Lee Kirksey, MD  
Cleveland , OH

Specialties: Peripheral Arterial Disease, PAD

Interests: vascular, specialist, treatment options
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Preventative Cardiovascular Program- A new paradigm

May 10, 2008 - 4 comments

heart disease prevention


risk factors


Cardiovascular Disease


cardiovascular testing


stress test


calcium scoring


Heart Disease


Chest Pain



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

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389974 tn?1331015242
by swampcritter, May 10, 2008
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.

469720 tn?1388146349
by Lee Kirksey, MDBlank, May 11, 2008
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.

Avatar universal
by SEady, Sep 18, 2009
Would you happen to know a school that would actually give the Cardiovascular Porgram

Avatar universal
by butters1954, Dec 29, 2011
sorry it's a questionwhat proactive procedures can/should be taken to check someone out with a family history of strokemale aged 55?

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