faqs
Do you accept insurance or does insurance pay these tests?
Heart Health Screening does not accept insurance as a form of payment as many health plans have limitations on preventative health services. HHS does provide to you, our client, an itemized invoice which includes generally recognized insurance codes that insured individuals can submit to their insurance or managed care companies. Health insurance policies and managed care plans are contracts between the insured (you the beneficiary) and the insurance or managed care company. Health insurance and managed care plans that cover preventive medicine and screening tests may pay some or all of the charges for the Heart Health Screening examination. Some clients do not submit their claims as this may cause their information to be submitted to the Medical Information Bank or MIB- a warehouse for your medical insurance claims which may impact your future health insurance process. Other clients have used Health Spending Accounts to put their health care dollars (up to $2850 per year for an individual) directly to work for preventative medical services.
A bus that provides seven tests of the heart and arteries for $200 is coming to our church. How are you different?
Preventative testing such as this has found asymptomatic yet critical disease such as aneurysms and clogged carotid arteries in numerous patients and appears to be a good value. The focus of Heart Health Screening is early detection of risk factors for artery disease in motivated individuals who wish to decrease their risk of developing symptomatic disease. The primary difference is combining the heart scan with advanced laboratory testing to accurately define risk.
What is the ideal cholesterol level?
Ideal cholesterol levels have been evolving as our knowledge and technology have advanced. In the 70s and 80s, total cholesterol was measured and ideal was considered under 200. Subsequently, total cholesterol was broken down into sub components including LDL(bad cholesterol), HDL (good cholesterol), and triglycerides(medium bad cholesterol). In your composite cholesterol profile all three are important, however, LDL levels are of primary concern and current guidelines are based on these levels. Guidelines have been established by expert panels that produced the National Cholesterol Education Program Adult Treatment Plan III (NCEP-ATP III). Your ideal cholesterol level is based on your current level of risk for vascular disease. Based on your risk, your ideal LDL cholesterol level may be as low as 70.
My cholesterol is normal. Am I at risk for vascular disease?
Possibly. Traditional cholesterol levels (LDL, HDL, triglycerides) don't tell the entire story. One third of people with symptomatic heart disease (MI, heart attack, angina) have normal cholesterol levels as per current guidelines. Advanced technology has led further subdividing the traditional classes of cholesterol into subclasses. Certain subclasses are associated with higher levels of diseases. It's possible to have a normal cholesterol level comprised of a bad subclass of cholesterol and be at higher risk for vascular disease than someone with a higher cholesterol comprised of a good subclass of cholesterol.
Does everyone get vascular disease?
Your lifetime risk of vascular disease is high. In the United States, vascular disease is the leading cause of death and morbidity in men and women. It can start early in life and progress undetected (asymptomatic disease). There are no warning symptoms in the early stages of disease but it is like a time bomb waiting to go off. Often the first indication of disease is a catastrophic and sudden event such as a heart attack or stroke or death (symptomatic disease). Among the 50-year-old adults enrolled in the Framingham Heart Study, the lifetime risk for developing symptomatic disease was 52% in men and 39% in women
Why is it important to screen for vascular disease?
Advances in technology have made early detection and monitoring of vascular disease possible and advances in knowledge and treatments have made prevention and reversal of vascular disease possible. Coronary Artery Disease is like a ticking time bomb. It is silent in its early stages. It can begin early in life and progresses without signs or symptoms until it explodes and manifests itself suddenly in a catastrophic heart attack, stroke or sudden death. The purpose of screening is to identify risk factors and look for early signs of disease (before the catastrophic event) and do something about it. Coronary artery disease can be reversed however it is better to prevent it in the first place. Early screening and detection of coronary artery disease provides the chance to make lifestyle and dietary changes and, if necessary, treat high cholesterol with cholesterol-lowering medications to slow or reverse the progression of plaque buildup
I recently had a stress test and was told my arteries were clear. Do I need a heart CT scan?
