Dr. Monica Kher, MBBS, DNB (General Medicine), DNB (Cardiology), Specialist – Cardiology, Aster Hospital
The “2024 World Heart Day” is a global campaign to advocate initiatives to improve heart health and execute heart action plans to prevent cardiovascular disease (CVD) and protect communities from the world’s biggest killer.
Early detection of cardiovascular disease and risk assessment is the need of the hour. The American Heart Association (AHA) guidelines on the primary prevention of cardiovascular disease emphasize routine assessment for all adults aged 40 to 75 years and calculate 10-year risk of ASCVD (Atherosclerotic cardiovascular disease). For younger adults aged 20 to 39 years, the assessment of traditional CVD risk factors, which include age, gender, hypertension, diabetes, dyslipidemia, obesity, smoking status, diet, lack of exercise, and psychosocial stress, should be done at every 4 to 6-years interval.
Assessment of ASCVD risk remains the foundation of primary prevention.
- Risk-Enhancing Factors which should be assessed by the clinician are:
- Family history of premature ASCVD (males, age <55 y; females, age <65 y).
- Primary hypercholesterolemia.
- Metabolic syndrome requires the presence of 3 or more metabolic abnormalities:
a) A waist circumference of more than 40 inches in men and 35 inches in women.
b) Serum triglycerides level of 150 mg/dL or greater.
c) Reduced high-density lipoprotein cholesterol, less than 40 mg/dL in men or less than 50 mg/dL in women.
d) Elevated fasting glucose of l00 mg/dL or greater.
e) Blood pressure values of systolic 130 mm Hg or higher or diastolic 85 mm Hg or higher.
- Chronic kidney disease (eGFR 15–59 mL/min/1.73 m2 with or without albuminuria; not treated with dialysis or kidney transplantation).
- Chronic inflammatory conditions, such as Rheumatoid Arthritis, lupus, or HIV/AIDS.
- History of premature menopause (before age 40 yrs) and history of pregnancy-associated conditions that increase later ASCVD risk, such as preeclampsia.
- High-risk race/ethnicity (e.g. South Asian ancestry).
- Lipids/biomarkers: associated with increased ASCVD risk.
Worldwide, executive cardiac health screening programs have been routinely performed due to the rising incidence of cardiovascular disease. On the contrary, indiscriminate use of diagnostic screening and treatments can have deleterious effects on a patient’s physical and psychological state.
The rising prevalence of cardiovascular diseases, stroke, and hypertension especially in young has raised alarming concerns. It’s high time that appropriate strategies are developed to decrease this rising trend as CVD among young people is spreading like an epidemic. Preventive healthcare and innovative technology are the key to creating awareness and offering solutions.
Prevention is the key to heart health, and frequent heart health screenings play a crucial role in reducing cardiovascular risk. This allows timely detection of CVD and the implementation of treatment strategies to prevent complications.
Cardiac health check-up offers battery of investigations:
- Routine urine and blood investigations (including lipid profile, blood sugars, kidney functions, thyroid functions and liver enzymes).
- Electrocardiogram.
- Two-dimensional Echocardiography.
- Exercise stress test.
- CT coronary calcium score and CT Coronary angiography depending on the risk profile of the patient and medical history.
An ideal executive cardiac health program should be comprehensive, consistent, cost-effective and patient-centered. Lifestyle modifications, such as a heart-healthy diet, regular physical activity, smoking cessation, adequate control of diabetes, hypertension, dyslipidemia, and stress management, improve heart health.
The goal of a clinician is to have a good understanding of a patient’s estimated ASCVD risk and selective use of appropriate investigations and patient centered care. Screening may seem futile for asymptomatic healthy individuals, but it is worth it in preventing a fatal outcome of undiagnosed silent heart disease. Evidence suggests that people who undergo a health check are more likely to receive risk factor interventions. This highlights the effectiveness of preventive interventions in reducing longer-term multimorbidity.
On this World Heart Day, with the theme of “Use Heart for Action,” let’s unite in our commitment to empower the prevention of heart disease by early detection and treatment.
Prioritize your heart health as your heart deserves the best care. As rightly said, a healthy heart is a gift you give yourself.
