September 2, 2005

Stopping heart disease before it starts: The MGH Cardiovascular Disease Prevention Center

More than 25 million Americans are considered at high risk for heart disease, the leading cause of death among U.S. adults. Some 1.1 million men and women will experience a heart attack this year, and for nearly half of them it won't be their first time.

At the MGH, treating patients diagnosed with heart disease is just one piece of the cardiac care puzzle. Since July, the hospital has focused new efforts on the aggressive management of risk factors that can lead to heart disease through the MGH Heart Center's Cardiovascular Disease Prevention Center.

The center, located at a new facility on New Chardon Street, is made up of three distinct programs aimed at different aspects of heart disease. In addition to the established Cardiac Rehabilitation Program — which emphasizes secondary prevention for existing heart disease — there are two new programs that focus on preventing a first heart attack — the Heart Attack Primary Prevention Program and the Cardiac Metabolic Syndrome Program.

Each program provides at-risk patients with an initial assessment and relevant medical tests, as well as customized exercise, behavior and nutritional supports. Consultations include a heart attack risk report — which summarizes a patient's risk factors, blood biomarker results and any relevant cardiac imaging tests — a set of risk reduction recommendations and a suggested action plan.

Sekar Kathiresan, MD, medical director of the Cardiovascular Disease Prevention Center, notes that the center provides patients at higher risk for heart attack — such as those with a family history — with an expanding array of diagnostic tests for risk assessment, including blood biomarkers and heart scan tests such as coronary calcium score and computed tomographic (CT) angiography. “Through the Heart Attack Primary Prevention clinic, we hope to guide patients and doctors in the application and interpretation of these tests,” Kathiresan says. “In addition, using our expanded exercise facility and nutrition services resources, we aim to help patients implement lifestyle changes that are critical for long-term prevention.”

The Cardiac Metabolic Syndrome Program is designed to reduce cardiovascular risk in patients who are overweight, have high blood pressure and/or cholesterol, and who may have diabetes. Paul Huang, MD, PhD, director of this program, says the goal is to reduce cardiovascular risks through lifestyle changes that people can easily adopt. Huang and Kate Traynor, RN, MS, program director for the center, have developed a 12-week nutrition and exercise program. Once a week, patients exercise under the guidance of the cardiac rehabilitation nurses, doing aerobic exercise as well as strength training. Participants also have an hour of relaxation, guided imagery and yoga. “The program is extremely popular, and many of our patients have already lost a significant amount of weight and lowered their blood pressure and cholesterol levels,” Huang says. “More importantly, they tell me they feel so much better.”

The MGH's Cardiac Rehabilitation Program, established in 1979, will continue to focus on helping prevent a recurrent heart attack or chest pain in patients who already suffer from coronary artery disease. Overall, through the new center, the MGH will take a leading role in adding education to the arsenal of weapons used to treat heart disease. “Many people don't realize even modest alterations in lifestyle choices can reduce the risk of heart attack,” says Traynor. “Women in particular are a prime audience for information about heart disease because their symptoms and disease progression are different than men's, and most women don't know what their symptoms are.”

The Cardiovascular Disease Prevention Center will be hosting an open house for all interested staff Oct. 6 from 11 am to 3 pm. For more information, contact Brenda Carrera-Allen at (617) 726-1843.