At his doctor's suggestion, the executive had an annual check of his cholesterol and blood pressure, and agreed to a stress test to determine coronary function. During his routine physical in 2004, he was pronounced to be “in good shape” and, in the executive's own words, he “aced” his stress test. A short time later, he was in a New York airport after returning from a trip to New Orleans when he experienced a severe tightening in his chest. Later that day, an angiogram revealed significant blockage in several coronary arteries. He was immediately scheduled for a quadruple bypass operation.
In this case, the executive was former President Bill Clinton, and the false sense of security he received from his annual physical is not uncommon.
For many in the medical profession, this highly visible case was the death knell for the thallium stress test, although many physicians are still reluctant to give up this lucrative in-office test. It also demonstrated the futility of relying on cholesterol testing, blood pressure monitoring and other “traditional” forms of risk factor analysis for heart disease.
“About half of all heart attacks occur in patients with normal cholesterol levels,” sais Dr. Robert Brunst, medical director of InnerVision Wellness Imaging in Carlsbad.
It is estimated that each year, approximately $300 billion is spent on cardiovascular disease in America, with more than $129 billion calculated in lost productivity. Heart disease is also the leading cause of premature, permanent disability in the United States workforce.
The Clinton example also provided momentum for a new, highly-effective screening test called the Electron Beam Tomography (EBT) heart scan, also known as the coronary calcium score. Although EBT was being used by leading cardiac institutions like Johns Hopkins medical centers and the University of California, Los Angeles medical center, its widespread use was impeded by a minority of highly vocal physician opponents of the technology who believed widespread screening would lead to false-positives and unnecessary medical procedures.
That argument was since proven to be meritless. In fact, within the past year, the test has been endorsed by the American Heart Association, the American College of Cardiology and numerous other preventive cardiology groups. Best-selling author of The South Beach Diet and a cardiologist, Arthur Agatston, said that using “diet alone to treat heart disease would be ignoring 30 years of lifesaving medical advances.” In his new book The South Beach Heart Program, Agatston shows how heart disease can effectively be reversed, and how the coronary calcium score is the best tool to measure the progress.
“One of the real benefits of the heart scan is that I can show my patients pictures of their actual coronary arteries and the extent of plaque buildup,” he said.
Despite the endorsements, perhaps the greatest impetus for the widespread use of heart scans comes from the Screening for Heart Attack Prevention and Education (S.H.A.P.E.) task force. Led by top cardiologists including Dr. Matt Budoff of UCLA, Dr. Pamela Douglas of Duke University Medical Center and Dr. P.K. Shah or Cedars Sinai Medical Center, S.H.A.P.E. accomplished what no other advocacy group has ever attempted; it has quantified both the financial and lifesaving impact of widespread coronary screening using the heart scan. S.H.A.P.E. predicted that if intermediate risk patients were assessed with a coronary calcium score equivalent in accuracy to EBT, 90,000 deaths from heart attack each year could be prevented, saving more than $21.5 billion in medical costs.
The new prevention paradigm will have an extremely positive effect on corporate America, both from the standpoint of reducing healthcare expenditures and in preventing the untimely death of key executives.
“The societal and economic benefits of a healthier population are tremendous,” write Dr. Harvey Hecht and Dr. Morteza Naghavi. “By leveraging the predictive ability of (the S.H.A.P.E.) guidelines, doctors could better treat heart patients with more targeted drugs and therapies, thereby preventing major and complicated cardiovascular difficulties that otherwise would result in much larger bills for individuals and reimbursements covered by insurance companies.”
“It's not often a technology comes along that can have such a dramatic effect on healthcare expenses,” said Brunst, whose Carlsbad-based InnerVision Wellness Imaging performs EBT heart scans, cancer screenings and other preventive imaging tests. “The cost of a heart scan is $395. The cost of bypass surgery can run as high as $100,000. It doesn't take a financial genius to realize the heart scan is going to save many corporate health plans a great deal of money.”
According to Brunst, integrating screening into an existing corporate wellness program is simple and cost-effective. InnerVision works with program administrators to select screening services that are designed to detect disease at an earlier stage.
Interestingly, many hospitals now perform the heart scan with coronary calcium score and the nation's chief executive routinely gets an EBT heart scan.
