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Treating risk factors for cardiovascular disease
Dr. Susan Dimick, MD, FNLA - Edmond, OK

Cardiovascular disease can lead to life-threatening events such as heart attack, heart failure, and stroke. Some of the risk factors that can lead to cardiovascular disease are well known, such as high cholesterol, high blood pressure, smoking, and diabetes. Some may be unexpected, such as psychosocial loneliness, which occurs when people don’t have close relationships with other people and therefore have no support group to help get to medical visits or cope with life’s stressors. There is also extraordinary risk among people with inflammatory diseases, such as lupus, rheumatoid arthritis, and psoriasis.

The consequences of cardiovascular disease are dangerous. However, with regular screening, early detection, and early intervention, it is often possible to prevent cardiovascular disease. Treatments range from lifestyle changes to medications that are often effective and inexpensive.

Risk factors for cardiovascular disease can occur individually or together, and having one can increase the odds of developing another. Because of this, it’s important for doctors to consider a patient’s personal history, social history, and family history, as well as their physical health. Dr. Dimick works on all of these factors together, presenting patients with a full range of treatment options.

For people in rural communities or those who have a hard time driving to see a doctor, Dr. Dimick offers telemedicine options, so patients can get lab work done, then meet with her for follow-up appointments via their iPad or laptop.

Common Questions on Treating Risk Factors

What are common risk factors for cardiovascular disease?

The primary risk factors doctors look for with regard to cardiovascular disease include dislipidemia, psychosocial factors such as loneliness or social isolation, smoking, high blood pressure, diabetes, and diseases or behaviors that cause inflammation in the body.

There is often overlap between these factors, and it is common for people to have more than one of them. For example, smoking and hypertension both cause inflammation, and diabetes increases the risk of having high lipid counts.

Which cardiovascular risk factors are controllable?

Some risk factors for cardiovascular disease, such as gender, age, and genetic makeup, are not controllable. The good news is the most dangerous risk factors, such as high lipids, high blood pressure, diabetes, and social factors are often controllable with lifestyle changes, medication, or a combination of the two.

Why is treating these risk factors important?

In order to avoid serious medical events, such as stroke or heart attack, it is critical that risk factors for cardiovascular disease be treated as early as possible. The longer certain risk factors, like smoking or high blood pressure, go unchecked, the greater toll they take on the body. Dr. Dimick recommends that people prioritize preventive care and avoid going to the doctor only when they’re sick. A good primary care doctor will screen for these risk factors, assess any potential issues, and work on preventing cardiovascular disease before it starts.

How is diabetes treated?

There is a wide range of pharmaceutical and lifestyle options available to help get diabetes under control. Diabetes is such an important risk factor for cardiovascular disease that anyone with diabetes must be treated aggressively. Fortunately, it is very easy to treat, and there is a wide range of pharmaceutical and lifestyle options available to get diabetes under control.

Medications for diabetes are generally inexpensive and well tolerated. New medications that both control diabetes and reduce blood sugars have been shown to decrease cardiovascular risk. Treating diabetes also often requires changes to lifestyle, including improved diet and more frequent exercise.

The key with diabetes is to get screened by a doctor regularly so that early intervention is possible if problems do arise. With early detection and intervention, it is possible to treat pre-diabetes. When you are pre-diabetic, your blood sugars are not yet in the diabetic range, however, they are not normal. That means your pancreas is already responding to insulin resistance, which usually starts 12 years before doctors can detect the laboratory changes.

How is high blood pressure treated?

There are several ways to get blood pressure back to healthy levels, and Dr. Dimick can help evaluate the individual factors that will be most helpful for you. One very effective approach is to adopt the Dietary Approaches to Stop Hypertension, or DASH, diet. This is an eating plan that reduces sodium, red meat, and sugary drinks, while increasing healthy foods, such as whole grains, fish, and vegetables. Increasing physical activity also makes a big difference. In addition, many blood pressure medications are effective, inexpensive, easy to access, and easy to use.

Dr. Dimick also recommends that people monitor their blood pressure regularly at home, since blood pressure tends to be higher in a doctor’s office. It is also possible to do a 24-hour monitor to get a more accurate picture of how blood pressure changes over the course of the day.

How is obesity treated?

Obesity overlaps with many of the known risk factors for cardiovascular disease, so treating obesity can help people in multiple ways. However, just losing weight isn’t medical care, and it’s important to see a doctor to be sure you’re addressing all risk factors.

For people with obesity, Dr. Dimick offers a therapeutic lifestyle program, through which patients can work individually with a dietician and a nursing PhD coach. The TLC program is highly personalized and helps people adopt a plant-based, low-carbohydrate diet. It also gives them an opportunity to have their blood pressure and medications checked weekly. The four-step program is based on a wealth of scientific data and focuses not only on weight loss, but also building sustainable habits that allow people to maintain health over time. The TLC program is adaptable to each patient’s needs, so it’s possible to work in the program for weeks or years, depending on your goals.

How is high cholesterol treated?

Simply looking at total cholesterol levels is not very helpful. Instead, it is important to understand why cholesterol is high and which treatments will be most effective. Dr. Dimick uses advanced lipid testing to study all types of cholesterol. She also does genetic testing that can determine why a person might absorb too much cholesterol, what types of cholesterol are problematic, and which medications they will respond to.

A change in diet can help with lipid disorders, but it is rarely enough to fully correct the problem on its own. A family of medications called statins are very effective at lowering cholesterol, and testing can determine whether someone will respond well to them. Some supplements can also be helpful with lipid disorders.

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