Can A Cardiologist Predict Your Heart’s Future?
A cardiologist is a doctor who specialises in the treatment of heart disease. This is an established fact. But can a cardiologist foresee the future of your heart? Let’s find out.
Doctors used to predict the risk of developing heart disease based on a variety of risk factors such as diabetes, high cholesterol, blood pressure, smoking, etc.
However, many people have more than one such risk factor, and their combined effect on the heart is multiplicative rather than additive.
As a result, researchers created risk calculators that take all of these risk factors into account and provide a score that predicts an individual’s risk of developing a heart attack. The most accurate risk assessment is the ASCVD risk score, which is easy to determine during a visit to the doctor.
What are the types of cardiovascular risk factors?
Cardiac risk factors are broadly classified as modifiable or non-modifiable. The presence of one or more risk factors raises a person’s chances of developing cardiovascular disease.
Risk factors for cardiovascular disease that cannot be altered are known as non-modifiable risk factors. Among these are a person’s age, ethnicity, and family history (genetics cannot be changed).
Modifiable risk factors for cardiovascular disease are those that can be reduced or controlled through changes in behaviour. Smoking, diet, and exercise are a few examples of how people can reduce their risk of developing cardiovascular disease by making certain lifestyle changes.
Cardiovascular diseases (CVDs) are a group of illnesses that primarily affect the heart and blood vessels. Examples of CVDs include coronary artery disease, rheumatic heart disease, cerebrovascular disease, peripheral arterial disease, deep vein thrombosis, and pulmonary embolism. According to the Indian Council of Medical Research and the Registrar General of India, India accounts for roughly 60% of the global burden of cardiovascular disease.
Did you know that early detection and modification of risk factors can prevent 90% of heart diseases?
What are cardiac risk calculators, and how effective are they?
A cardiac risk calculator is a screening tool that analyses your personal health data to predict your future risk of cardiovascular disease. The information thus obtained can assist you in taking steps to reduce your risk.
The doctor will use the results of the cardiac risk calculators to:
- Examine your current heart health.
- Determine your likelihood of high blood pressure and high cholesterol.
- Assist you in taking steps to avoid heart-related problems.
- Choose appropriate treatments to reduce your risk of heart disease.
- Examine the efficacy of treatments.
A heart disease risk assessment calculator might take into account your age, sex, blood pressure and use of medications to treat high blood pressure, cholesterol levels and use of statins to treat high cholesterol, diabetes status, family history of CVDs, and other modifiable risk factors like smoking history and body weight, among others.
Two of the most reliable cardiac risk calculators are the ASCVD risk calculator and the Reynolds risk score.
ASCVD Risk Calculator
The Atherosclerotic Cardiovascular Disease (ASCVD) Risk Calculator predicts the risk of developing a heart problem. It is a tool that contains a series of questions to help assess the chances of a person between the ages of 40 and 79 developing heart disease over the next 10 years as well as over their lifetime.
Reynolds Risk Score
The Reynolds Risk Score evaluates heart disease risk for all but excludes people with diabetes because they already have a higher likelihood of heart disease and strokes.
This tool takes into account parameters such as your age, sex, blood pressure and cholesterol levels, and family history (whether your mother or father had a heart attack before age 60).
It also takes into account your hsCRP level, which may be requested as part of a blood test to determine your risk of coronary artery disease.
How is cardiac risk calculated?
Cardiac risk calculators give a heart disease risk score as a percentage. The lower the percentage, the lower your chances of developing heart disease in the next 10 years. The higher the percentage, the more likely you are to have significant heart problems now and in the future.
To calculate your score, the tool compares your information to patient data from previous heart disease clinical studies.
Many heart risk calculators classify your risk of cardiovascular disease as:
- Low: Less than 5% risk
- Borderline: 5% to 7.4% risk
- Intermediate: 7.5% to 19.9% risk
- High: More than 20% risk
Depending on your cardiovascular risk assessment score and symptoms (if any), your healthcare provider may order additional tests such as:
- Blood tests
C-Reactive Protein
Lipid Profile Tests
- Electrocardiogram (ECG)
- Exercise Stress Test
What is done after the risk calculation?
