As published in the Union Leader—Feb 1, 2022
When physicians work together, amazing care happens. That’s the foundation of the newest offering from CMC’s New England Heart & Vascular Institute. The Center for Cardiometabolic Health & Preventive Cardiology looks to assess and address a patient’s risk for heart disease. To be successful, “I’m working in partnership with someone’s cardiology team, their endocrinologist, or their primary care physician,” says cardiologist Jonathan Eddinger, MD, FACC, FASE.
“To me, it’s a great approach to have doctors talking to each other instead of staying in their own specialties, and just considering what a medication does for the problem they’re focused on,” says Stephen Gray of Rindge, one of Dr. Eddinger’s patients at the Center.
It seems intuitive, but it hasn’t always been the norm for doctors to collaborate closely across specialties on a patient’s care, especially when it comes to medication. A patient with diabetes and high cholesterol may be getting prescriptions to manage both conditions, but the providers aren’t necessarily talking to each other on the best way to optimize the medications.
“We see a lot of drugs that can lower mortality,” says Dr. Eddinger, “but those drugs are researched and trialed in silos. There is a lot of data on individual drugs but how to layer and combine them requires communication with other specialists about the benefits and risk.”
Such is the approach Dr. Eddinger is looking to take with Gray’s endocrinologist, “because he feels the heart needs some protection and there are some diabetic drugs that will do both—reduce my blood sugars and also protect my heart.”
The Center for Cardiometabolic Health & Preventive Cardiology goes well beyond medication management. Cardiometabolic Health is an emerging field that aims to reduce the risk for—and hopefully prevent—heart disease.
Cardiologists who work in cardiometabolic health, like Dr. Eddinger, create an individual risk profile for every patient. “We have a lot of risk calculators in cardiology but they’re all pretty simple,” says Dr. Eddinger. “I need to add factors like family history and genetics, inflammatory disorders and past pregnancy or childbirth problems for women. We will sometimes use imaging to get a better sense of risk as well as lab work. It is an individualized approach.”
Then there’s the partnership of a patient’s other specialists and primary care physicians to address health issues that don’t necessarily fall under cardiology but may be further increasing cardiovascular risk. Diabetes is a prime example because, “heart disease is the primary cause of death for a diabetic patient,” says Dr. Eddinger.
Heart disease refers to refers to several conditions, including coronary artery disease (a narrowing of the arteries), which decreases blood flow to the heart. Factors that contribute to heart disease include high blood pressure, smoking and high cholesterol.
“We spend a lot of resources and money on people when they’re having heart events and when they’re at the end of life,” notes Dr. Eddinger. “My hope would be that by improving preventive health, we can minimize the need for procedures and have people have longer, healthier lives without heart disease.”
So what kind of patient should have a risk assessment? For many, assessing heart disease risk is a fairly easy task. For others, however, Dr. Eddinger says “there might be more questions about what their risk for heart disease is. When those questions are getting more complicated, or if a person already has heart disease but it is difficult to manage, that’s when they should come see us.”
A few years ago, Gray and his friends would never talk about their health. These days, he chuckles, “it seems like we start our conversations with, ‘what’s wrong with you now.’” He is able to say, “I feel well.”
CMC’s Center for Cardiometabolic Health & Preventive Cardiology
(formerly the Cholesterol Management Center) hours:
Mon & Wed 8 AM–1 PM
Tue & Thu 8 AM–5 PM