A heart scan gives you different information. Stress tests can pick up significantly obstructing lesions, narrowing of the artery by 50 to 70% or more but most coronary events occur from smaller lesions that can't be picked up by stress testing. It has been shown that 68% of acute coronary events occur in arteries that, shortly before that event, were without significantly obstructive lesions. It is possible to walk out from a "normal" stress test and suffer a heart attack within minutes, hours or days after. A heart scan score is related to the amount of plaque present in your heart and determines your risk of a future event. Based on your risk, you can adjust the intensity of lipid lowering therapy according to guidelines from the National Cholesterol Education Panel, American Heart Association and the American College of Cardiology.
Who should be tested?
Men between ages 30 and 65 and women between ages 35 and 65 should know their cardiovascular risk factors. Men without risk factors should consider advance screening by age 45 and women without risk factors by age 55. Earlier testing should be considered if other risk factors are present. Major Risk factors include and: a family history of coronary heart disease in first-degree relatives (male relatives under age 55; female relatives under age 65), high cholesterol, history of smoking, high blood pressure, diabetes, overweight, sedentary lifestyle.
What is an EKG?
An EKG or ECG is a safe and painless test that studies the electrical activity of the heart. It presents a graphic tracing of the variations of electrical impulses as they are detected and measured through electrodes connected to the skin.
I am 70 years old and in good health. I am not on a medication and have been told that my cholesterol level is "good". Should I be tested?
Yes, you may find subclinical atherosclerosis and benefit decreased risk and increased longevity from aspirin and cholesterol-lowering therapy. Approximately 90% of men and 80% of women have atherosclerosis at 80 years old. The following is from the National Cholesterol Education Panel Executive Summary:
"Older adults (men ³ 65 years and women ³ 75 years). Overall, most new CHD events and most coronary deaths occur in older persons (³ 65 years). A high level of LDL cholesterol and low HDL cholesterol still carry predictive power for the development of CHD in older persons. Nevertheless, the finding of advanced subclinical atherosclerosis by noninvasive testing can be helpful for confirming the presence of high risk in older persons. Secondary prevention trials with statins have included a sizable number of older persons, mostly in the age range of 65 to 75 years. In these trials, older persons showed significant risk reduction with statin therapy. Thus, no hard-and fast age restrictions appear necessary when selecting persons with established CHD for LDL-lowering therapy. For primary prevention, TLC is the first line of therapy for older persons. However, LDL-lowering drugs can also be considered when older persons are at higher risk because of multiple risk factors or advanced subclinical atherosclerosis."
What blood pressure is considered high?
Normal blood pressure is 120/80.
What is Framingham Risk?
The Framingham risk is a well accepted tool for calculating risk of symptomatic coronary artery disease over the next 10 years. It is based on The Framingham Heart Study - a study of a large group of patients over 60 years and three generations. It uses easily measured factors - age, gender, total cholesterol, systolic blood pressure, and smoking history. The National Cholesterol Education Panel has guidelines for cholesterol levels that are based on level of risk.
What is a Heart CT Scan?
A Heart CT Scan is a simple non-invasive test used for early detection of heart disease. The scan is a painless test that takes about 10 minutes. The process is similar to taking an x-ray of your body. An individual lies on the scanner table and multiple images of the heart are taken. A qualified physician then interprets these images to determine the amount of calcified plaque in the arteries
What is a Comprehensive Metabolic Panel?
A comprehensive metabolic panel is a blood test that measures your sugar (glucose) level, electrolyte and fluid balance, kidney function, and liver function.
Your doctor may use this test to check on a medical condition, such as high blood pressure, or to help diagnose a medical condition, such as diabetes.
What is a Lipid (Cholesterol) Panel?
A lipid panel usually measures 3 different kinds of lipids in the blood, all of which are related to a type of fat called cholesterol. Most of the cholesterol in your blood is made by your liver from the fats, carbohydrates, and proteins you eat. You also get cholesterol by eating animal products such as meat, eggs, and dairy products. The 3 kinds of lipids measured in a lipid panel are: LDL cholesterol (low-density lipoprotein) HDL cholesterol (high-density lipoprotein) triglycerides. The lipid panel also measures total cholesterol, which is the sum of all the types of cholesterol in your blood.
