What a Preventive Cardiologist Can Do For You

Have you ever heard of a preventive cardiologist or wondered if you should see one?

A preventive cardiologist practices a subspecialty of medicine that is focused on lowering patients’ risk for developing heart disease and having a first heart attack or stroke. A preventive cardiologist also works with patients who already have cardiovascular disease to prevent further issues.

People most likely to benefit from seeing a preventive cardiology team include those with:

• A strong family history of heart attack, stroke or peripheral artery disease.
• A personal history of cardiovascular disease, especially in people younger than 60.
• Difficult-to-control risk factors for atherosclerosis, particularly significant cholesterol disorders.
• Controllable risk factors, including:
  • High blood pressure.
  • High blood sugar or diabetes.
  • Obesity, especially with excess abdominal fat.
  • Tobacco use.
  • Unhealthy diet.
  • Lack of exercise/sedentary lifestyle.
• Non-modifiable risk factors, including:
  • Gender: Men are at higher risk for cardiovascular disease than women.
  • Age: Older people, including postmenopausal women, are more likely to have heart disease.
  • Family history of cardiovascular disease.

New Tools to Reduce Cardiovascular Risk

Preventive cardiologists have more tools available than ever before to help measure and reduce patients’ cardiovascular risk.

Newer medications, such as SGLT2 inhibitors, GLP-1 receptor agonists for patients with diabetes and obesity, and PCSK9 inhibitors for patients with recurrent cardiovascular disease events such as heart attack, severe high cholesterol or familial hyperlipidemia are making a measurable difference for high-risk patients.

At the same time, more widespread coronary artery calcium scoring and advanced lipid testing allow for more nuanced and sophisticated assessment of cardiovascular risk.

“As preventive cardiologists, one of the things we can provide is advanced risk testing,” says preventive cardiologist Ian Neeland, MD, Director of the Center for Cardiovascular Prevention at University Hospitals Harrington Heart & Vascular Institute.

For example, advanced lipid and lipoprotein testing quantifies LDL particle number and small particle size and number, beyond just providing LDL cholesterol (sometimes called “bad cholesterol”) content. It may also be important to measure lipoprotein (a), which is a risk factor for early heart disease and blood clots. For some patients, it’s a distinction that matters a lot.

“High numbers here portend additional risk,” Dr. Neeland says. “People with high LDL particle numbers are at three-fold higher risk over five years for developing a heart attack, even when LDL cholesterol overall is considered normal. Higher cholesterol means higher particles, but there is a lot of variation. There’s no way to know that without doing this advanced testing.”

Working with Primary Care Physicians

Preventive cardiologists collaborate with primary care providers and their patients who are at high risk of heart attack or stroke. They can help in managing a patient’s care and are also available for guidance on a more informal basis.

Patients at high risk of cardiovascular disease should talk with their primary care physician about consulting with a preventive cardiologist to help manage their risk.

“We are laser-focused on risk assessment and risk mitigation. It’s what we do and focus on every day,” he says. “We can provide a very specific and detailed assessment of risk from a cardiovascular standpoint to provide appropriate care for patients in partnership with their primary care physicians.”

When a patient sees a preventive cardiologist, their health outcomes improve, Dr. Neeland says.

“There’s data that shows a preventive cardiology program really can improve outcomes for patients, by decreasing hospitalizations for cardiac events, like heart failure and heart attacks,” he says.

Related Links

UH Harrington Heart & Vascular Institute offers more options for cardiovascular care close to home with multiple locations across Northern Ohio. Ongoing investments in our local facilities ensure our team has the latest tools and therapies available to continue to deliver truly personalized care for patients where and when they need it most.