A Healthy Heart: Unlocking the Key to Long Life
The heart of the matter is this: The single organ of our bodies that most rewards attention with a long and healthy lifespan is the heart. Flip side of this equation: Heart disease is the No. 1 killer in America, by a long ways.
This month, we go to a top authority for good advice on the key ingredients of medical care for your heart. The lesson faithful readers will see is that healthy people should stop worrying, but the first sign of any heart-related symptoms needs to be pursued aggressively. Read on for more.
A Maintenance Plan for the Heart
- Blood pressure: Check it every year.
- Weight: Check your body mass index (a measure of body fat based on height and weight; click here for a calculator) every year.
- Cholesterol test (lipid profile): Get your first check by age 20. If results are normal, check again in five years.
- Fasting blood sugar: Check this annually if you are overweight.
- Heart calcium scans. They expose patients to excessive radiation and have not been demonstrated to save lives.
- Total body CT scans. They examine the heart and other organs throughout the body, involve huge doses of radiation and have not been shown to improve outcomes. The FDA has warned the public about this procedure.
- Exercise stress tests, or treadmill tests, in people without symptoms. The chances of a false positive (i.e., abnormal) test are high. (An abnormal result — as we’ve noted on the Malone blog before for any medical test — brands you as a “patient” and puts you on the medical assembly line. It often leads to unnecessary heart catheterization, an invasive procedure in which long tubes are inserted through the blood vessels.)
- Some ultrasound examinations (echo tests). They should not be performed on healthy individuals, only on people with other signs of heart disease, such as a heart murmur or heart failure. Carotid ultrasounds are sometimes ordered for healthy people to determine if they have thickened walls of the artery. But this screening test can lead to unintended consequences. We strongly prefer to get a medical history, then measure the well-validated risk factors such as cholesterol and blood pressure.
- Fancy cholesterol tests. Well-meaning physicians frequently order special cholesterol tests that measure cholesterol “particle size,” sometimes known as VAP or NMR cholesterol tests. They are expensive and do not improve outcomes. They are unnecessary.
Heart Risk Factors You May Not Know
Here is more from the USA Today interview with Drs. Nissen and Gillinov on heart risk factors worth knowing about.
Patrick Malone & Associates