Who is at risk for heart attacks and strokes?

People with one or more of several well-described risk factors are at an increased risk:

  • Hypertension
  • Diabetes/insulin resistance
  • Gingival/periodontal diseases or root canal lesions
  • Cigarette smoking/second-hand smoke
  • Obesity
  • High cholesterol
  • Family history of premature heart attacks or strokes
  • Sedentary lifestyle
  • Chronic inflammatory conditions or autoimmune disease

What is different about the Heart Attack and Stroke Prevention Center?

As a board certified cardiologist who has been practicing standard cardiology including noninvasive, invasive and clinical for more than thirty years, I have come to realize that the standard approach to coronary artery disease is not really slowing the occurrence of heart attacks as much as it could. I have come to believe that a more aggressive approach to prevention is needed.  The key to prevention is controlling the various causes of inflammation in the body.  Many of these distant areas of inflammation can actually set up the arteries of the heart and head to develop blockages.  We not only look for the inflammation to control, but we also monitor the progress of our efforts through simple, noninvasive arterial imaging and periodic blood tests.

What is the Bale Doneen Method?

This is an approach developed by Drs. Bradley Bale and Amy Doneen over the past fifteen years which relies on 6 principles: EDFROG

  1. Education: By understanding the process behind the development of the blockages in the arteries that cause the heart attacks and strokes, you will become a more involved partner in your prevention.
  2. Detect Disease: We look very carefully for evidence of atherosclerosis. This is important because we then use simple office testing to follow the atherosclerotic process, ensuring maximum control. We will follow your atherosclerosis with annual CIMT testing to actually look at the level of blockage in your Carotid arteries.
  3. Fire: We look carefully to judge the level of inflammation (fire) in your arteries. This is done initially and followed quarterly, if necessary, to make sure we are getting the inflammatory process under control. It is the inflammation in the arteries that allows more cholesterol to build up in the arterial walls and block off the blood flow through the arteries.
  4. Root Causes: There is a multitude of root causes for the inflammation that can affect the coronary and cerebral arteries. Many of these disease states are silent, or overlooked, and include insulin resistance, metabolic syndrome, periodontal disease, failing root canals and obstructive sleep apnea. Abnormalities of the gut biome is a growing area of research that can play a large role in the cause of inflammation as well.
  5. Optimal: We design a personalized plan just for your particular situation to bring the atherosclerotic process under control.
  6. Genetics: We use several genetic tests to evaluate your individual makeup so that we can recommend the ideal medications and diet to control your atherosclerotic process as best as possible.

How does the Bale Doneen Method differ from “standard of care” cardiology?

In the standard of care style of medical practice, the physicians use a risk factor model called the Framingham Risk Score or Reynold’s Risk Score. They look at your blood pressure, cholesterol, blood sugar, family history and level of exercise. This is all entered into a formula to arrive at your 10-year risk of having a heart attack. If the number is low enough, you receive a pat on the back and are told you are doing fine; You don’t need to worry about a heart attack.

Unfortunately, a recent retrospective study looked at a series of men and women with heart attacks and found that by calculating the standard risk scores for these men and women, those risk scores missed finding a significant risk of heart attack in 82% of the women and 66% of the men. Is that result good enough for you? We don’t think so.

The Bale Doneen Method uses an individualized approach to your care. Standard medical treatment assumes you don’t have any atherosclerosis. We assume you do have atherosclerosis until we can prove that you don’t. If we find evidence of some blockages, even if they are mild, we work hard to make sure they will not get any bigger. There is a lot of new research that tells us the atherosclerotic process can be slowed down, halted and even reversed. Unfortunately, it is often the mild blockage that can lead to a heart attack or stroke.

If we find mild blockages, we will attack them with stabilizing medications and look for other medical problems that may cause the blockages to worsen.

You talk about offering personalized care, what does that mean?

The standard model of cardiac care looks at the several risk factors above and comes up with a 10-year risk level for you. This risk is based on studies looking at thousands of people. If your number is low enough, then your doctor will tell you not to worry.

Instead, we look at you individually and arrive at a plan based upon your particular genetic makeup and level of atherosclerotic disease already present. This is personalized care based on YOU, not on statistics. We are looking not only for the presence of atherosclerosis in your heart but also the level of inflammation in your body allowing the blockages to progress. Half of all heart attacks occur during the first symptom of coronary artery disease.

I already have a cardiologist, why should I consider care at the Heart Attack and Stroke Prevention Center?

We will work with your current cardiologist to minimize your risk. By looking at your genetic tests, we can suggest the correct diet and statin. Not all statins are right for everyone. As just one example, if you have diabetes, you might need to be on vitamin E. For others with diabetes, it may not be necessary or even be harmful.

We will work with your current cardiologist/primary care physician/dentist to optimize your care and prevent that heart attack or stroke.

Does my insurance cover this care?

The Heart Attack and Stroke Prevention Center of Central Ohio is a concierge practice. We feel that by using this model we can supply you the most personalized care. While we are not covered by Medicare or third party insurance, many of your lab tests may be. We will supply you with ICD-10 codes to submit to Medicare or your third party insurer.