What is a Cardio CRP (hs-CRP)?
Cardio CRP is the first heart disease indicator to be recommended by the American Heart Association in twenty years. This test entails a surprisingly simple, inexpensive blood test. This high sensitivity C-reactive protein (hs-CRP) test takes the traditional cardiac check-up a step further, pinpointing those people who are at a much higher risk than others for heart disease, America's leading cause of death. From hs-CRP results, doctors gain crucial insight into inflammation of the blood vessels around the heart, a factor not considered until now for patients at risk.
I have heard that a CT angiogram is a better test to see blocked arteries. Shouldn't I just get this test to see if everything is okay?
The CT angiogram is an excellent test however it should not be used for screening due to the relative high radiation (6-10 X) exposure compared to the heart scan.
I am a woman and just see my gynecologist each year for a Pap and mammogram. They have checked my cholesterol. Do I have to worry about vascular disease?
Yes, vascular disease is the number one killer of women. The disease kills nearly half a million women each year and young women are not immune. "I've seen thirtysomething marathon runners with borderline or high cholesterol levels who are shocked to learn that are at risk. I tell them that heart disease doesn't care if you wear a size 2 or a size 20: If you've got just one red flag- like high blood pressure- you're in danger. The lack of awareness among doctors when it comes to women and heart disease is horrifying. Since heart disease is under diagnosed and undertreated in women, it's vital to be your own advocate- which means knowing your blood pressure and cholesterol levels and being able to spot worrisome symptoms. " quoted Susan Bennett, M.D., director of Women's Heart Program at George Washington University Hospital in Shape magazine. And American Heart Association survey found that less than 20% of doctors(including ob-gyns, primary-care physicians, and cardiologists) knew that more women die of heart disease each year than men. Also women with heart disease are nearly twice as likely as men to suffer a potential fatal heart attack - probably because they are less likely to be referred for diagnostic tests or given preventive medication for lowering blood pressure or cholesterol levels. Furthermore, women suffering heart attacks often have atypical symptoms such as fatigue, shortness of breath or indigestion as the prominent symptom which may delay diagnosis and prompt treatment. From the National Cholesterol Education Panel Executive Summary: "Women (ages 45-75 years). In women, onset of CHD generally is delayed by some 10-15 years compared with that in men..... For primary prevention, ATP III's general approach is similarly applicable for women and men. However, the later onset of CHD for women in general should be factored into clinical decisions about use of cholesterol-lowering drugs.
Vascular Disease
Does anyone else support the strategy of primary prevention of vascular disease?
Yes, the American Heart Association and the American Cardiology College formed the National Cholesterol Education Program Expert Panel which produced Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP III). The following is a quote from the Executive Summary "Primary prevention of CHD offers the greatest opportunity for reducing the burden of CHD in the United States. The clinical approach to primary prevention is founded on the public health approach that calls for lifestyle changes, including: 1) reduced intakes of saturated fat and cholesterol, 2) increased physical activity, and 3) weight control, to lower population cholesterol levels and reduce CHD risk, but the clinical approach intensifies preventive strategies for higher risk persons. One aim of primary prevention is to reduce long-term risk (>10 years) as well as short-term risk (²10 years). LDL goals in primary prevention depend on person's absolute risk for CHD (i.e., the probability of having a CHD event in the short term or the long term) — the higher the risk, the lower the goal. Therapeutic lifestyle changes are the foundation of clinical primary prevention. Nonetheless, some persons at higher risk because of high or very high LDL cholesterol levels or because of multiple risk factors are candidates for LDL-lowering drugs. Recent primary prevention trials show that LDL-lowering drugs reduce risk for major coronary events and coronary death even in the short term."
What is "risk" and why is it important?
"Risk" is the chance that an event will happen. For vascular disease, you look at risk over 3 time frames: current (now through 2 years), 10 year risk and lifetime risk. Also a distinction is made between symptomatic disease (heart attack, chest pain, sudden death) and silent asymptomatic disease.
