Heart Disease, Genetic Testing and the Development of New Predictive Tools

For centuries, medicine has been reactive. Doctors have often been held back in their ability to combat a killer until the time when it rears its head. Today, armed with the growing knowledge of the genetic components of illness, and tests that reveal a deeper understanding of the body’s processes, doctors are gaining “pre-emptive strike” capability in the war against sickness and disease.

Doctors are now able to find increasing amounts of detail about what’s going on inside the body, giving them, in turn, increasing indications of and clues to various tendencies towards disease. And, what is even more astounding, is that doctors can also begin to determine a tendency towards improvement with medication long before an expected disease becomes rampant and a more insurmountable problem.

How are these advances taking place? Today, more physicians rely on a battery of investigative techniques including imaging devices, genetic screening and sophisticated serum analysis. These types of tests and scans have become indispensable tools in the early detection and diagnosis of many diseases. Unfortunately, they have had limited application in some arenas, specifically in the fight against cardio-vascular disease. In order to properly diagnose and treat cardio-vascular disease, physicians often must rely on invasive, costly and sometimes painful procedures. However, Dr. Paul Ridker, a cardiologist at Brigham and Woman’s Hospital in Boston, has made a discovery that could possibly change all that. Dr. Ridker has been working for over a decade on research in trying to understand other parameters that predict vascular risk. According to Dr. Ridker, inflammation is a very important biologic process that allows our body to react and repair certain tissues. It’s fundamental to everything we do in terms of fighting infections, fighting trauma, and in fact fighting vascular disease. A measure of inflammation can be taken simply by measuring C-reactive protein. C-reactive protein is a substance produced in the liver that is released as a response to inflammation. C-reactive protein was actually discovered in the 1940’s when scientists first were beginning to understand the basics of the immune response. And now, new technology has come about which gives doctors the ability to achieve a very fine measurement of the C-reactive protein. And, this turns out to have tremendous predicative value for vascular disease.

What is this new testing technology that is turning the corner for prediction of vascular disease? The test, known as HS-CRP can detect even trace amounts of the protein in a patient’s blood. According to medical experts, this test, when used in conjunction with HDL and Cholesterol testing, can measure a patient’s risk of heart attack or stroke as much as ten years in advance! The segment of the population that will benefit from this test would be the 30-60 year old population, both male and female that have not had a prior cardiac event. This means it will be used as a valuable screening test in conjunction with Cholesterol and HDL testing.

With heart disease and stroke currently costing billions of dollars a year to treat, economical and accurate tests can reduce the drain on an already over burdened healthcare system. It is true that imaging techniques such as electron beam CT scanning or MRI scanning help to indicate vascular disease. But these are very expensive at 300-400 dollars to detect underlying disease. What the CRP test provides is a very inexpensive way at getting at a fundamental biological issue because it’s a simple blood test that can be run at any diagnostic lab. The American Heart Association predicts that 370 billion dollars a year goes toward cardiac disease. It’s the number one killer in the US. If lives can be saved by the use of a less expensive test, than this would have a macro-economic effect in the economy and also on the healthcare system. The American College of Cardiology and The American Heart Association have both been very interested in this test because if doctors can better predict heart disease it is hoped that this disease can in fact be prevented.

“An ounce of prevention is worth a pound of cure,” is an old adage to be sure. But perhaps it is truer now than ever, as advances in diagnostic sciences give doctors more and more opportunities to stop conditions before they occur.

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