Heart attacks are preventable.
How can that be true when we all know seemingly healthy people who have had unsuspected heart attacks?
Heart disease is the No. 1 killer of men and women in the United States. About 900,000 people will have a heart attack this year. One-fourth of first-time heart attack victims will die. One-half of first-time heart attack victims will have had no prior symptoms.
How then are heart attacks preventable? To prevent your heart attack, you have to know whether you are truly at risk. Coronary artery disease causes heart attacks. Simply put, if you have coronary artery disease you are at risk for a heart attack, and if you do not have coronary artery disease you are not at risk.
Traditionally, doctors have determined risk for coronary artery disease by whether you have risk factors such as smoking history, high blood pressure, high cholesterol levels, family history and diabetes. Lifestyle changes and medications for these risk factors have lowered the rate of rise of heart attacks over the years, but the data shows heart attacks are still our No. 1 killer.
We also have learned there are a significant number of people who have multiple risk factors for coronary artery disease who do not have the disease, and there are people with no risk factors who have significant coronary disease.
So, what we really want to know is not whether we are at risk for coronary artery disease but whether we already have it. If we have coronary artery disease, we are at risk for a heart attack and should do everything we can to decrease our risk. This would include aggressive lifestyle change and medications to reduce risk, and might include further cardiac testing if very significant disease is found.
If we do not have coronary disease, perhaps we could liberalize our treatment and not need medication to lower cholesterol, avoiding the cost and side effects.
There are tests available to simply, safely and inexpensively determine whether you have coronary artery disease and are at risk for a heart attack. These tests are just not commonly used.
To learn more about these tests, please join me for a program at 7 p.m. July 17 at Baptist Health HealthwoRx Fitness & Wellness Center. The program is free, but we ask that you register if you plan to attend by calling (859) 260-5500.
Dr. Phillip Hoffman, an internal medicine specialist, practices at Baptist Health Lexington.