“It is time to turn off the faucet instead of just mopping the floor.” American College of Cardiology President Dr. Kim Williams.

Dual Approach

Atherosclerosis - the underlying cause of most heart attacks and strokes. It is the number 1 cause of premature deaths and disabilities in adults over the age of 45.

Preventable Deaths

Scenario 1. A jumbo jet crashed in the outskirt of a major city killed all 300  passengers. News breaking headline gets the television and Internet coverage worldwide. CNN is there to cover minute by minute developments. This event receives daily coverage for a week or longer.

Scenario 2. Everyday in the US, 10 jumbo jet-loads of American die and another 10 jumbo jet-loads survive heart attack and stroke that cost the economy $1.2 billion a day. That’s an even bigger news but it gets no coverage. They are largely preventable. Why is this ignored? When a celebrity suffered a heart attack, it might get a 30 second coverage that day.

IMG 0573

Atherosclerosis - causes a tremendous total economic burden in the US which is estimated at $550 billion annually and rising.

AHA Statistics Oct2017

Stare at these numbers and let them sink in. And ask yourself, what if there is a way to reduce these numbers by a third? What would happen? It is doable.

Atherosclerosis - the goose that lays the golden egg. It supports, sustains and fuels the growth of a large cardiovascular healthcare industry.

Natural Course of Atherosclerosis

The natural course of atherosclerosis is that it starts early in life and progresses silently for many years and decades in many arteries in the heart and in the brain until suddenly a plaque ruptures causing a clot to form quickly, clogging the artery and causing a heart attack or stroke depending on the artery’s location.

Before statin drugs became available, treatment was limited to angioplasty, stent placement or heart bypass surgery. 

Stop Plaque Progression

Statin drugs opened the door to prevention by preventing plaque rupture, stopping plaque progression and inducing plaque regression. Reversing heart disease, if detected earlier, has become possible.

But this revolutionary approach will wait. The large cardiovascular healthcare industry is not willing to give up a large guaranteed revenue stream in exchange for better patient outcomes. Nearly two decades will pass; many millions will die and suffer; hundreds of billions will be spent in disease care and hundreds of billions will be earned by the cardiovascular healthcare industry.

So, why aren’t all cardiologists preventive?

ACC President 2004-2

In 2004, the president of the ACC said that cardiologists were not preventive because they made a lot of financial investments in the interventional treatment of cardiovascular disease. He warned that the evolution to a more preventive approach is inevitable, like it or not. And it will not come painlessly.

Our industry was not ready, but I was ready in 2001.

2015 ACC President Dr. Williams

After 14 years, in 2015, the ACC president, Dr. Kim Williams, said “It is time to turnoff the faucet instead of just mopping the floor.” 

Unlike placebo-controlled statin clinical trials that ended after just two years, the benefits seen in clinical practice are even greater. The longer the duration of treatment, the greater the benefits. It was beyond my expectations - what used to be common and expected events before 2001 became rare and unexpected after 2006. The first 20 years of my practice helped me prepare to make the next 20 years even better with much improved patient outcomes and lower healthcare cost using the latest advances in medical treatment and care innovations I developed myself for my patients.

© Rolando L. deGoma MD  2018     www.deGomaMD.com     Capital Cardiology Associates     Princeton Physicians' Organization