There are some new advanced heart disease tools…and boy do we need them! There are some heart-health trends that are concerning cardiologists. There is a crisis in terms of a lowered life expectancy for the first time in decades according to cardiologist Sadiya Khan, M.D., assistant professor of medicine and of preventative medicine at the Northwestern University Feinberg School of Medicine in Chicago. The lowered life expectancy is due to several reasons: 1) midlife and younger adults are dying of heart diseases more often- death rates rose 8.5% for adults aged 45-64 between 2010-2020. 2) Fatalities due to heart disease for those over the age of 65 also rose significantly with our older population growing. 3) The COVID pandemic fueled the heart disease resurgence. The side effects of the pandemic’s long-term legacy of weight gain, inactivity and stress raised heart attack deaths by 21% for those 45-64 and 17.9% for people over age 65. The virus itself also plays a direct role in how lingering heart risks have been found a year after COVID infection. COVID could emerge as the #1 risk factor for future heart disease. We know a lot about how our lifestyle habits- diet and exercise-can prevent or increase cardiovascular risk. There are 4 new advanced heart disease tools to know and ask your doctor about.
- Cleerly- an FDA approved system created by James Min, M.D. for evaluating heart plaque in CCTA (coronary computed tomography angiography) images. The plaque is assigned to a risk stage determining if it is hard stable plaque (good) or soft unstable plaque (not good). Patients can actually view the pictures and see what’s going on inside their own heart. This motivates people to stick with their medications and healthy habits. Cleerly health
- Intravascular Lithotripsy is a new technique approved by the FDA in 2021 that uses shock waves to break up hard plaque deposits in vessels (similar to what they use to break up kidney stones). Patients can receive a stent after this procedure that are stronger, safer and more flexible. Biodegradable stents are on the horizon.
- Advanced heart drugs: Sodium glucose transporter 2 (SGLT-2) inhibitors have been on the market to treat diabetes. But they really reduce episodes of heart failure in patients with or without diabetes. Studies have shown it can be used to cut the risk of hospitalization or death from heart failure by 33%. The other drug is PCSK9 for those who cannot tolerate or have not seen enough of a therapeutic effect with statins. It is given by injection q 3 or 6 months and lowers LDL cholesterol by 50-60% and also reduces the odds of a heart attack by 20% more than statins alone.
- Transcatheter aortic valve replacement (TAVR). Instead of requiring open heart surgery which is deemed too risky for the elderly population (that need it most), the aortic valve can be repaired by implanting a new valve using a catheter that is threaded through the femoral artery. Patients are usually discharged after 1 overnight stay in the hospital.
According to a 2021 report from the American Heart Association, 77.5% of men and 75.4% of women ages 60-79 have some form of cardiovascular disease. Among those of us 80 and older, 90% have it. And by the time women reach their 70’s or 80’s, their risk of heart disease exceeds that of men. I know these statistics sound daunting….but the more we are aware of our own risk factors and have tools to measure our own heart disease, the more we can be proactive in prevention and early treatment.
Harrar, S. America’s war against heart disease. AARP Bulletin. Jan/Feb 2023. P 8-16.