Furthermore, with the introduction and widespread availability of various tests such as TMT, stress echocardiogram, CT calcium score, CT angiogram, and so on, the accuracy of this prediction has improved. These are the first-line tests used to screen for heart disease and refer patients to an angiogram, which is the next and final-line diagnostic test. An angiogram is currently the gold standard test for detecting heart disease, and doctors will recommend the appropriate test based on your clinical history and examination.
How can you lower your risk score?
A heart-healthy lifestyle can aid in the prevention of heart disease. Here are some suggestions to help you maintain a healthy heart.
- Be physically active
Heart disease risk can be lowered by engaging in regular, daily physical activity. Exercise not only helps you maintain a healthy weight but also lowers your risk of developing heart-related illnesses like high blood pressure, high cholesterol, and type 2 diabetes.
- Eat a heart-healthy diet
Dietary approaches to stop hypertension (DASH) and other heart-healthy eating regimens can lower the risk of type 2 diabetes, lower blood pressure, and improve cholesterol. Fresh fruits and vegetables, lean meats and fish, low-fat or fat-free dairy products, and whole grains are all part of a heart-healthy diet.
- Maintain a healthy weight
Heart disease is more likely to develop in people who have conditions linked to being overweight, such as high blood pressure, high cholesterol, and type 2 diabetes. A BMI of 25 or higher is regarded as overweight and is typically linked to higher blood pressure, cholesterol, and an elevated risk of heart disease and stroke.
- Get good quality sleep
Lack of sleep increases the risk of obesity, high blood pressure, heart attacks, diabetes, and depression in individuals.
- Manage stress
Physical activity, relaxation exercises, or meditation can help you manage your stress and thereby improve your health.
- Do not smoke
Stopping smoking and not breathing secondhand smoke is one of the best things you can do for your heart. Cigarette smoke contains chemicals that are harmful to the heart and blood vessels. It depletes the oxygen in the blood, raises blood pressure and heart rate, and causes the heart to work harder to supply enough oxygen to the body and brain.
- Get regular health screenings
High blood pressure and cholesterol can both harm the heart and blood vessels. You probably won’t be able to tell if you have these conditions without getting tested. Regular screenings can help you stay informed about your health and whether or not you need to take action.
In India, heart disease is more prevalent and occurs at a younger age than in Western countries, and data suggest that 90% of heart disease is preventable through early detection and risk factor modification.
Coming back to the interesting headline, “Can a cardiologist predict your heart’s future?” The answer is a big “YES.”
References:
- The Future of Heart Attack Prediction
https://mendedhearts.org/story/the-future-of-heart-attack-prediction/
- New Tests Can Improve the Ability to Predict Future Heart Attacks
https://health.clevelandclinic.org/new-tests-can-improve-the-ability-to-predict-future-heart-attacks/
- A Novel Way to Predict Heart Attacks — Years Before They Occur
https://health.clevelandclinic.org/a-novel-way-to-predict-heart-attacks-years-before-they-occur/
- Changes in heart shape can predict future sudden cardiac arrest
https://www.kcl.ac.uk/news/changes-in-heart-shape-can-predict-future-sudden-cardiac-arrest
- India’s burden of heart diseases: Study says elderly, women more at risk
https://www.downtoearth.org.in/blog/health/india-s-burden-of-heart-diseases
- Cardiovascular diseases
https://www.who.int/india/health-topics/cardiovascular-diseases
- Heart disease statistics 2022
https://www.singlecare.com/blog/news/heart-disease-statistics/
- Cardiovascular Disease Risk Factors
https://ada.com/cardiovascular-disease-risk-factors/
- Strategies to prevent heart disease
https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease-prevention
- Cardiac Risk Calculator
https://my.clevelandclinic.org/health/diagnostics/17085-heart-risk-factor-calculators
About Author –
Dr. Jagadesh Madireddi, Consultant Cardiologist, Yashoda Hospital, Hyderabad
MD, DM (Cardiology)