Podcast #14: Assessing The Risk Of Cardiovascular Disease in 2025 with Dr. Susan Gilchrist
By
Leonard Zwelling
Assessing cancer risk seems to be getting all the attention in the lay press. Despite this, cardiovascular disease is still the number one killer of Americans. Thus, we thought we would dive into what assessments of cardiovascular risks that ought to be done in your doctor’s office. What do they mean? What is considered above average risk and what should be done about it?
To do this, we explored these issues with Dr. Susan Gilchrist, Professor of Cardiology at the University of North Carolina who is also the Director of Cardiovascular Prevention and the co-Director of Cardio-oncology.
It turns out there is a cardiovascular risk calculator (here’s the one from the American College of Cardiology, https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/) that can give you and your doctor a good picture of your risk of disease based on certain metrics including age, weight, and blood pressure.
Certainly, one of the key variables is blood cholesterol including high (good cholesterol) and low (bad cholesterol) density lipoproteins. If you and your doctor believe treatment is in order there are statins used most frequently as well as newer agents that lower cholesterol and your risk.
Coronary artery disease, the cause of heart attacks, can also be screened for using advanced imaging techniques.
Individual degrees of fitness may be assessed using things like Apple watches, but these may not be completely accurate. Measurement and treatment of high blood pressure and diabetes is also readily accomplished as long as screening is done to assess the presence of abnormal values.
In short, much of cardiovascular disease is preventable. Diet, exercise, not smoking, and adequate sleep all can decrease cardiovascular risk. In addition, broad calculators for assessing risk and the introduction of specific lab tests can go a long way to preserving cardiovascular health. Of equal importance, those factors that tend to increase cardiovascular risk like obesity also increase cancer risk. Getting healthy decreases a patient’s vulnerability to a host of illnesses.
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