My dad had the high blood pressure and the high cholesterol, but him and his doctor went back and forth on when and how to intervene. With poor sleep, obesity, and a calorie-dense diet my dad had all the right risk factors which predictably led to a cardiac event requiring several stents. I'm grateful for medical technology such as CABG and PCI but not everyone is lucky enough to survive their first cardiac event. Until that puzzle is solved, decreasing any existing risk is really valuable.
This is a powerful reminder that in the vast majority of cases, cardiovascular disease doesn't just appear out of the blue. Your summary of the study showing that over 99% of CVD events are preceded by at least one suboptimal risk factor is a crucial message. It effectively debunks the myth of the "silent killer" striking without any warning signs and reframes it as a "predictable killer."
The case of "Frank" is a perfect and sobering illustration of this. It highlights a critical gap in our healthcare approach: the disconnect between the existence of risk factors and the awareness and management of them. The idea that "what you don't know can kill you" is particularly potent here. It underscores the importance of proactive and regular health screenings.
This also brings to mind the challenge of patient engagement and health literacy. Even when risk factors are identified, motivating individuals to make the necessary lifestyle changes or adhere to treatments can be difficult. Your call to action for annual screening is spot on, and it would be interesting to hear your thoughts on the most effective strategies to ensure that once these risk factors are identified, they are consistently and optimally managed.
Thank you for breaking this down in such an understandable way. This is a message that needs to be shared widely.
Suboptimal treatment was defined as BP higher than 120/80 or on BP meds, total cholesterol blood levels of >200 or taking lipid-lowering medications, fasting blood sugar> 100 or a diagnosis of diabetes, and past or current tobacco use
But that says if someone has a BP of 110/70 because of BP meds, the "good" BP is still a risk factor. The BP meds have no impact on risk? What good are BP meds if they don't reduce the risk? What would be optimal treatment for someone who comes in with BP of 130/90?
My dad had the high blood pressure and the high cholesterol, but him and his doctor went back and forth on when and how to intervene. With poor sleep, obesity, and a calorie-dense diet my dad had all the right risk factors which predictably led to a cardiac event requiring several stents. I'm grateful for medical technology such as CABG and PCI but not everyone is lucky enough to survive their first cardiac event. Until that puzzle is solved, decreasing any existing risk is really valuable.
Excellent and timely post, Dr. Mokotoff.
This is a powerful reminder that in the vast majority of cases, cardiovascular disease doesn't just appear out of the blue. Your summary of the study showing that over 99% of CVD events are preceded by at least one suboptimal risk factor is a crucial message. It effectively debunks the myth of the "silent killer" striking without any warning signs and reframes it as a "predictable killer."
The case of "Frank" is a perfect and sobering illustration of this. It highlights a critical gap in our healthcare approach: the disconnect between the existence of risk factors and the awareness and management of them. The idea that "what you don't know can kill you" is particularly potent here. It underscores the importance of proactive and regular health screenings.
This also brings to mind the challenge of patient engagement and health literacy. Even when risk factors are identified, motivating individuals to make the necessary lifestyle changes or adhere to treatments can be difficult. Your call to action for annual screening is spot on, and it would be interesting to hear your thoughts on the most effective strategies to ensure that once these risk factors are identified, they are consistently and optimally managed.
Thank you for breaking this down in such an understandable way. This is a message that needs to be shared widely.
Dr Tom Kane
You write
Suboptimal treatment was defined as BP higher than 120/80 or on BP meds, total cholesterol blood levels of >200 or taking lipid-lowering medications, fasting blood sugar> 100 or a diagnosis of diabetes, and past or current tobacco use
But that says if someone has a BP of 110/70 because of BP meds, the "good" BP is still a risk factor. The BP meds have no impact on risk? What good are BP meds if they don't reduce the risk? What would be optimal treatment for someone who comes in with BP of 130/90?
Is treated hypertension (and hypercholesterolemia, etc.) that is within normal parameters a risk factor? Or is it only a risk factor if still high?