A new study by The Lancet suggests that doctors should rethink how heart disease is treated. Instead of waiting for a heart attack or stroke to happen, they recommend acting earlier when signs of plaque build-up in the arteries first appear. This early intervention could save more lives and reduce the huge costs of treating advanced heart disease.
The current approach to treating heart disease focuses on detecting and managing the disease only when there is restricted blood flow (ischemia) or after a heart attack. However, by this time, the disease is often too advanced for treatment to be fully effective. The new study suggests that doctors should shift their focus from treating symptoms to preventing plaque build-up in the arteries in the first place.
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The study also recommends reclassifying heart disease to a condition called atherosclerotic coronary artery disease (ACAD), which focuses more on understanding and preventing the build-up of fat and cholesterol in the arteries, rather than just treating the end-stage heart disease. This new approach could save millions of lives worldwide.
Experts agree with the need for this change. Dr. Upendra Kaul, a cardiologist, emphasized the importance of focusing on preventing the plaque build-up, which is the root cause of advanced heart disease, rather than spending a lot of money on treating the later stages of the disease.
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Dr. Ashok Seth, another expert, pointed out that while we have advanced treatments for heart disease, many of these treatments are expensive and not affordable for everyone. Focusing on prevention could help reduce the financial burden, especially in regions like Asia where heart disease is widespread.
In countries like India, where heart disease is affecting people younger than expected, early preventive measures are crucial. These should start in childhood, helping people maintain healthy habits to avoid conditions like high blood pressure, high cholesterol, and diabetes, which contribute to plaque build-up in the arteries.
The Lancet Commission suggests that eliminating or controlling risk factors like smoking, poor diet, high cholesterol, and high blood pressure could dramatically reduce heart disease worldwide. If these factors are managed from an early age, heart disease deaths could decrease by more than 80% by 2050, saving millions of lives.
The study stresses that heart disease starts early in life, and the early signs of plaque build-up in arteries often go unnoticed. Therefore, a shift is needed from treating only heart attacks and strokes to focusing on early diagnosis, prevention, and management of plaque build-up in arteries. The goal should be to prevent the disease from developing or even reverse its progress if possible.
Finally, the Commission recommends screening programs to detect people at risk of heart disease early. By identifying those at risk, doctors can provide early treatment to stop or slow down the disease, reducing the chances of heart attacks and strokes later in life.