Your lifetime risk for vascular disease, both asymptomatic and symptomatic, is high - approaching 90% for men and 80% for women. One in three women will die from vascular disease compared to 1 in 30 for breast cancer.
Your current risk is determined by a number of factors and tests - including those provided by Heart Health Screening.
Defining your current risk is important because it determines the intensity of lifestyle changes (diet and exercise) and dietary supplements and medication needed now to reduce your risk and slow or reverse disease.
The Framingham Risk determination assesses your 10 year risk of symptomatic disease.
Heart Health Screening does not accept insurance as a form of payment as many health plans have limitations on preventative health services. HHS does provide to you, our client, an itemized invoice which includes generally recognized insurance codes that insured individuals can submit to their insurance or managed care companies. Health insurance policies and managed care plans are contracts between the insured (you the beneficiary) and the insurance or managed care company. Health insurance and managed care plans that cover preventive medicine and screening tests may pay some or all of the charges for the Heart Health Screening examination. Some clients do not submit their claims as this may cause their information to be submitted to the Medical Information Bank or MIB- a warehouse for your medical insurance claims which may impact your future health insurance process. Other clients have used Health Spending Accounts to put their health care dollars (up to $2850 per year for an individual) directly to work for preventative medical services.
A bus that provides seven tests of the heart and arteries for $200 is coming to our church. How are you different?
Preventative testing such as this has found asymptomatic yet critical disease such as aneurysms and clogged carotid arteries in numerous patients and appears to be a good value. The focus of Heart Health Screening is early detection of risk factors for artery disease in motivated individuals who wish to decrease their risk of developing symptomatic disease. The primary difference is combining the heart scan with advanced laboratory testing to accurately define risk.
What is the ideal cholesterol level?
Ideal cholesterol levels have been evolving as our knowledge and technology have advanced. In the 70s and 80s, total cholesterol was measured and ideal was considered under 200. Subsequently, total cholesterol was broken down into sub components including LDL(bad cholesterol), HDL (good cholesterol), and triglycerides(medium bad cholesterol). In your composite cholesterol profile all three are important, however, LDL levels are of primary concern and current guidelines are based on these levels. Guidelines have been established by expert panels that produced the National Cholesterol Education Program Adult Treatment Plan III (NCEP-ATP III). Your ideal cholesterol level is based on your current level of risk for vascular disease. Based on your risk, your ideal LDL cholesterol level may be as low as 70.
My cholesterol is normal. Am I at risk for vascular disease?
Possibly. Traditional cholesterol levels (LDL, HDL, triglycerides) don't tell the entire story. One third of people with symptomatic heart disease (MI, heart attack, angina) have normal cholesterol levels as per current guidelines. Advanced technology has led further subdividing the traditional classes of cholesterol into subclasses. Certain subclasses are associated with higher levels of diseases. It's possible to have a normal cholesterol level comprised of a bad subclass of cholesterol and be at higher risk for vascular disease than someone with a higher cholesterol comprised of a good subclass of cholesterol.
Does everyone get vascular disease?
Your lifetime risk of vascular disease is high. In the United States, vascular disease is the leading cause of death and morbidity in men and women. It can start early in life and progress undetected (asymptomatic disease). There are no warning symptoms in the early stages of disease but it is like a time bomb waiting to go off. Often the first indication of disease is a catastrophic and sudden event such as a heart attack or stroke or death (symptomatic disease). Among the 50-year-old adults enrolled in the Framingham Heart Study, the lifetime risk for developing symptomatic disease was 52% in men and 39% in women
Why is it important to screen for vascular disease?
