Heart disease: It’s in the genes
Published 8:30 pm Saturday, March 26, 2011
Genetic testing serves as another option in determining heart health
Heart disease is a serious problem, and one local doctor says most heart attacks can be prevented if patients are screened with the proper tests.
Cardiovascular disease is a factor in more than half the deaths in the United States, according to Dr. Christopher Dowd of Cornerstone Private Practice.
Statistics show that cardiovascular disease has been the No. 1 cause of death in the United States since 1920, and people are twice as likely to die from cardiovascular disease than cancer.
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Dowd hosted a presentation this week on “Optimal Health — The Heart of the Matter” at Sushi Aka.
His presentation focused on a recent University of Minnesota study that indicates if people are screened in advance and medicated properly, 90 percent of first-time heart attacks might be prevented.
Traditional standards of care are not as effective as most people believe, he said. Traditional methods might not properly indicate the likelihood of a stroke or cardiovascular disease.
“We don’t all look the same,” he said. “We shouldn’t be treated by an algorithm that says, ‘If this, then that.’”
Dowd presented cases in which patients exhibited characteristics that would be considered within the normal range, only to fall victim to cardiovascular disease or a heart attack soon afterward.
He cited the example of Tim Russert, former moderator of NBC’s “Meet the Press.” Six weeks before dying of a heart attack, Russert passed a stress test.
Doctors traditionally use stress tests to determine if there is a blockage of more than 70 percent, but he explained that heart attacks often occur in people who have blockages less than 70 percent.
Doctors also traditionally rely on the Framingham Risk Score to determine whether or not a patient is at risk of developing “hard” coronary heart disease, but this test has an 83-percent miss rate, Dowd said.
Many doctors are not looking at the correct markers, he said.
Dowd compared the human body to a jigsaw puzzle and said that genetic testing is a better method for determining how those pieces fit together. “If we just look at standard risk factors, we’re only looking at a few of the puzzle pieces,” he said.
Dowd uses two types of genetic tests in his practice — one that focuses on risks for heart attacks and the severity of heart disease, and one that looks at a patient’s responsiveness to clopidogrel, a medication used commonly in patients who have recently had a stent or a heart attack.
“Genetic testing can give us a perspective on risks that isn’t captured by any of the other standard risk factors we look at,” he said.
Once a patient understands his risks, they are better able to work with the doctor to create a plan of action, he said.