Preventive Cardiology

Preventive cardiology is an area of medicine that focuses on lowering your risk for cardiovascular diseases (conditions that affect your heart and blood vessels). These diseases are the top cause of death in the U.S. and around the world. But they’re often preventable. The key is stepping in early before serious issues, like heart attack or stroke, occur. Or even before you have any risk factors.

Some hospitals have preventive cardiology programs. They’re made up of doctors, nurses, dietitians, psychologists and others. These healthcare providers all work together to make plans tailored to your needs.

Your primary care provider (PCP) may refer you to a preventive cardiology program for these reasons:

• Family history: If heart or blood vessel issues run in your biological family, that’s a good reason to think about prevention. Ideally, you’d start as early in life as possible. This is true even if you don’t have any risk factors and feel fine.
• Risk factors: The more personal risk factors you have, the greater the odds of developing heart disease. These include high blood pressure, high cholesterol, having overweight/obesity, diabetes, tobacco use, unhealthy diet, poor sleep and not getting enough physical activity.
• Cardiovascular disease diagnosis: Preventive cardiology can help if you’ve been diagnosed with atherosclerosis. You can take steps to slow plaque buildup or keep it stable. This can help lower your risk of a heart attack or stroke.
• Prior heart attack or stroke: Having a heart attack or stroke is one of the strongest risk factors for having another one. In other words, you’re far more likely to have a second one than you were to have the first one. Prevention efforts can help lower your risk.

Preventive cardiology can help people of all ages. It’s never too early to think about your heart and take action to protect it.

What is a preventive cardiologist?

A preventive cardiologist is a physician who specializes in helping people lower their heart disease risk. You’ll work with this type of doctor if you join a preventive cardiology program.

They don’t take the place of your usual provider, like your PCP. But they become another member of your care team. They’ll work closely with your PCP and other providers so everyone stays on the same page.

Preventive cardiologists are also helpful because they’re very knowledgeable about the newest information on heart disease risk factors — like the different subtypes of cholesterol that don’t show up on standard blood tests that may increase your risk.

What can I expect at my first preventive cardiology appointment?

Your first visit will involve a complete risk assessment. This will show you and your care team any risk factors you have right now. Your preventive cardiologist will:

• Talk with you about your medical history
• Ask you about your daily habits, including foods you eat and how much you move around
• Perform a physical exam
• Order blood tests to check your cholesterol, blood sugar and other substances linked with heart disease risk

You might also need tests that check your heart and blood vessels. You may have them on the same day or a different one. Possible tests include:

• Electrocardiogram (EKG/ECG)
• Echocardiogram (echo)
• Stress test
• Coronary artery calcium test

The risk assessment guides your treatment plan. Your care team may use different “risk calculators” and tools to come up with a score. This number shows how likely you are to develop heart disease within so many years (for example, in the next 10 years). Your team will talk about the results with you. They’ll also set up a schedule for future visits.

Seeing your preventive cardiology team will become part of your normal routine. It’s just like seeing your PCP or going to the dentist. You’ll go more or less often depending on your heart disease risk and needs.

What is preventive care for heart disease?

This term refers to all the steps you take to reduce your risk for issues like heart attacks, abnormal heart rhythms and heart failure. It includes things you do in your daily life, like eating heart-healthy foods and exercising. It also includes treatments your care team prescribes, like medicines to manage blood pressure or cholesterol. Routine check-ups and screenings allow you and your providers to know your latest numbers and adjust your goals as you go along.

Preventive care generally falls into three main stages based on your current health:

• Primordial prevention: This is the earliest type. You don’t yet have heart disease risk factors and are trying to keep it that way. This may involve habit changes to maintain a healthy weight and keep things like blood pressure in a healthy range.
• Primary prevention: This means you have some risk factors and are working to manage them. Healthcare providers may use the term “risk management” to describe what you’re doing at this stage. You may change some habits and/or take medications.
• Secondary prevention: This means you’ve been diagnosed with cardiovascular disease. Prevention efforts focus on lowering your chances of having a heart attack or stroke. If you’ve already had one, the goal is to prevent more from happening (recurrences). 

It might seem like prevention focuses a lot on what you do or don’t do — like what you eat, or whether you take your medications. But if you work with a preventive cardiologist, they’ll also talk with you about things you can’t control — like how far you live from a grocery store or a safe place to walk.

These factors can make it hard to get heart-healthy foods or do other things that you know are good for your heart. Your provider will offer advice and connect you with resources that can help. You don’t have to try to make all these changes on your own.