“There are better reasons to focus on prevention than cost alone,” said Brunst. “But if the ability to reverse the trend of escalating healthcare costs leads to more widespread screening, so be it. Many more lives will be saved.”
For more information, visit www.innervisionwellness.com, or call InnerVision Wellness Imaging at (760) 804-9929.
In this case, the executive was former President Bill Clinton, and the false sense of security he received from his annual physical is not uncommon.
For many in the medical profession, this highly visible case was the death knell for the thallium stress test, although many physicians are still reluctant to give up this lucrative in-office test. It also demonstrated the futility of relying on cholesterol testing, blood pressure monitoring and other “traditional” forms of risk factor analysis for heart disease.
“About half of all heart attacks occur in patients with normal cholesterol levels,” sais Dr. Robert Brunst, medical director of InnerVision Wellness Imaging in Carlsbad.
It is estimated that each year, approximately $300 billion is spent on cardiovascular disease in America, with more than $129 billion calculated in lost productivity. Heart disease is also the leading cause of premature, permanent disability in the United States workforce.
The Clinton example also provided momentum for a new, highly-effective screening test called the Electron Beam Tomography (EBT) heart scan, also known as the coronary calcium score. Although EBT was being used by leading cardiac institutions like Johns Hopkins medical centers and the University of California, Los Angeles medical center, its widespread use was impeded by a minority of highly vocal physician opponents of the technology who believed widespread screening would lead to false-positives and unnecessary medical procedures.
That argument was since proven to be meritless. In fact, within the past year, the test has been endorsed by the American Heart Association, the American College of Cardiology and numerous other preventive cardiology groups. Best-selling author of The South Beach Diet and a cardiologist, Arthur Agatston, said that using “diet alone to treat heart disease would be ignoring 30 years of lifesaving medical advances.” In his new book The South Beach Heart Program, Agatston shows how heart disease can effectively be reversed, and how the coronary calcium score is the best tool to measure the progress.
“One of the real benefits of the heart scan is that I can show my patients pictures of their actual coronary arteries and the extent of plaque buildup,” he said.
Despite the endorsements, perhaps the greatest impetus for the widespread use of heart scans comes from the Screening for Heart Attack Prevention and Education (S.H.A.P.E.) task force. Led by top cardiologists including Dr. Matt Budoff of UCLA, Dr. Pamela Douglas of Duke University Medical Center and Dr. P.K. Shah or Cedars Sinai Medical Center, S.H.A.P.E. accomplished what no other advocacy group has ever attempted; it has quantified both the financial and lifesaving impact of widespread coronary screening using the heart scan. S.H.A.P.E. predicted that if intermediate risk patients were assessed with a coronary calcium score equivalent in accuracy to EBT, 90,000 deaths from heart attack each year could be prevented, saving more than $21.5 billion in medical costs.
The new prevention paradigm will have an extremely positive effect on corporate America, both from the standpoint of reducing healthcare expenditures and in preventing the untimely death of key executives.
“The societal and economic benefits of a healthier population are tremendous,” write Dr. Harvey Hecht and Dr. Morteza Naghavi. “By leveraging the predictive ability of (the S.H.A.P.E.) guidelines, doctors could better treat heart patients with more targeted drugs and therapies, thereby preventing major and complicated cardiovascular difficulties that otherwise would result in much larger bills for individuals and reimbursements covered by insurance companies.”
“It's not often a technology comes along that can have such a dramatic effect on healthcare expenses,” said Brunst, whose Carlsbad-based InnerVision Wellness Imaging performs EBT heart scans, cancer screenings and other preventive imaging tests. “The cost of a heart scan is $395. The cost of bypass surgery can run as high as $100,000. It doesn't take a financial genius to realize the heart scan is going to save many corporate health plans a great deal of money.”
According to Brunst, integrating screening into an existing corporate wellness program is simple and cost-effective. InnerVision works with program administrators to select screening services that are designed to detect disease at an earlier stage.
Interestingly, many hospitals now perform the heart scan with coronary calcium score and the nation's chief executive routinely gets an EBT heart scan.
“There are better reasons to focus on prevention than cost alone,” said Brunst. “But if the ability to reverse the trend of escalating healthcare costs leads to more widespread screening, so be it. Many more lives will be saved.”
For more information, visit www.innervisionwellness.com, or call InnerVision Wellness Imaging at (760) 804-9929.