A Feasible, Simple, Cost-Saving Program to End Cardiovascular Disease in the United States

Schade, David S.; Obenshain, S. Scott; Ramo, Barry W.; Eaton, R. Philip

doi:10.1016/j.amjmed.2019.03.043

Cited by 8 publications

(9 citation statements)

References 12 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additional information and details of the approach to eliminate cardiovascular disease can be found in references [4] and [8]. Accomplishing this goal will require approximately five years and a commitment from healthcare providers, their institutions, and major organizations that support cardiovascular research and patient care.…”

Section: The Goal For Reduction In Atherosclerosis Should Be 100%mentioning

confidence: 99%

Can the 2019 AHA/ACC Cardiovascular Guidelines Be Improved?

Schade¹,

Adolphe²,

Bouchonville³

et al. 2020

WJCD

Self Cite

View full text Add to dashboard Cite

The 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease for treatment of atherosclerosis in asymptomatic individuals is an advance over previously published recommendations. However, since all guidelines are based on a limited quantity of published studies and result from a consensus of experts in different fields of medicine, omissions and errors are inevitable. The present manuscript identifies four areas in these 2019 AHA/ACC guidelines that alternative approaches or changes would result in improved outcomes and reductions in atherosclerotic events. First, the goal for the reduction in the prevalence of cardiovascular disease should be total (100%) eradication of the disease. This is a feasible goal as the facilities and resources to accomplish this task are currently available. Second, guidelines should acknowledge that atherosclerosis is a reversible disease as has previously been documented by multiple studies. If reversible, then under the appropriate clinical circumstances, it is preventable. Third, the goal for LDL cholesterol reduction should be <50 mg/dl, if eradication of atherosclerosis is to be achieved. This goal is achievable and safe as suggested by published studies. Fourth, widespread use of the coronary artery calcium scan needs to be recommended so that early atherosclerosis can be reversed before a major cardiovascular event occurs. Treating all individuals at a specific risk category without regard for the presence of disease results in poor adherence to therapy and unnecessary side effects. Consideration of these four issues would improve the AHA/ACC guidelines and result in better patient care.

show abstract

Section: The Goal For Reduction In Atherosclerosis Should Be 100%mentioning

confidence: 99%

Can the 2019 AHA/ACC Cardiovascular Guidelines Be Improved?

Schade¹,

Adolphe²,

Bouchonville³

et al. 2020

WJCD

Self Cite

View full text Add to dashboard Cite

show abstract

“…This approach requires testing asymptomatic individuals for heart disease before they have a heart attack or stroke [63] (Figure 3). In reality, The arguments for using one LDLc goal for all individuals at increased risks have previously been made [64]. Briefly, recommending one goal has the attributes of simplicity, safety, effectiveness, and achievability in almost all individuals.…”

Section: A Simplified Approach-the Goal Of Prevention Is To Identify mentioning

confidence: 99%

“…When combined with ezetimibe 10 mg, at least 60% reduction in circulating LDLc may be expected [75]. When that pharmaceutical combination is employed with a low cholesterol diet, almost all individuals will achieve a circulating LDLc below 50 mg/dl [64].…”

Section: A Simplified Approach-the Goal Of Prevention Is To Identify mentioning

confidence: 99%

See 1 more Smart Citation

The Rationale for a Different Approach to Preventing Cardiovascular Disease

Schade¹,

Ramo²,

Obenshain³

et al. 2019

WJCD

Self Cite

View full text Add to dashboard Cite

The Problem: We have previously suggested that an alternative approach to preventing cardiovascular disease is necessary because atherosclerotic cardiovascular disease (ASCVD) has been increasing for the last 50 years and has now reached epidemic status. Since the year 2000, approximately 600,000 heart attacks and ASCVD related deaths have occurred annually in the United States. It is the most common cause of death in the U.S., more than all cancers combined. The financial costs are staggering, amounting to 555 billion dollars per year in direct and indirect costs. Outlook for an improvement in these statistics is not encouraging as the U.S. population continues to become more obese and to develop diabetes. The Question: Why is ASCVD continuing to be a major challenge to healthcare providers when the pathogenesis is known and inexpensive preventative treatment is available? The reasons are multiple and complex. First, present financial reimbursement policies of healthcare organizations reward treatment of a disease and its complications instead of preventing the disease. Second, professional guidelines and treatment goals are often too complex, subject to interpretation, and time-consuming to be useful in the clinical setting. Third, no specific follow-up of patients at risk for ASCVD is recommended when the risk assessment changes. Fourth, many expensive cardiovascular diagnostic tests are utilized without meeting appropriate guidelines for their use. Fifth, treatment of individuals without first proving the presence of disease results in poor adherence to therapy. The Solution: This article describes the rationale for a new approach to the prevention of ASCVD in asymptomatic individuals. It is based upon preventing ASCVD by identifying all asymptomatic individuals How to cite this paper:

show abstract

“…The pledge for screening asymptomatic individuals ages 30 to 50 with coronary artery calcium scanning to end cardiovascular disease in the United States deserves comment. 1 First, detection of subclinical atherosclerosis is an old concept intended to individualize treatment decisions in subjects at risk, and since 1993, no clinical trial has shown it improves clinical outcomes in at-risk subjects. 2 Applying this concept to healthy subjects is premature.…”

mentioning

confidence: 99%

Ending Cardiovascular Diseases, Fast, Effectively, and Cheaply . . . in Capitalist Utopia?

Braillon

2020

The American Journal of Medicine

View full text Add to dashboard Cite

A Feasible, Simple, Cost-Saving Program to End Cardiovascular Disease in the United States

Cited by 8 publications

References 12 publications

Can the 2019 AHA/ACC Cardiovascular Guidelines Be Improved?

Can the 2019 AHA/ACC Cardiovascular Guidelines Be Improved?

The Rationale for a Different Approach to Preventing Cardiovascular Disease

Ending Cardiovascular Diseases, Fast, Effectively, and Cheaply . . . in Capitalist Utopia?

Contact Info

Product

Resources

About