A Message from Dr. Jay N. Cohn, MD
All cardiovascular morbid events are a consequence of a complication in a progressive biological disease process in the large arteries, the small arteries or the left ventricle. By identifying the disease process at an early asymptomatic phase it is possible to intervene with therapy that can slow the biological disease process and/or prevent complications that precipitate symptoms.
The HeartSavers Clinics' process includes our 10-test panel utilized in our evaluation, which consists of tests that document the health of the large arteries, the small arteries and the left ventricle. Small artery disease is manifested by reduced small artery compliance (C2), elevated diastolic blood pressure, elevated exercise blood pressure, microalbuminuria, and abnormal retinal vascular photography.
Large artery disease is characterized by reduced large artery compliance (C1), elevated systolic blood pressure, widened pulse pressure, and atherosclerotic plaques in the carotid arteries. Left ventricular disease is associated with abnormal ECG, enlarged or hypertrophied left ventricular chamber, and an elevated blood level of NT ProBNP.
Each of the 10 tests are scored, zero for normal, one for borderline abnormal and 2 for abnormal. The total score of the 10 tests defines the severity of disease: 0-2 normal, 3-5 early disease and 6+ advancing disease. In general, scores of 6 or greater mandate preventive drug therapy and scores of 3-5 mandate sequential re-testing to document disease progression. A normal score should reassure an individual that they are currently free of cardiovascular disease and would ideally be tested again at 5-year intervals.
The 10-test assessment also opens the door to selective pharmacologic intervention. Optimal preventive therapy may vary depending on the site of the potential disease.