Framingham Risk Scores

Live Healthier and Lower Your Risk for Heart Disease

  • Posted Jan 29, 2019
  • hchadmin

Did you know that according to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death in the United States?

February is American Heart Month and Holy Cross Hospital would like to encourage you to care for yourself, and your loved ones, by reminding you of the importance of preventive care. 

The most common type of heart disease is coronary artery disease (CAD), according to the CDC. The great news is that you can greatly reduce your risk for CAD through lifestyle changes and preventive care, including embracing a healthier spirit.

To keep your heart healthy, the American Heart Association recommends the following:
•    Maintain a healthy weight
•    Quit smoking and avoid secondhand smoke
•    Control your cholesterol levels and blood pressure
•    Drink alcohol only in moderation
•    Get regular exercise and eat healthier
•    Ask your doctor about taking aspirin every day (if you are a man over the age of 45, or a woman past menopause)
•    Manage stress

While controlling physical risk factors is obviously a great way to help prevent any condition, so is maintaining a healthier spirit. For example:
•    Remain optimistic. Research shows that happiness and a positive attitude are associated with lower rates of disease.
•    Control stress. Stress relievers like deep breathing and muscle relaxation exercises, as well as keeping a journal, can be helpful in controlling the impact stress has on your body.
•    Do everything in moderation. Don’t try to do too much at one time – make sure to have time for proper nutrition, sleep, work and play.
•    Create a network. Maintaining a close circle of family and friends can provide you with emotional support when you need it.

Lastly, getting annual physicals and tests from your doctor is key in sustaining your health and preventing heart disease. Having a primary care physician (PCP) who can coordinate your care is vital to your good health. A PCP typically specializes in family medicine, internal medicine or general practice.
If you don’t have a PCP, finding one is easy! Just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

As your trusted health partner for life, Holy Cross Hospital is committed to helping you Live Your Whole Life by nurturing well-being through body, mind and spirit.

How to Proceed?

  • Posted Jul 17, 2010
  • Alan Niederman, MD, FACC, FACP

If you fall into the age groups that I discussed in my last blog, what should you do?  First, remember that this discussion is only about asymptomatic patients. Those that do not have a history of heart attack, stroke or do not suffer from claudication, which is pain in the legs on exertion. 

First and foremost, if you are smoking stop, and after you stop, stay stopped.  Believe me it is not so simple if you judge from what my patients tell me.  Cholesterol levels are not the whole answer.  There is no such thing as a normal cholesterol level.  Each patient's level is a number and then an atherogenicity potential. Although these can be determined by particle testing and such, our knowledge remains incomplete and our methods crude.

What has been proposed is finding a simple and reliable method to identify which patients have evidence of atherosclerotic changes in their vessels and then try to prevent the furtherance of the disease process by medical i.e. lipid lowering treatment.  We have these methods available to us now and the article cited in my previous blog provides the background for these methods.  One is calcium scoring by electron beam imaging. 

It is fast, simple and accurate.  However, it provides individuals with a small dose of radiation (median 2.3 mSv).  If negative, it virtually excludes significant atherosclerosis and the chance of a cardiovascular event in 5-10 years is .6% at the greatest.

Another modality is carotid ultrasound which is done slightly differently than normal and looks at the intima- media and measures the thickness of it.  This measurement has been shown to correlate with the disease process.  It is not as predictive as calcium scoring but does not use radiation.  It is not clear whether both tests are additive.

Imaging in this manner and using the SHAPE guidelines, it is estimated that almost 50% of the patients screened would be in a higher class and eligible for lipid lowering therapy.  The cost of this screening varies, but some institutions offer it at around $150.

All of the information we have to date supports screening for all patients who have intermediate risk based on Framingham Risk Scores in addition to those patients with low HDLs.  It is very unlikely that a large randomized study will ever be done.  Who wants to be in the placebo group?  We just have to manage with common sense.

Is it true that lipid lowering therapy saves lives?  In my next blog I will explore that.


About Holy Cross Hospital

Holy Cross Hospital is a nonprofit, Catholic hospital in Fort Lauderdale, Florida, dedicated to innovative, high quality and compassionate care. For nearly six decades, Holy Cross has continuously expanded its services to provide leading-edge care for their patients in Florida and for those from elsewhere in the United States. Holy Cross also offers an International Services program to ensure that patients from outside the U.S. receive the care they need.

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