Evidence Based Risk Assessment for Primary Prevention to Target Asymptomatic, Subclinical Disease in Patients with Intermediate to High Risk.

This statement is based on the following question. Is terminology that identifies “primary prevention” the correct classification, if the patient already has asymptomatic, subclinical, yet active disease? Can we not do a better job identifying asymptomatic, subclinical disease, and thus do a better job at “primary prevention”?

Cardiovascular disease is by far the number one killer of both men and women in America. In an article from, Dr. Michael O’Riordan wrote,

In the next 20 years, more than 40% of the US population is expected to have some form of cardiovascular disease, and this will triple the total direct medical cost of caring for hypertension, coronary heart disease, heart failure, stroke, and other forms of cardiovascular disease form the current $273 billion to more than $800 billion, according to a new statement from the American Heart Association.”

Dr. Paul Heidenreich adds,

“In addition, the AHA estimates that the prevalence of cardiovascular disease will increase by approximately 10% over the next 20 years given no changes to prevention and treatment trends. If some risk factors, such as diabetes and obesity, continue to increase rapidly, cardiovascular disease prevalence and associated cost might increase even more.”

In September, 2013 another article in, stated:

“Doing nothing about CVD will Cost $47 trillion in the next 25 years.”

The same articles also states:

“We do have a chance, and one that we cannot afford to miss. This is an epidemic that need not happen.”

“Doing nothing” seems a costly option for a “preventable” disease that will affect 40% of the population. More and more healthcare providers are adopting aggressive CVD prevention protocols. These protocols include advanced lipid testing (or ALT) which was pioneered at the Lawrence Livermore Laboratory in Berkeley, CA, which later evolved into Berkeley Heartlab, Inc., Carotid-IMT testing through ultrasound scan, endothelial function testing (measuring vascular reactivity), echocardiogram and nuclear stress testing.

Each of these diagnostic tools plays a vital role in helping identifying asymptomatic, subclinical disease. Groups employing these tactics include noted cardiologist, Arthur Agatston, MD (author of The South Beach Diet), The Bale/Doneen Method (Dr. Bradley Bale and Dr. Amy Doneen and their Heart Attack and Stoke Prevention Center) and SHAPE (Society for Heart Attack Prevention and Eradication). Each of these groups provides testimonials of the declining event rates, when these aggressive CVD prevention tools are properly utilized.

For more information, review the details on our website, or visit the following related sites.


← Return to Blog Listing