%0 Journal Article
%T The Rationale for a Different Approach to Preventing Cardiovascular Disease
%A David S. Schade
%A Barry Ramo
%A S. Scott Obenshain
%A Ron Schrader
%A R. Philip Eaton
%J World Journal of Cardiovascular Diseases
%P 489-510
%@ 2164-5337
%D 2019
%I Scientific Research Publishing
%R 10.4236/wjcd.2019.97043
%X
The Problem: We have previously suggested that an alternative
approach to preventing cardiovascular disease is necessary because
atherosclerotic cardiovascular disease (ASCVD) has been increasing for the last
50 years and has now reached epidemic status. Since the year 2000,
approximately 600,000 heart attacks and ASCVD related deaths have occurred
annually in the United States. It is the most common cause of death in the
U.S., more than all cancers combined. The financial costs are staggering,
amounting to 555 billion dollars per year in direct and indirect costs. Outlook
for an improvement in these statistics is not encouraging as the U.S.
population continues to become more obese and to develop diabetes. The
Question: Why is ASCVD continuing
to be a major challenge to healthcare providers when the pathogenesis is known
and inexpensive preventative treatment is available? The reasons are multiple
and complex. First, present financial reimbursement policies of healthcare
organizations reward treatment of a disease and its complications instead of
preventing the disease. Second, professional guidelines and treatment goals are
often too complex, subject to interpretation, and time-consuming to be useful
in the clinical setting. Third, no specific follow-up of patients at risk for
ASCVD is recommended when the risk assessment changes. Fourth, many expensive
cardiovascular diagnostic tests are utilized without meeting appropriate
guidelines for their use. Fifth, treatment of individuals without first proving
the presence of disease results in poor adherence to therapy. The Solution: This article describes
the rationale for a new approach to the prevention of ASCVD in asymptomatic
individuals. It is based upon preventing ASCVD by identifying all asymptomatic
individuals with subclinical disease before an ASCVD
%K Cardiovascular Disease
%K Preventing
%K ASCVD
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=94084