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Health Beat | Risk factor assessment key to heart health

Cumberland Times-News - 2/18/2024

Feb. 18—CUMBERLAND — Heart disease has been the primary cause of death in the U.S. since 1950.

Part of the reason for that is there's no definite way to predict someone's risk of having a heart attack.

There are known risk factors for heart disease that include high blood pressure, smoking, high cholesterol, diabetes, obesity, unhealthy diet, physical inactivity and too much alcohol.

"You can greatly reduce your risk for heart disease through lifestyle changes and, in some cases, medicine," according to the Centers for Disease Control and Prevention.

While symptoms of heart failure can happen slowly and be hard to diagnose, studies are underway to better assess someone's risk for heart disease.

Dr. Christopher Haas is medical director of cardiology at UPMC Western Maryland.

All human beings have some degree of plaques — deposits of fat, cholesterol and other substances that build up — in their coronary arteries, he said.

Over time, plaques can narrow or block arteries throughout the body and lead to health problems.

"Pretty much everybody is at risk at some point in their lifetime," Haas said. "Even though everybody has the disease, not everybody progresses to the disease where it becomes obstructive or ruptures."

It can be hard to know when plaques will become dangerous for a patient, but studies aim to learn more.

According to the British Heart Foundation, a blood test for certain antibodies could be used across the United Kingdom in three to four years to determine a patient's risk of heart and circulatory diseases.

Further research is underway to learn whether the antibodies could be produced and administered therapeutically.

"This study ... is looking at a specific antibody that goes after essentially the LDL molecule, so the bad cholesterol molecule that makes the plaques," Haas said.

"If you have a lot of these antibodies, then it means that you're getting rid of the LDL," he said and added patients with low levels of the antibodies could be at higher risk for a heart attack.

"The question is going to be, does this particular antibody tell us when somebody is imminently ready to rupture, or is it just a marker for patients that are going to make more and more plaques," Haas said.

Statins, which have been widely prescribed for patients for decades, reduce production of and restrict movement of LDL cholesterol in blood, and bolsters the defense mechanism of artery inner lining.

"They're the only medications that we know that approach all three of those issues," he said.

In about the past two decades, a major focus in the medical community has been on preventative cardiology, said Dr. Hani Alkhatib, director of the structural heart program at UPMC Western Maryland.

Coronary calcium scoring is a non-invasive scan of the heart that can be used on patients with certain risk factors.

The test looks for calcium deposits in the arteries.

"Even in a person with completely normal cholesterol, and they have a high calcium score, that is still an indication for them to be on a statin," Alkhatib said.

A risk calculator can help determine what patient should undergo coronary calcium scoring, he said.

Other tests include heart imaging that help determine if plaque buildup has narrowed the coronary arteries.

"That's a very good initial test to help us identify whether a person has blockages," Alkhatib said.

The testing path is determined by whether a patient has symptoms, as well as their age and other risk factors.

People should talk to their primary care physician to learn more about their heart health.

Meanwhile, diet and exercise are important, Alkhatib said.

At least 30 minutes of brisk walking per day promotes a healthy lifestyle, he said.

"I always encourage my patients to check their blood pressure at home," Alkhatib said.

Teresa McMinn is a reporter for the Cumberland Times-News. She can be reached at 304-639-2371 or tmcminn@times-news.com.

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