Until recently, patients of Newtown’s Community Health Associates and Dr Jeffrey Friedman who were tipping the scales, showing evidence of high blood pressure, cholesterol, hypertension or other conditions threatening their heart health, might have received a stern look or candid lecture, and been sent home with reference materials on how to lose weight or dial down their stress.
Others may have been put on, or were warned that they were facing the prospect of being prescribed, blood pressure or cholesterol medication.
But thanks to a new tool and guidelines for physicians introduced last November, Dr Friedman can now show patients a computerized profile of their cardiovascular health, and work with them using the tool to help minimize, and in some cases eliminate, their potentially heart-harming conditions.
The American Heart Association (AHA) and the American College of Cardiology (ACC) are providing a series of new cardiovascular prevention guidelines for the assessment of cardiovascular risk. To support the implementation of these guidelines, the new Pooled Cohort Equations CV Risk Calculator and additional Prevention Guideline Tools were made available for download for computers and mobile devices, or as an interactive technology via the web.
Visual Aspect Helps
Dr Friedman is finding that by using the visual and interactive capabilities the new tool provides, that his patients are paying closer attention and getting better results tracking their own cardiovascular risk, supporting lifestyle modifications that reduce risk, managing their elevated blood cholesterol, and using the tool to reduce their increased body weight.
“We haven’t been using it for long,” Dr Friedman told The Newtown Bee. “But our patients say they really like to track their progress, and to see actual evidence of how they can, or how they are already improving their overall health by addressing their individual health concerns.”
According to the AHA, a downloadable spreadsheet serves as a perfect companion tool to the 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. The spreadsheet enables health care providers and patients to estimate ten-year and lifetime risks for atherosclerotic cardiovascular disease (ASCVD), defined as coronary death or nonfatal myocardial infarction, or fatal or nonfatal stroke.
The information Dr Friedman enters into the system to estimate his patients’ risk factors includes age, sex, race, total cholesterol, HDL cholesterol, systolic blood pressure, blood pressure lowering medication use, diabetes status, and smoking status.
Estimates of ten-year risk for ASCVD are based on data from multiple community-based populations and are applicable to African American and non-Hispanic white men and women 40 through 79 years of age.
Estimates of lifetime risk for ASCVD are provided for adults 20 through 59 years of age and are shown as the lifetime risk for ASCVD for a 50-year old without ASCVD who has the risk factor values entered into the spreadsheet.
The tool and guidelines are critically important for greater at-risk populations. For the first time, African Americans can receive an individually tailored snapshot of their cardiovascular risk, and both heart attack and stroke risk can be measured at the same time.
And updated risk equations for non-Hispanic white men and women — and the first risk equations for African American men and women — are based on the latest findings from research studies that have followed roughly 25,000 people. There is not yet enough data available for Hispanics/Latinos, but this will be a goal in the future, according to the AHA.
If risk is still not clear after the assessment, doctors can use any of four “tiebreaker” risk markers, the simplest being a history of premature cardiovascular disease in a parent, sibling, or child. The other additional risk markers are ankle-brachial index, high-sensitivity C-reactive protein, and coronary artery calcium score.
The new equations allow doctors to be smarter about who should receive medications to lower cardiovascular risk.
Nearly a third of US adults are at high enough risk for a heart attack or stroke that they would benefit from cholesterol-lowering statin drugs, according to a companion guideline on cholesterol that recommends statins for people with a risk of having a cardiovascular event, including stroke, of at least 7.5 percent within the next decade.
These latest guidelines are basically recommendations for health care providers across the nation, created through years of scientific research.
For information visit communityhealthnewtown.com or reach Dr Friedman at 203-270-1077.