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Focus - Heart

Sunday Focus: There’s no one-size-fits-all solution for heart health

  • 2 min to read
The electricians of the heart

Dr. Richard Markiewicz, interventional cardiologist at Great Plains Health, speaks to a patient about heart disease.

Heart health can come in different forms, but in all cases, prevention can be a key element.

The fundamentals still apply — eating right, exercise, maintaining a healthy blood pressure and cholesterol — but other factors such as age and family history can impact your chances of developing heart disease.

Dr. Richard Markiewicz recommends health screenings to determine a person’s risk of heart disease. Markiewicz is an interventional cardiologist at Great Plains Health, which offers such screenings.

Patients will have their blood glucose level, cholesterol level, calcium score, body mass index (BMI) and blood pressure assessed. The calcium score, Markiewicz said, can give people a broader picture of their health than they realize.

This method involves a CT scan that will detect calcium build-up in a patient’s chest. Depending on the score, the next steps can vary. A score of 200 or 300 can often be treated with medication; a score above 500 may require further procedures, such as a stress test.

The challenge can come when convincing patients the processes and treatments are necessary. For example, if a man has a family history of heart disease but he shows no symptoms and has a cholesterol level of 80, it would be hard for Markiewicz to justify prescribing him a medication. The calcium score can help further stratify that patient’s risk factors.

People are also sometimes willing to take risks with little benefit. For example, the CT scan involves a small amount of radiation, but a stress test involves a much greater dose at a much greater cost, and can’t show the specifics that a calcium score can.

The side effects of medications can often give patients pause as well, Markiewicz said.

“I had one patient ask me, ‘What are the risks of taking this?’ and I said, ‘A better question is what are the risks of you not taking it.’ ”

There’s also a misconception in the general public about cholesterol, Markiewicz said. The rule of thumb has been “a higher cholesterol puts you at greater risk,” but it’s a bit more complicated than that. There are both good and bad types of cholesterol, and genetics play a big role in the particle size — smaller particles can get into vessels easier. If one person has a high amount of bad cholesterol but the particles are large, their overall level could still be healthier than someone with a “normal” cholesterol level.

“There is no one-size-fits-all solution,” Markiewicz said.

The heart screenings may not benefit every patient, however. They are aimed at that “middle population,” Markiewicz said, people who are around 40 or 45 years old.

“The first health fair totally missed the mark,” he said. “People who showed up were either young and healthy, or the elderly who should really speak with a primary doctor.”

GPH offers screenings at a discounted price to boost the importance of prevention and early detection. For more information, contact the Heart and Vascular Clinic at 308-568-8575.