Risk factor screening for Heart Attack Prevention
Who is our Hardy Heart program for?
Do you want natural treatments to prevent a heart attack or stroke?
Do you have a Framingham risk score of intermediate?
Do you have a family risk of early heart disease?
Are you on any medications for blood pressure or cholesterol?
Have you had a heart attack or stroke?
Are you diabetic?
Do you have a body mass index of 30 or more?
Do you have family history of high cholesterol?
Do you have elevated blood pressure and would like to treat it without resorting to medications?
Do you have erectile dysfunction?
Did you have high blood pressure when you were pregnant?
Do you have sleep apnea?
Do you have chronic obstructive pulmonary disease?
If you've answered yes to any of the above questions then you likely are a candidate for further screening and subsequent management of any risk factors for developing atherosclerosis or stroke. Our medically supported program includes initial screening for artery health, determination of existing plaque, and a plan to address the contributors to the plaque progression . This plan includes medications, nutraceuticals, dietary support, and physical exercise suggestions. Book a consultation to learn more about the program.
Hardy Heart Program
How Plaque is made
It is very important to understand how plaque is formed in our blood vessels in order to be able to develop a plan to prevent more plaque from forming in our blood vessels.
We can use the diagram above to refer to when trying to understand how plaque forms and what are the roles of LDL , HDL, and the lining of the artery called the endothelial lining.
Let’s think of the endothelial lining as a net that lines the inside of our arteries. Let’s think of LDL as particles of varying sizes floating around in our blood. Think of these different size particles as marbles, golf balls, and baseballs with the dense LDL (as shown in the diagram above) being the marbles. When the net lining the artery is functioning normally then what we have is adequate protection from plaque production therefore low risk for heart attack and stroke. Part of the reason we have lower risk of heart attack and stroke when it is functioning normally or healthy is because healthy levels of nitric oxide will be produced therefore causing the blood
vessel to fully dilate and therefore lower blood pressure. As well, with adequate nitric oxide levels, the marbles will have a more difficult time to slip through the net as shown in the diagram above where the net is unhealthy. If the net is unhealthy, then you can notice that mostly small dense or marble size particles make it through and the larger golf balls or baseballs don’t generally slip through. This helps to
understand why determining your composition of your LDL is so important along with determining the health of your lining of your artery (net). You can also notice that there are HDL particles floating around as well in our blood. What do HDL particles do in our blood? These particles are like cholesterol garbage trucks that travel through our blood looking to pick up LDL particles (marbles, golf balls, baseballs) and take them back to the liver to be remade into new LDL particles. When you look at the
HDL particles you can notice there are different size particles (or cholesterol garbage trucks) that have different efficiencies when picking up the LDL particles. The most efficient HDL particles are the HDL 2b particles. So you can see why having adequate HDL particles in your blood can affect your risk for developing a stroke or heart attack. Once those marbles have slipped through the artery lining or net, then the next step is for one of our white blood cells of our immune system (macrophages) to try and
remove the LDL particle (marble) that has slipped through the lining of the artery (net). When the white blood cell collects some LDL particles (marbles) then it produces a foam cell which when joined with other foam cells, they form plaque leading to atherosclerosis or coronary artery disease. Over the years if this process continues, the result is plaque building up in the artery wall like a pimple forms with acne.
Progressing further in the process, this pimple can burst and cause a clot in the artery which is called a heart attack.
Risk factor Management
Current Model
New Technology
Current Model
The current model of delivering patient care when it comes to heart health has good intentions but does have it's shortcomings.
New Paradigm
New Technology
Current Model
The improved knowledge about heart health has raised the level of care when it comes to prevention and treatment of heart disease. Watch for one of our seminars to help explain the often confusing topic on how to prevent having a heart attack. In the seminar we explain why the current model of prevention misses many patients who need more aggressive management even though they're considered moderate or low risk.
New Technology
New Technology
Diabetes - The Start of Arteriosclerosis
A combination of improved knowledge about the complexities of how arteriosclerosis develops and the technology that's become available because of this knowledge enables much greater monitoring of risk factors.
Diabetes - The Start of Arteriosclerosis
Diabetes - The Start of Arteriosclerosis
Diabetes - The Start of Arteriosclerosis
Our epidemic of obesity is acting as a starting point for a large proportion of our population to cultivate the seeds of arteriosclerosis.
Testing
Diabetes - The Start of Arteriosclerosis
Statin Drugs
The plethora of available tests to help manage the risk factors or the monitoring of arteriosclerosis in a patient makes patient management better than its ever been. We are especially happy to announce that we'll be adding a comprehensive carotid ultrasound assessment to our selection of comprehensive risk factor screening available to help with your health. The program we offer for stroke and heart attack prevention has helped hundreds of people to avoid or greatly reduce the risk of having a stroke or heart attack.
