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Heart disease prevention: For your health and the community’s

"Put prevention into practice and, in doing so, demand more of yourself and our health care system."

By Phillip Bale, MD

While many significant advances have been made over the past several decades, heart disease remains the No. 1 killer in the country. Including stroke, cardiovascular disease accounts for approximately 40 percent of all deaths in the United States. Someone dies of a heart attack every 36 seconds in the U.S., and 40 to 50 percent of these deaths are sudden and unexpected. For many of those people, the first indication of a problem is sudden death. Heart disease will kill eight times more women in America this year than breast cancer and two to three times more Americans than all cancers combined. Due in large part to unhealthy lifestyles, Kentuckians are near the very top of the dismal statistics involving cardiovascular diseases in our nation.

There is good news, however. Large-scale clinical trials and observational studies published in reputable scientific journals now make it clear that most of these adverse events and deaths are preventable. There is even mounting evidence that reversal of atherosclerotic plaque, the primary culprit in most heart attacks and strokes, is now possible. Just a few years ago the concept of reversal of this disease was unheard of, but it is now time to shine a new light on what is possible and to dispel fatalistic beliefs with regard to cardiovascular disease.

Emphasizing prevention

The pathway to better health and prevention of heart attacks, strokes and interventional procedures varies from one person to another. Everyone has his or her own unique set of risk factors and requires personalized evaluation and planning for prevention. Lifestyle changes that emphasize a good diet, regular exercise, and avoidance of tobacco products or excessive alcohol consumption are central to any prevention strategy. However, it is important to recognize that lifestyle changes alone are often inadequate. Lab tests and imaging studies can identify other critical risk factors—often years or decades before an event would occur. Modern medications, combined with lifestyle changes prescribed for each person’s unique needs, are often essential to good outcomes.

As value becomes a common buzzword with respect to health care reform in America, prevention must escape the shadows and move to the forefront of our health care system. A cost-effective system, more concerned with prevention of disease than disease management, must evolve if value is to become a reality. Optimal medical care with an emphasis on prevention would radically alter the health and economy of our current dysfunctional system, with its perverse reimbursement policies that are penny-wise and pound-foolish.

I encourage everyone to take a moment to reflect upon the things most near and dear to them. Put prevention into practice and, in doing so, demand more of yourself and our health care system. By preempting cardiovascular disease, much heartache can be avoided while you, your family and all of us reap the benefits.

Dr. Bale is the Medical Director and Founder of Bale Prevention Center, in Glasgow, Ky. He is also a family physician with Primary Care Associates, a member of T.J. Health Partners, and faculty member with the University of Louisville Family Medicine Residency in Glasgow. Dr. Bale is also on the board of Directors of the Foundation for a Healthy Kentucky and the Friedell Committee for Health System Transformation.
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