Putting a stop to heart attacks

Carrie Click
Post Independent Staff
Post Independent Photo/Jim Noelker

GLENWOOD SPRINGS ” Drs. Peter Cohen and Greg Feinsinger are on the lookout.

The two Glenwood Medical Associates physicians ” Dr. Cohen is an internist and Dr. Feinsinger practices family medicine ” are seeking out people with obvious risk factors for heart disease ” and those who may not even know they may be in jeopardy.

That’s why the two doctors have established the Glenwood Medical Associates’ Heart Attack Prevention Program.

Nurse practitioner Ann Cox is the program’s coordinator, and new cardiologist in town Dr. Carlos Albrecht is the program’s consultant.

“It’s a brand new program,” explained Dr. Feinsinger. The program will begin on Monday, Nov. 17, and offers patients long- or short-term heart-disease monitoring ” depending on each patient’s needs.

With the program, Dr. Feinsinger said each patient will have an initial 40-minute doctor’s appointment, but without the classic treadmill test.

“Treadmill tests aren’t good for identifying early heart disease,” said Dr. Feinsinger. “They only tell if there’s already a major blockage in the arteries. We want to prevent that blockage.”

Instead, patients will fill out an extensive personal medical history, including diet and exercise information, and a family medical history as well. Based on this information, and on the patient’s blood pressure readings and cholesterol counts, doctors then can order more detailed, individualized testing from the Berkeley HeartLab, a diagnostic facility developed by Dr. Robert Superko, a research cardiologist and author of “Before the Heart Attacks.”

Dr. Superko’s lab has a technique for breaking down cholesterol readings. These more detailed readings help health-care providers better determine specific types of cholesterol particles present in a patient that could potentially lead to heart disease.

“Even though there’s a big need for this type of prevention ” heart attack is the leading cause of death in developed countries ” there are very few programs like this in this country,” Dr. Feinsinger said.

Dr. Feinsinger said one reason for instigating the program is because he and Dr. Cohen see people dying from cardiovascular disease at younger and younger ages.

“It’s one thing to die from a heart attack at 95, but to die at 40 or 45, or even 65 or 75 from heart disease … There are now techniques we can use to detect and prevent at least some disease from progressing.”

Dr. Cohen said he wanted to start the program because of what he witnesses every day at Valley View Hospital’s intensive care unit.

“We want to find patients before they get to that stage,” Dr. Cohen said. “I work in critical care, and I see the results of not detecting heart disease early on. We want to be more aggressive in finding people at high risk so we can lower their odds of dying from heart disease.”

To do that, patients with risk factors ” and even those without them who may be concerned they’re at risk ” can call GMA and make an appointment.

“Roughly 80 percent of people with heart disease have one or more traditional risk factors,” said Dr. Feinsinger (see box). “It’s a scary thought, but the other 20 percent of people may not even know they’re at risk. But now we have advanced tools that can help identify those people, calculate their chances for a future cardiac event. With that information, we can help change a patient’s outcome for the better.”

And with that information, doctors can recommend both lifestyle changes and specific medication to monitor patients’ cholesterol levels.

Still, not all doctors are supportive of Berkeley HeartLab’s testings.

“This is cutting-edge science,” said Dr. Cohen, “and not all the studies have been completed for this type of testing. But we believe in prevention. Why wait when we have the possibility of helping a patient avoid heart disease?”

Dr. Feinsinger said the classic factors such as cholesterol, high blood pressure, tobacco use, family history and obesity only account for a portion of why people get heart disease ” and die from it.

“We’re not just talking lifestyle,” he said. “We’re finding other factors, often genetic, that can lead to heart disease.”

Dr. Feinsinger said he recently treated a patient who benefited from the Berkeley HeartLab’s tests. After undergoing a heat scan in Denver, the patient, who has no history of family heart disease, exercises regularly and eats right, discovered from Dr. Feinsinger he had calcified plaque building in his main coronary artery ” a potentially dangerous situation. The patient immediately went on a highly restricted diet, with only 10 percent fat. After receiving the patient’s advanced lipid test results from the Berkeley HeartLab, Dr. Feinsinger determined that the patient should actually be eating a 35 percent monounsaturated fat diet.

“His diet was so low in fat it was bringing down his good, HDL cholesterol levels,” Dr. Feinsinger said, noting the advantages of the HeartLab’s detailed testing.

Dr. Feinsinger said patients can sign up for the program and take their results back to their own physicians for diagnoses and follow-up care.

“We’re not intending this program to take the place of people’s established physicians,” he said. He added that GMA will accept new patients into the program who may not have a regular physician they currently use.

“It’s like fishing,” Dr. Cohen explained. “We now have a bigger net. We have the tools so we can do more screening and change the outcome of people who might be at risk for heart disease.”

Contact Carrie Click: 945-8515, ext. 518

If you have two or more of the following risk factors, you may be at risk for coronary heart disease and a candidate for participation in this new program:

– Have had a heart attack, bypass surgery or other evidence of hardening of the arteries

– Diabetes, particularly type II

(The above count for two risk factors apiece)

– Family history of heart disease, especially a heart attack before age 60

– Total cholesterol more than 200; LDL (bad) cholesterol more than 130; HDL (good) cholesterol less than 40

– Blood pressure more than 140/90

– Tobacco use

– Waist circumference more than 40 inches in men, and more than 35 inches in women

– Physical inactivity

For more information, contact Glenwood Medical Associates at 945-8503.

Courtesy of GMA’s Heart Attack Prevention Program

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