Technology can spot patients earlier for symptoms beyond traditional heart risk factors

Recent research suggests new strategies for treating cardiovascular disease -- the long-established No. 1 killer in the United States.

By Susan J. Landers, AMNews staff. Dec. 13, 2004.

Washington -- Physicians can effectively use a range of technologies, including electrocardiograms and ankle-brachial blood pressure readings, to help determine which of their patients might be headed for a heart attack or stroke, even if they have only moderately elevated risk factors.

"Now we can identify older men and women who don't have any clinical disease or other risk factors and yet who are at very high risk," said the study's author Lewis Kuller, MD, DrPH, professor of public health at the University of Pittsburgh Graduate School of Public Health.

Dr. Kuller presented findings from the Cardiovascular Heart Study, a population-based longitudinal study of coronary heart disease and stroke in adults 65 and older, at the American Heart Assn.'s scientific sessions held in New Orleans in early November.

Dr. Kuller and colleagues found that early cardiovascular changes such as narrowing of the carotid arteries, electrocardiographic abnormalities and measures of carotid intima-media thickness were strong, independent risk factors for future heart attacks and strokes.

The researchers analyzed data for 2,454 patients with subclinical disease and 1,608 people who did not have early evidence of cardiovascular disease. They found that, 10 years later, those with early evidence of subclinical disease faced a substantially higher risk of cardiac events.

"Early interventions, perhaps with drugs to treat cholesterol and hypertension, as well as controlling diabetes and making modifications in exercise and diet, could perhaps help to reverse the process," Dr. Kuller said.