After a certain age, screenings such as mammograms and colonoscopies are considered routine for disease prevention. But heart-health screenings often are ignored, until it’s too late.
Many people think they should only be referred to a cardiologist if they are getting chest pains, but that is like closing the barn door after letting the horse out. The leading cause of death for men and women in the United States is still heart disease, despite advances in managing and treating it.
Cardiovascular health is all about paying attention to your risk factors: measuring, monitoring and mitigating them over time. Your blood pressure, cholesterol, blood glucose and BMI (body mass index) should be checked routinely during your annual physical exam. These screenings provide a road map of your cardiovascular risk, which can be managed with lifestyle changes and medication.
The CAC Test
Additionally, it would be helpful if a relatively simple screening called a coronary artery calcium (CAC) test were more widely used for middle-aged people with risk factors such as family histories of heart disease, high blood pressure and high cholesterol.
The CAC is an ultrafast CT scan to measure the amount of calcified plaque in the coronary arteries. Formed by cholesterol, the plaque grows slowly over time and creates blockages that can lead to blood clots, heart attacks and stroke. The CAC test provides a score that helps a doctor assess a person’s risk of developing cardiovascular diseases such as heart problems and stroke. This is one test you’d like to get a zero on, as the higher the score, the greater the risk.
CAC tests are non-invasive, painless, fast (10 minutes or so) and relatively inexpensive. There is no anesthesia or prep. The scores can reveal risk while it’s still manageable and treatable, before there are warning signs, like chest pains. The test can be a life-saver.
A baseline CAC test, which gives an accurate window into how much plaque is inside a person’s blood vessels, may spare a patient from being prescribed unnecessary cholesterol-lowering statin medications. Although statins are highly effective and safe, they can cause side effects.
Screenings and Healthy Lifestyles Save Lives
Men and women over the age of 50 should consider getting a CAC test particularly if they have at least one strong risk factor, such as a cholesterol reading over 200. Patients can and should be proactive in asking for the scan, which has been in use for quite a while and is covered in many situations by most insurance. The test is reliable, accurate and gives a handle on potentially deadly situations.
Your physician may recommend further diagnostic screenings, such as a CT angiogram or a stress test, but the CAC is a good baseline for middle-aged patients. A CAC test may be repeated every three to five years, if needed.
Healthy lifestyles – getting cardiovascular exercise, eating well and maintaining a healthy weight, avoiding smoking and heavy drinking - can help reduce your risk factors. However, if you have high blood pressure or high cholesterol, your doctor may prescribe medication.
Remember: Heart disease kills more people than any other illness. Don’t wait for potentially deadly or debilitating symptoms. Make your heart health a priority. It’s all about risk factor modification, and screenings can help us take control of those risks.
Francis J. Murdaco, MD, a primary care physician with more than 30 years of experience, is board-certified in internal medicine and cardiovascular disease. He is a fellow of the American College of Cardiology and a member of the New York Cardiovascular Society. His offices are in Maywood. To schedule an in-person or telemedicine appointment with him, call 201-845-6448 or visit HolyNameMedicalPartners.org.