Advances in technology have made early detection and monitoring of vascular disease possible and advances in knowledge and treatments have made prevention and reversal of vascular disease possible. Coronary Artery Disease is like a ticking time bomb. It is silent in its early stages. It can begin early in life and progresses without signs or symptoms until it explodes and manifests itself suddenly in a catastrophic heart attack, stroke or sudden death. The purpose of screening is to identify risk factors and look for early signs of disease (before the catastrophic event) and do something about it. Coronary artery disease can be reversed however it is better to prevent it in the first place. Early screening and detection of coronary artery disease provides the chance to make lifestyle and dietary changes and, if necessary, treat high cholesterol with cholesterol-lowering medications to slow or reverse the progression of plaque buildup
I recently had a stress test and was told my arteries were clear. Do I need a heart CT scan?
A heart scan gives you different information. Stress tests can pick up significantly obstructing lesions, narrowing of the artery by 50 to 70% or more but most coronary events occur from smaller lesions that can't be picked up by stress testing. It has been shown that 68% of acute coronary events occur in arteries that, shortly before that event, were without significantly obstructive lesions. It is possible to walk out from a "normal" stress test and suffer a heart attack within minutes, hours or days after. A heart scan score is related to the amount of plaque present in your heart and determines your risk of a future event. Based on your risk, you can adjust the intensity of lipid lowering therapy according to guidelines from the National Cholesterol Education Panel, American Heart Association and the American College of Cardiology.
Who should be tested?
Men between ages 30 and 65 and women between ages 35 and 65 should know their cardiovascular risk factors. Men without risk factors should consider advance screening by age 45 and women without risk factors by age 55. Earlier testing should be considered if other risk factors are present. Major Risk factors include and: a family history of coronary heart disease in first-degree relatives (male relatives under age 55; female relatives under age 65), high cholesterol, history of smoking, high blood pressure, diabetes, overweight, sedentary lifestyle.
What is an EKG?
An EKG or ECG is a safe and painless test that studies the electrical activity of the heart. It presents a graphic tracing of the variations of electrical impulses as they are detected and measured through electrodes connected to the skin.
I am 70 years old and in good health. I am not on a medication and have been told that my cholesterol level is "good". Should I be tested?
Yes, you may find subclinical atherosclerosis and benefit decreased risk and increased longevity from aspirin and cholesterol-lowering therapy. Approximately 90% of men and 80% of women have atherosclerosis at 80 years old. The following is from the National Cholesterol Education Panel Executive Summary:
"Older adults (men ³ 65 years and women ³ 75 years). Overall, most new CHD events and most coronary deaths occur in older persons (³ 65 years). A high level of LDL cholesterol and low HDL cholesterol still carry predictive power for the development of CHD in older persons. Nevertheless, the finding of advanced subclinical atherosclerosis by noninvasive testing can be helpful for confirming the presence of high risk in older persons. Secondary prevention trials with statins have included a sizable number of older persons, mostly in the age range of 65 to 75 years. In these trials, older persons showed significant risk reduction with statin therapy. Thus, no hard-and fast age restrictions appear necessary when selecting persons with established CHD for LDL-lowering therapy. For primary prevention, TLC is the first line of therapy for older persons. However, LDL-lowering drugs can also be considered when older persons are at higher risk because of multiple risk factors or advanced subclinical atherosclerosis."
What blood pressure is considered high?
Normal blood pressure is 120/80.
What is Framingham Risk?
The Framingham risk is a well accepted tool for calculating risk of symptomatic coronary artery disease over the next 10 years. It is based on The Framingham Heart Study - a study of a large group of patients over 60 years and three generations. It uses easily measured factors - age, gender, total cholesterol, systolic blood pressure, and smoking history. The National Cholesterol Education Panel has guidelines for cholesterol levels that are based on level of risk.
What is a Heart CT Scan?
A Heart CT Scan is a simple non-invasive test used for early detection of heart disease. The scan is a painless test that takes about 10 minutes. The process is similar to taking an x-ray of your body. An individual lies on the scanner table and multiple images of the heart are taken. A qualified physician then interprets these images to determine the amount of calcified plaque in the arteries
What is a Comprehensive Metabolic Panel?
A comprehensive metabolic panel is a blood test that measures your sugar (glucose) level, electrolyte and fluid balance, kidney function, and liver function.
