3 Ways to Attack Your Heart Risk

Cardiologist Joel K. Kahn, MD explains the smartest ways to approach heart disease prevention.

Get the right tests.

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Basic imaging tests, such as electrocardiograms and stress tests, detect only large, old heart attacks or the worst blockages (more than 70 percent narrowed). Only advanced imaging tests, such as coronary artery calcium scans or carotid artery intima-media thickness (CIMT) ultrasounds, find early signs of silent atherosclerosis. I recommend them to high-risk people: those with type 2 diabetes, abnormal cholesterol, high blood pressure, obesity, a family history of heart disease, or a personal history of smoking. Though these tests may not always be covered by insurance, you may find them at a lower cost at some centers. In my community in Michigan, several hospitals offer them for between $50 and $125. If a test detects mildly clogged arteries, your doctor may recommend things like daily aspirin or other meds, a cholesterol-lowering plant-based diet, vitamin K², and exercise and stress management to reverse the damage.

Avoid the three D’s: Delay, denial, and death.


An artery that is only 50 percent blocked can become fully obstructed in a matter of hours, leading to a
serious heart attack. That’s why I tell my patients to never ignore worrisome symptoms such as chest pressure, shortness of breath, or sudden fatigue. These may be signs of a forthcoming heart attack. If you’re concerned, get checked ASAP.

Watch your blood sugar.


Contrary to what most of my patients think, not all “bad” LDL cholesterol is equally harmful. The latest science shows it is more damaging when it is modified by oxygen or glucose. Tests that directly measure these modified LDLs aren’t widely available, but doctors can follow this simple secret to get an estimate: The higher your blood sugar, the higher your modified LDL cholesterol levels. Ask your doctor about including an HgbA1C blood sugar test in your next workup.

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