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Wednesday, July 15, 2015 12:05 am

Prevent heart attack and stroke

Don’t just react. Be proactive for a healthy heart.

Dr. Craig Backs works out regularly at Crossfit Instinct. He encourages patients to include exercise as part of their heart health program.
PHOTOS BY PATRICK YEAGLE

 

Heart attack and stroke will affect one of every two men and one of every three women in their lifetime. Cancer causes great suffering, but vascular disease kills suddenly and unpredictably, often in the prime of life.

Orthodox treatment relies on dramatic lifesaving intervention in the form of stents, bypass operations, pacemakers and defibrillators. When these are available, lives are extended.

But what if you don’t make it to the hospital when heart attack or stroke strike? What if the first signal of disease is sudden death? Would it not be better to prevent the event from occurring in the first place? Wouldn’t it save more lives at a lower cost?

Automobile safety is evolving from making a car safe for the occupants in the event of a crash to using technology to avoid the crash in the first place. Fire departments spend more time on inspections and education, preventing rather than just fighting fires. It is time to apply the same principles to vascular disease.

About two years ago, I became aware of the Bale Doneen method. I attended an educational program in late 2013 that dramatically changed my perspective on what to expect and what to do when confronted with patients at risk for heart attack and stroke. Those at highest risk have already had an event.

We all know that treating high blood pressure and getting people to not smoke and to take a statin is helpful. But there are still a lot of deaths and disability due to vascular disease, even in those whose “numbers” are good. Is that the best we can do?

Thankfully, I now know we can do better. I now pay attention to periodontal health by flossing and encouraging my patients to floss every day. I measure inflammation, using tests that are very specific to vascular inflammation, which is fundamental to the formation of plaque and plaque rupture. Plaque rupture or ulceration is the unpredictable event that sets in motion the events leading to formation of a thrombus (clot) that blocks vital blood flow to the heart or brain.

We measure the disease using Carotid Intima Media Thickness Scanning to detect plaque and monitor for response to treatment. Along with coronary calcium scoring, we can get an early warning that more should be done to prevent stroke and heart attack. Why measure risk factors when we can monitor the actual disease?

We look for conditions like sleep apnea, insulin resistance and other hormonal issues that are overlooked in the guideline-driven treatment methods. We encourage a diet that decreases inflammation by limiting the most prevalent poison in our food supply – sugar. We encourage exercise because sitting is as dangerous to the vascular system as smoking.

But perhaps the most important difference in my new approach is that each treatment plan is individualized. We include genetic testing when it will affect choices of medication or diet. The one-size-fits-all approach doesn’t work any better in health promotion than in clothing people. We need a “good fit” in our treatment plan for the best results.

Craig A. Backs, M.D., of Springfield specializes in personal medicine and heart attack and stroke prevention. For more information, visit www.craigbacksmd.com.

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