Heart Disease Prevention

Heart disease prevention is available for people with a wide range of goals and risk profiles, including those who have:

• Few or no heart disease risk factors and want to keep it that way
• One or more cardiac risk factors and want to reduce or eliminate them
• Established heart disease or have experienced a cardiac event, like a heart attack, and want to improve their heart health and avoid future events

Depending on your current health status and goals, you may choose to contact a heart disease prevention specialist yourself, or you may be referred by another doctor. Regardless, check with your insurance provider to see what services they’ll cover.

Your risk evaluation includes an initial health assessment and a review of your personal and family history of heart disease. We’ll continue to periodically assess your heart health and related risk factors with the following tests.

Measurements
We monitor your weight, BMI (body mass index), blood pressure, and waist circumference. Too much abdominal fat indicates a higher risk for type 2 diabetes and other heart disease risk factors.

Lab Tests
Blood tests measure your cholesterol profile, which includes triglycerides and other fats in your blood that can affect your heart. Your cardiologist may request a more detailed lipid protein profile to gather more information about your risk. Glucose levels and hemoglobin A1c may be checked for diabetes or pre-diabetes. Thyroid function and other tests look for related endocrine issues. Special testing for inflammation markers such as C-reactive protein may also be part of your cardiovascular workup.

Imaging
Imaging studies help assess your risk for heart events or your need for catheterization or surgery. Your cardiologists can also review imaging tests done at other facilities. These may include:

• Echocardiograms -- a type of ultrasound that shows how your heart is working
• Nuclear imaging -- a picture of heart function and structure, which are highlighted with a radioactive dye that is administered via IV
• Coronary calcium imaging -- an X-ray that detects dangerous plaque in the heart and its arteries

Cardiopulmonary Exercise Testing
This specialized metabolic exercise test accurately measures your cardiorespiratory fitness level, which is an important measure of your overall health and risk for heart disease. The test can also be used to determine precise and personalized exercise prescriptions to optimize your health. During this test, you’ll exercise on a stationary bike while doctors monitor your vitals.

Lifestyle Factors
We review the behaviors that affect your heart health -- such as smoking, exercise, psychological stress, and eating habits -- and work with you to create personalized treatment plans designed to improve your health and reduce your risk.

Medical Management
We review any medications you currently take, discuss them with you, and report any potential problems with drug interactions. We’ll continually assess these drugs’ effectiveness and look for side effects.

Education
We provide educational lectures and resources that teach you how to maintain a heart-healthy lifestyle and incorporate regular exercise.

Smoking Cessation
If you smoke or use other tobacco products, we want to help you quit. We are committed to partnering with you in an effective cessation program. We offer counseling, support groups, nicotine-replacement therapy, prescription tobacco-cessation drugs, and cognitive therapy.

Nutrition Counseling
We help you to establish and maintain realistic weight goals through healthy eating. In individual meetings with our nutritionists and in group lectures, you’ll learn to make the best food choices to meet your goals.

Stress Reduction
Psychological risk factors put you at greater risk for heart disease. Our skilled counselors work with you to address emotional concerns, and we provide access to courses in stress-reduction techniques like meditation and relaxation.

National Leaders in Preventive Medicine
Duke doctors have been members of the U.S. Department of Health and Human Services Physical Activity Guidelines Advisory Committee, contributing to the first national exercise guidelines for heart disease prevention. We use the same knowledge and expertise to develop a care plan that meets your needs. Duke has been and continues to be a leader in cardiac prevention.

Full Range of Prevention
Preventive care is vital for people who have risk factors or established heart disease, but we also offer expert prevention services for people who don’t yet have risk factors or disease and want to be proactive with their heart health.

Access to Clinical Trials
We participate in clinical trials that examine whether patients benefit from prevention efforts and which approaches are most effective.