
Philadelphia - PA
Specialties: Peripheral Arterial Disease, PAD, Cardiovascular Disease, stroke, treatment, angioplasty, spider veins, laser ablation, wound treatment, surgery, leg pain, Prevention, Varicose veins
Interests: vascular, specialist, treatment options, diagnosis, spider veins, stroke, Prevention, Varicose veins
Penn Presbyterian Medical Center of the Univ. of Pennsylvania Healthcare Clinical Assistant Professor at The University of Pennsylvania School of Medicine
51 North 39th Street
51 North 39th Street
Philadelphia - PA
Preventative Cardiovascular Program- A new paradigm
May 10, 2008 08:40PM
- 2 comments
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Our traditional western paradigm of medical care is a "fix it when it's broken approach". Our system is very reactive, not proactive. A perfect example is our society's inability or unwillingness to address the core cause of our America's as well as the world's number one killer. Cardiovascular disease (CVD). CVD kills more people annually than all cancers combined. In the overwhelming majority of cases, risk factors that are all a result of our dietary intake are ultimately responsible for CVD. Hypertension, diabetes, high cholesterol are all related to diet.
60% of Americans are overweight and 30% are obese. And poor diet is not limited to these individuals, it is possible to have excess intake of fatty foods and simple carbohydrates, both dietary hazzards, and still appear outwardly slim and fit.
One out of two individuals that present emergently with cardiac cause of chest pain have had no previous diagnosis. It is our inability to identify these people earlier which prevents us from implementing aggressive measures to prevent disease from getting to that severe state.
Recently, many physicians are proposing more aggressive testing measures in people who are identified to be at high risk. The goal would be to identify people earlier and institute measures such as like dietary changes and aggressive cholesterol and blood pressure management. Some studies are even beginning to show that early treatment of blockages in blood vessels results in regression of those blockages.
Who is a Vulnerable Patient?
Each year close to 1.4 million people in the United States experience a heart attack and in excess of 500,000 die from it. Amazingly, 50 to 70 percent of those individuals who died from a heart attack were not aware of their risk. Worldwide, over 19 million people die from a heart attack each year
The concept is simple. Additional screening measures would allow identification of the "vulnerable patient" illustrated in the image. Aggressive treatment of the vulnerable patient would prevent progression to the symptomatic chest pain stage. Early screening and identification of tangible atherosclerotic findings is a very strong motivating factor for lifestyle changes
60% of Americans are overweight and 30% are obese. And poor diet is not limited to these individuals, it is possible to have excess intake of fatty foods and simple carbohydrates, both dietary hazzards, and still appear outwardly slim and fit.
One out of two individuals that present emergently with cardiac cause of chest pain have had no previous diagnosis. It is our inability to identify these people earlier which prevents us from implementing aggressive measures to prevent disease from getting to that severe state.
Recently, many physicians are proposing more aggressive testing measures in people who are identified to be at high risk. The goal would be to identify people earlier and institute measures such as like dietary changes and aggressive cholesterol and blood pressure management. Some studies are even beginning to show that early treatment of blockages in blood vessels results in regression of those blockages.
Who is a Vulnerable Patient?
Each year close to 1.4 million people in the United States experience a heart attack and in excess of 500,000 die from it. Amazingly, 50 to 70 percent of those individuals who died from a heart attack were not aware of their risk. Worldwide, over 19 million people die from a heart attack each year
The concept is simple. Additional screening measures would allow identification of the "vulnerable patient" illustrated in the image. Aggressive treatment of the vulnerable patient would prevent progression to the symptomatic chest pain stage. Early screening and identification of tangible atherosclerotic findings is a very strong motivating factor for lifestyle changes
What additional screening measures are proposed, and for what ages?
Furthermore, is there an age at which testing should be reduced or eliminated? (For instance, if a 93 year old man has not yet had an adverse finding, is there any reason to test them?)
Swampy wonders about the last statement, that negative findings are powerful motivators for lifestyle changes. For some people, it is probably true, but for others...well, people still smoke despite knowing full well the dangers of doing so, and many continue long after their health has deteriorated.
Furthermore, is there an age at which testing should be reduced or eliminated? (For instance, if a 93 year old man has not yet had an adverse finding, is there any reason to test them?)
Swampy wonders about the last statement, that negative findings are powerful motivators for lifestyle changes. For some people, it is probably true, but for others...well, people still smoke despite knowing full well the dangers of doing so, and many continue long after their health has deteriorated.
I dont think that this is a program that everyone should be entitled to nor would if be financially feasible. I personally think that this is a program that would be more suitable for our newly developing medical environment. The environment where employees are now required to bear an increasing responsibility for their personal health care costs either by increasing annual premiums or increasing co pays. Or it is an option for an individual who is committed to improving their own personal health and is willing to invest out of pocket to their health. Many younger people (for this discussion less than 55) understand the long term financial and lifestyle consequences of chronic medical conditions.This is not a government paid for type of program for the very reason that you described. The government cannot afford to provide cutting edge, effective measures to many individuals who assume no personal responsibility for their life style behaviors and the untoward current and future consequences of those behaviors.
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