May 10, 2008
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