What You May Not Know About Preventing Heart Attacks, Strokes, and Diabetes

By Bradley Bale MD and Amy Doneen ARNP with Lisa Collier Cool

Have you ever wondered why someone could feel perfectly fine and then minutes later have a massive heart attack or stroke that either kills the person or causes a life-long disability? Even more challenging is the concept that some people can go in for a full medical exam, including cholesterol and blood pressure check and a stress test, and be told they are fine only to drop dead of a heart attack days or weeks later. 

Here’s what you need to know in order to avoid those tragic scenarios:

What causes a heart attack or an ischemic stroke? The blockage that triggers a heart attack or stroke is actually a blood clot, not cholesterol build-up as many believe. The potentially lethal clot occurs when a cholesterol deposit (plaque) inside an artery wall becomes inflamed and causes a tear in the inner lining of the artery. In an attempt of repair this injury, the body tries to seal the crack by forming a blood clot. If the blood clot, or thrombus, blocks the flow of blood in the heart, it can cause a heart attack. If the clot occurs in the brain, it is called a stroke.   

Because the plaque hides in the artery wall, common tests such as the stress test can’t find this silent disease. We recommend tests that utilize B-mode ultrasound testing, called the carotid intima media thickness test (CIMT) to look for plaque in the wall of the artery. Another test is the coronary calcium test (CACS) that can identify calcified plaque in the vessels around the heart. These tests are not expensive and they are safe, reliable and reproducible.   

Inflammation is the driver of both disease and events (heart attacks and strokes). Chronic low-grade inflammation in the blood vessel lining is linked to the development of vascular disease and vascular events (heart attacks and strokes). People with high levels of inflammatory biomarkers are up to nine times more likely to develop blockages in their arteries compared to people with lower levels. There are cost-effective laboratory tests that should be performed regularly to determine if you have inflammation in your arterial system and to know if your treatment is working.  If treatment such as lifestyle changes and medication are working, the inflammation should be eradicated. If inflammation is treated properly, the body will heal.