Save Your Heart Campaign

Twenty years after practicing traditional cardiology, in 2001, I started to find a way to incorporate aggressive heart attack prevention as part of a routine cardiology visit. By 2006, I became convinced that preventing heart attack is the future of cardiology as I witnessed a progressive incremental reductions in heart attacks in my own practice. I made enthusiastic presentations to several hospital administrators. The responses were the same: preventing heart attack is a good thing and that is in the future.... but prevention does not work for us... we need more, not less, heart attack and stroke patients,,, we have stroke center to support... The lesson I learned quickly - the healthcare system is hard if not impossible to change. The status seems to be working just fine except for patients and their employers. It seemed hopeless to fight a goliath and I stopped fighting for change. After this pandemic, there may be a new opportunity to improve patient outcomes while reducing cost by preventing most heart attacks and strokes.

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900,000 Americans have already died since the pandemic began, more than during the 1918 Spanish flu. It is a devastating calamity that we have not completely processed yet. While the acute phase of the pandemic appears to be coming to an end sometime this year, this pandemic will continue to impact our lives for years to come. As of February 2022, about one out of every 300 adult Americans who were alive before the pandemic are no longer here - killed by the COVID-19 virus.

 

There is another longstanding epidemic here is the US that we have been trying to fight for many decades. We have won many battles but continue to lose the war against heart attacks. Every year, about 600,000 Americans have their first heart attack. About 200,000 die without reaching the hospitals. They are largely preventable - an established medical truth that no one can dispute. So why have we not win the war. It's quite complicated. 

 

Experts are forecasting an increase in heart attack after the pandemic ends.  There are several reasons for this: patients are not having their usual follow-up visits, needed blood tests are not being done, medications are not being refilled, patients are not taking their medications regularly, diet is less healthy, lack of physical exercise and prolonged sustained mental and emotional stress from isolation and stress from work and family situations. And for the many millions who got infected and survived, there is also concern about an increase in heart attack risk. 

 

The is a high concentration of virus in the heart in addition to the lungs where it caused severe endothelial dysfunction. The arteries are rich in ACE2 receptors - the binding site of the spike protein and portal of entry of the virus into the cells of the endothelium. Once infected, these cells are destroyed after making millions of copies of the COVID-19 virus. This destruction of the endothelial cells causes endothelial damage and severe endothelial dysfunction. This is the cause of elevated cardiac troponin enzyme - a marker of heart muscle damage, among those hospitalized. Endothelial dysfunction initiates, fosters and, without optimal medical therapy, accelerates atherosclerosis - the plaque build up in the coronary arteries.

 

All of these are reasons behind our Save Your Heart Campaign. I believe we should make every effort to save more lives whenever it is possible after losing so many in the last two years. 

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For now, we will start a virtual campaign and produce a series of short ten-minute videos that are educational and empowering while also fighting medical misinformation and medical disinformation in social media. You will then be able to take charge and be responsible for not becoming another victim of a heart attack or stroke. We are here to help but ultimately, it is up to you to become more engaged and ask questions when you see your primary care physician and cardiologist on your next visit.

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The science-based approach that we developed and  refined since 2001 can be described simply as "stop your  heart attack before it happens". There are two steps to this approach: (1) determine if and how much calcified plaques are present in one's coronary arteries by coronary calcium scoring for eligible patients and (2) and if plaques are present, initiate a comprehensive medical therapy that induces plaque stabilization to prevent plaque rupture, that stops disease progression and even induces disease regression. This goal is achievable in most patients. We have proven that in our practice.

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The stakeholders are you - the patients, the cardiovascular healthcare industry, the insurance companies including Medicare and the federal government. Are their interests aligned?  (No, they are not.)  And if not, how can we make all the parties align themselves to a common goal - eliminating premature heart attack and stroke.