We also encourage the testing of endothelial health as it's the earliest indicator to use for heart attack prevention.
Statin Drugs
Diabetes - The Start of Arteriosclerosis
Statin Drugs
A common family of cholesterol medicines used to lower cholesterol to prevent heart attacks. Should you be taking this family of medication? Did you know that there are studies that indicate that statin drugs don't help over 90% of people on them? The paradigm is changing from a cholesterol centric problem to a more multiple cause centric problem where there are proven ways to increase life span.
Carotid Artery Assessment - Carotid IMT /Plaque Detection
What Is A Carotid Artery Assessment
A carotid artery assessment involves an ultrasound scan of both the left and the right carotid artery. With traditional ultrasounds of the carotid, the goal is to assess if there are significant blockages in the carotid artery by use of Doppler. Doppler ultrasound is used to determine how much the artery is blocked by measuring the blood flow through the artery. It may not be effective for identifying plaque in both the common and external carotid. Our program examines each part of the external and internal carotid as well as the bulb to identify hard and soft plaque present. This program is therefore able to measure the success of the treatment by showing the halting of plaque formation.
How Is Our Carotid Assessment Different
When a patient typically goes for a carotid artery assessment it usually results in a Doppler test to determine if there's significant stenosis or narrowing of the artery without indicating the vulnerability of the plaque present. Our program, in addition to carotid IMT, identifies plaque present in the external carotid artery, the internal carotid artery and the common carotid artery. In addition, the vulnerability of the plaque is assessed to help identify the likelihood that the plaque could rupture and cause a stroke or heart attack. Our scan also provides an indication of how much the artery is narrowed.
Why is it important to monitor the carotid artery for plaque
According to a Major Study in the July 2017 Edition of the American Journal of Cardiology: It is important to assess plaque when doing a carotid ultrasound.
One of the highlights of the study which included about 21000 men and women, was that even with the carotid IMT being less than 1 mm, greater than 30% of the people were showed to have mixed or soft plaque putting them at elevated risk. Additionally, even though people had a normal carotid IMT, finding mixed or soft plaque was common, further emphasizing the importance of looking for plaque when an ultrasound is performed. This is part of our motivation to incorporate the ultrasound component to our program. Call for your complimentary consultation to find out more.
Why a Carotid Doppler Test Fails
A doppler test for the carotid artery involves measuring the blood flow speed through an artery measured with ultrasound. The doppler test may not be accurate when it comes to monitoring for common carotid artery plaque. This can also be said for the external carotid artery. With early detection and management of atherosclerosis, the key to prevention is sequential measuring of the carotid IMT to determine if measures undertaken to slow atherosclerosis are working.
Why Our Carotid Assessment Works
Our carotid artery assessment involves measuring the carotid IMT and plaque detection which helps direct how aggressively the risk factors should be managed. The Society for Heart Attack Prevention and Education endorses the use of carotid IMT for early detection of atherosclerosis. The society uses carotid IMT along with coronary calcium to detect atherosclerosis and similarly our clinic uses both of these testing modalities to prevent heart attacks and strokes. Call our clinic today to book your assessment at 780-700-1692
High Blood Pressure
High blood pressure is one of the many risk factors for the development of coronary artery disease, it's also one of the worst. Many people would be surprised to know that if both cholesterol and blood pressure were elevated, high blood pressure would promote artery disease faster. It is the silent killer. Many people with family history of elevated blood pressure become comfortable with their elevated pressure and don't feel that it can be managed or that it won't contribute to an earlier heart attack or stroke. This cannot be further from the truth. Whether you have family history or not, the goal is to manage it with all efforts.
It may be surprising that many people who've been told their blood pressure is normal are actually walking around with elevated blood pressure contributing to the development of coronary artery disease. Diagnosing high blood pressure with in office blood pressure tests and home testing may not be the most accurate way. Much research has clearly shown that 24 hour blood pressure is a reliable method to diagnose hypertension and other blood pressure risk factors. In the Hardy Heart Program we use 24 hour blood pressure monitors to manage blood pressure. Recent studies such as SPRINT have shown how out dated the blood pressure guidelines have been.
Many patients want to able to manage their blood pressure without taking blood pressure medications and are open to the multiple ways there are to help manage the pressure. In a recent study published, 62% of patients could taper or discontinue drug therapy by utilizing targeted nutrient and lifestyle changes. Our programs incorporate this approach for people willing to make changes. In some cases, pharmaceutical therapy is utilized.