Why Your Patient Would Benefit from Seeing a Preventive Cardiologist

New Center for Cardiovascular Prevention at UH offers specific expertise in managing high-risk patients

UH Clinical Update | April 2021

Preventive cardiologists have more tools available today to help measure and mitigate patients’ cardiovascular risk than ever before. Newer medications, such as SGLT2 inhibitors, GLP-1 receptor agonists for diabetes and obesity, and PCSK9 inhibitors for patients with recurrent cardiovascular disease events, severe high cholesterol, or familial hyperlipidemia are making a measurable difference for high-risk patients. At the same time, more widespread coronary artery calcium scoring and advanced lipid testing allow for more nuanced and sophisticated assessment of cardiovascular risk.

“As preventive cardiologists, one of the things we can provide is advanced risk testing,” says Ian Neeland, MD, who directs the new Center for Cardiovascular Prevention at UH.

He cites the example of advanced lipid and lipoprotein testing, which quantifies LDL particle number and small particle size and number, beyond just providing LDL cholesterol content. For some patients, it’s a distinction that matters a lot.

“High numbers here portend additional risk,” says Dr.  Neeland. “People with high LDL particle numbers are at three-fold higher risk over five years for developing a heart attack, even when LDL cholesterol overall is considered ‘normal.’ Higher cholesterol means higher particles, but there is a lot of variation. There’s no way to know that without doing this advanced testing.”

Dr. Neeland says that he and his preventive cardiology colleagues at UH, available on both the East and West side, are eager to share this expertise with primary care providers and their patients who are at high risk of heart attack or stroke.

“We’re of the belief that every patient at high risk of cardiovascular disease should see a preventive cardiologist,” he says. “Primary care providers can utilize us as a resource. We are laser-focused on risk assessment and risk mitigation. It’s what we do and focus on every day. We can provide a very specific and detailed assessment of risk from a cardiovascular standpoint to help them manage their patients better.”

When more patients see a preventive cardiologist, outcomes improve, both for individuals and the hospital systems where they receive care, Dr. Neeland says.

“There’s data out there showing that a preventive cardiology program really can improve outcomes for patients and also for health systems, by decreasing hospitalizations for cardiac events, like heart failure and heart attacks,” he says. “It’s lower-cost, more efficient, high-quality care.”

Dr. Neeland says he looks forward to collaborating with primary care providers at UH in caring for their patients at high cardiovascular risk, whether informally or by co-managing the patient.

“I always CC the primary care provider on the note, but I’ll also often email them to describe my thoughts, why I’m recommending A vs. B, and what I think best fits the patient,” he says. “I’ll offer assistance in managing the care, or if referring providers just want some recommendations and advice and guidance, that’s fine, too.”

You can refer to Dr. Neeland or his colleagues in the UHCare Ambulatory EMR by typing “Cardiology-Prevention.” For more information about Dr. Neeland or the Center for Cardiovascular Prevention, email Ian.Neeland@UHhospitals.org.