Statewide Heart Program To Originate In Newtown On June 24

By Kaaren Valenta

Newtown has been selected as the model site for a cardiovascular risk program that will be used throughout the state and the country to help identify families with a high risk of heart disease.

A free screening will take place on Saturday, June 24, in the Edmond Town Hall gymnasium from 8 am to noon for persons aged 35 to 65 who have a high blood pressure or obesity, high blood pressure, diabetes, stroke, or heart disease in themselves or family members below the age of 65.

The free screening will include cholesterol/HDL/triglycerides and blood sugar level tests; blood pressure evaluation with follow-up 24-hour blood pressure recordings (if indicated); and a heart attack/stroke risk multiplier evaluation. Immediate test results will be provided; after discussion of the results, participants will be referred back to their doctor’s office for follow-up.

Newtown Heart Health Day is the inspiration of Dr Joseph Buchman, a recently retired cardiologist who conducted a similar program in Newtown in 1994. That screening identified 110 at-risk persons, 60 of whom subsequently took part in an ongoing program that documented the effects of lifestyle changes – diet, exercise, yoga, and meditation – on blood pressure and cholesterol/HDL levels over the following year. Participants in that program also are being invited to return June 24 to be re-tested and evaluate their progress during the past five years.

“Heart Day will be a very important program and will provide a lot of good information,” Dr Buchman said. “It is expected that this session will unite the American College of Cardiology, the American Heart Association, the schools of nurse practitioners, and the community home care associations of Connecticut to support and sponsor similar programs in other areas.”

The Ridgefield VNA will staff the free screening and will direct a statewide VNA screening effort.

Representatives of Visiting Nurse Associations throughout the state have been invited to be observers at the cardiovascular risk intensity program so they might replicate it in their own communities. During the afternoon of June 24, the VNA nurses will attend a two-hour seminar on preventive cardiology. Presented by Dr Buchman; Dr Laurel Halloran of Newtown, director of the nurse practitioner program at Western Connecticut State University; Dr Susan Pittman-Lowenthal, a cardiologist who has a master’s degree in public health and works for Bayer Pharmaceutical; Harvey Kramer, former president of the Connecticut chapter of the American College of Cardiology; and Danbury cardiologist Michael White, chief of the University of Connecticut School of Pharmacy/Hartford Hospital; and Karen Gottlieb, director of the AmeriCares Clinic in Danbury and Nurse of the Year in Connecticut last year.

While advances in modern medicine have made significant improvement in the treatment of heart disease, the key to better health is prevention, Dr Buchman said.

“Taking family [medical] histories is a weak link in the current health process,” he said. “But it is an important part of preventive medicine. If we detail family history of heart and hypertension, now we have the medical know-how to focus upon the risks beforehand. We now know that heart disease is a disease that has been prevalent in individuals in our country at a very young age. If we can address this earlier, through preventive medicine, we can save lives and save dollars, and keep families intact for 30 years longer.”

Dr Buchman said that because diseases incubate since childhood and symptoms usually don’t appear until after age 35 in high-risk families, early treatment of alterable risk factors – obesity, smoking, inactivity, cholesterol/HDL ratios, blood sugar, triglycerides, and early hypertension – are all essential because they are multipliers of risk when they co-exist and are easily alterable. This was demonstrated in the 1995 program in Newtown which altered behavior over the 18 weeks of group  While at age 65, 40 to 50 percent of the population will have a mildly elevated blood pressure or elevated blood sugars, or both, persons who have other cardiac risk factors face a significantly greater challenge.

“For example, an elevated cholesterol, a low HDL, and an elevated blood pressure may put one at 20 times the risk of an elevated blood pressure alone, or an elevated cholesterol/low HDL alone,” Dr Buchman explained. “Smoking and a family history of premature vascular disease would add greatly to one’s risks.”

Despite the fact that there are now safe, simple medicines to control high blood pressure and cholesterol, and it is known that lifestyle changes alone can reduce the risk of cardiac disease, “we just aren’t doing it,” Dr Buchman said. “The 1994 study modified lifestyle. The question is now, did the lesson stick? That’s why we want to reexamine the same group.”

“Sixty percent of the general population may need to be on a pill  – prescription or over-the-counter – to be brought to goal,” he said. “That’s because the target goals have been lowered since 1988 and are much harder to achieve. And of those who are placed on medication, only 20 percent are still taking it at the end of the year. They stop because of the cost, because it is inconvenient, or because of a lack of education [about its necessity]. Of the 20 percent, only one in every four is treated until they reach goal.”

The new heart program, “Control to Goal,” has several sponsors including the pharmaceutical company Parke-Davis, which provided an unrestricted grant. Newtown resident Roger Clark, a representative of Parke-Davis, became involved last year.

“What Dr Buchman told me about the previous study intrigued me,” Mr Clark said. “Dr Buchman is doing some very visionary work. So much has been learned in the past few years about the genetic part – the role of family history – in heart disease and stroke.  But it is important to educate the community. I wanted to get involved to do something for the community in which I live and because I work for a major corporation that services this area. The study will utilize resources that my company can supply.”

Newtown is ideal to be a central location for a study, Dr Buchman said. “The population is pretty stable so you can get back to the participants for follow-up. We want to see what has happened to the people who were in the 1994-95 study.”

In that study the risk factors that were targeted to goal included hypertension (blood pressure of 130/80 or higher); family history of coronary disease, heart attack, or stroke; cholesterol readings of more than 200 with cholesterol/HDL ratios of more than 4 to 1; elevated triglycerides; diabetes; and smoking.

The new study will go even farther.

“Outcome studies and plaque progress dictate new cut points for treatment,” Dr Buchman said. “All these points have been changed over the last five years. We are now addressing treating blood pressure of 130, blood sugars over 110, cholesterol/HDL ratios of more than 4 to 1, and triglycerides of 150 – not so much with drugs at these levels, but with diet, physical activity, and lifestyle changes. We also see the patients more frequently. That’s why we are bringing in people who have these levels and having them tested. There has to be more frequent testing to see the trends and to test adherence through review of self-monitoring, as well.”

Residents of Newtown, Monroe, and Southbury, and persons who participated in the previous study, will be tested free. Out-of-area residents will be charged a $50 fee.

Persons who are interested in taking part in the free screening should call 426-5524 for an appointment or for more information.