What can a preventive cardiologist do for you?

Inova’s preventive cardiology services can help you identify and reduce your heart disease risk

When most people think of cardiology, they think of providers who focus on treating existing cardiovascular disease, from heart attacks and valve disease to heart rhythm problems and heart failure. And of course, many cardiologists do focus on these areas. But as the field has evolved, some cardiologists have started specializing in stopping people from developing heart disease in the first place – preventing heart attacks, strokes and other negative outcomes. This specialty is called “preventive cardiology,” and Inova Schar Heart and Vascular offers a team of experts in this area.

“Our goal as preventive cardiologists is to find out what specific risk factors exist that predispose a patient to heart disease and to work with that patient in a comprehensive manner to determine – and modify – that risk,” said preventive cardiologist Jared Spitz, MD, Director of Inova’s Advanced Lipid Program. “Our hope is that we might be able to intervene earlier to prevent heart disease from happening.”

Who can benefit from a consultation with a preventive cardiologist?

Preventive cardiologists can help patients:

• Who have genetic cholesterol issues
• Who have low 10-year heart disease risk but high 30-year risk
• Who are young but have a strong family history of heart disease, especially if they have risk factors
• Who have a lot of risk factors for heart disease – very high cholesterol, diabetes or prediabetes, kidney disease, high blood pressure
• Whose medical histories indicate an increased cancer risk – including certain inflammatory conditions, rheumatoid arthritis, HIV or a history of cancer treatment
• Who are of South Asian ancestry and have a strong family history of heart disease or multiple risk factors
• Who have had a poor pregnancy outcome, gestational diabetes, gestational hypertension or preeclampsia
• Whose primary care provider or regular cardiologist wants a “second set of eyes” to review their risk and the treatment plan their provider has designed
• Who need to be evaluated for certain specialty medications or participation in clinical trials

What does a preventive cardiologist do?

• They conduct tests and collect information to identify a person’s specific risk factors including things that can’t be changed (like genetics or family history) as well as things that can be changed (like lifestyle habits or cholesterol levels)
• Based on this information, they use sophisticated algorithms to quantify a person’s risk of developing heart disease in the next 10 years and in the next 30 years
• After they have established the person’s current 10-year and 30-year risk, they work proactively, using medications, lifestyle changes and other treatments to bring those risk percentages down
• Their goal is to prevent the person from ever having a cardiac event

“Traditionally, cardiology evolved from secondary prevention. A patient has a heart attack, comes into the hospital, gets the heart attack fixed by a stent or bypass surgery, and then is asked to live a really healthy lifestyle. Unfortunately, the poor outcome has already occurred in their life,” said Garima Sharma, MD, Director of the Inova Preventive Cardiology Program, Director of Women’s Cardiovascular Health at Inova, and Director of the Cardio-Obstetrics Program – a collaboration between Inova Schar Heart and Vascular and Inova Women’s. “We use a forward-thinking approach that looks at a patient’s potential trajectory over a lifetime.”

How does a preventive cardiologist pinpoint a person’s heart disease risk?

Cardiologists, including preventive cardiologists, use risk stratification as the basis of many treatment decisions. Risk stratification uses data to evaluate patients’ short- and long-term risk of developing heart disease, and on the basis of that risk stratification, preventive cardiologists tailor treatment to the degree of future risk.

“While we can risk stratify patients, that’s a very general ballpark. The question of personalized risk goes beyond traditional risk models,” Dr. Sharma said. “As preventive cardiologists, we dig deeper, incorporating both risk optimization and precision risk understanding that includes genetic and specific personal elements.”

Benefits of a preventive cardiology consultation

Inova’s preventive cardiology team is always happy to weigh in. “Sometimes, I may have nothing to add other than to confirm that the plan developed by the primary care provider is excellent,” Dr. Spitz said.

Preventive cardiologists can also help determine when the time is right to begin aggressive lifestyle modifications and medications. They are familiar and comfortable prescribing specialty medications for unusual cholesterol conditions, which a primary care provider may not often need to prescribe. They are also experienced at interpreting the nuances of a patient’s calcium score, for example.

Inova’s preventive cardiology capabilities include an advanced lipid clinic and a cardiometabolic clinic, complemented by several other outstanding programs focused on cardio-obstetrics, obesity medicine and weight loss, cardio-oncology, endocrinology, nephrology, hepatology, and nutrition. Inova’s program is also heavily involved in clinical trials and can help patients enroll in those trials, potentially gaining access to cutting-edge medications and treatments. Currently, Inova’s preventive cardiology team includes four physicians and four advanced practice providers.

Learn more about Inova’s preventive cardiology team.