Your doctor may use this test to check on a medical condition, such as high blood pressure, or to help diagnose a medical condition, such as diabetes.
What is a Lipid (Cholesterol) Panel?
A lipid panel usually measures 3 different kinds of lipids in the blood, all of which are related to a type of fat called cholesterol. Most of the cholesterol in your blood is made by your liver from the fats, carbohydrates, and proteins you eat. You also get cholesterol by eating animal products such as meat, eggs, and dairy products. The 3 kinds of lipids measured in a lipid panel are: LDL cholesterol (low-density lipoprotein) HDL cholesterol (high-density lipoprotein) triglycerides. The lipid panel also measures total cholesterol, which is the sum of all the types of cholesterol in your blood.
What is a Cardio CRP (hs-CRP)?
Cardio CRP is the first heart disease indicator to be recommended by the American Heart Association in twenty years. This test entails a surprisingly simple, inexpensive blood test. This high sensitivity C-reactive protein (hs-CRP) test takes the traditional cardiac check-up a step further, pinpointing those people who are at a much higher risk than others for heart disease, America's leading cause of death. From hs-CRP results, doctors gain crucial insight into inflammation of the blood vessels around the heart, a factor not considered until now for patients at risk.
I have heard that a CT angiogram is a better test to see blocked arteries. Shouldn't I just get this test to see if everything is okay?
The CT angiogram is an excellent test however it should not be used for screening due to the relative high radiation (6-10 X) exposure compared to the heart scan.
I am a woman and just see my gynecologist each year for a Pap and mammogram. They have checked my cholesterol. Do I have to worry about vascular disease?
Yes, vascular disease is the number one killer of women. The disease kills nearly half a million women each year and young women are not immune. "I've seen thirtysomething marathon runners with borderline or high cholesterol levels who are shocked to learn that are at risk. I tell them that heart disease doesn't care if you wear a size 2 or a size 20: If you've got just one red flag- like high blood pressure- you're in danger. The lack of awareness among doctors when it comes to women and heart disease is horrifying. Since heart disease is under diagnosed and undertreated in women, it's vital to be your own advocate- which means knowing your blood pressure and cholesterol levels and being able to spot worrisome symptoms. " quoted Susan Bennett, M.D., director of Women's Heart Program at George Washington University Hospital in Shape magazine. And American Heart Association survey found that less than 20% of doctors(including ob-gyns, primary-care physicians, and cardiologists) knew that more women die of heart disease each year than men. Also women with heart disease are nearly twice as likely as men to suffer a potential fatal heart attack - probably because they are less likely to be referred for diagnostic tests or given preventive medication for lowering blood pressure or cholesterol levels. Furthermore, women suffering heart attacks often have atypical symptoms such as fatigue, shortness of breath or indigestion as the prominent symptom which may delay diagnosis and prompt treatment. From the National Cholesterol Education Panel Executive Summary: "Women (ages 45-75 years). In women, onset of CHD generally is delayed by some 10-15 years compared with that in men..... For primary prevention, ATP III's general approach is similarly applicable for women and men. However, the later onset of CHD for women in general should be factored into clinical decisions about use of cholesterol-lowering drugs.
Vascular Disease
Does anyone else support the strategy of primary prevention of vascular disease?
Yes, the American Heart Association and the American Cardiology College formed the National Cholesterol Education Program Expert Panel which produced Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (ATP III). The following is a quote from the Executive Summary "Primary prevention of CHD offers the greatest opportunity for reducing the burden of CHD in the United States. The clinical approach to primary prevention is founded on the public health approach that calls for lifestyle changes, including: 1) reduced intakes of saturated fat and cholesterol, 2) increased physical activity, and 3) weight control, to lower population cholesterol levels and reduce CHD risk, but the clinical approach intensifies preventive strategies for higher risk persons. One aim of primary prevention is to reduce long-term risk (>10 years) as well as short-term risk (²10 years). LDL goals in primary prevention depend on person's absolute risk for CHD (i.e., the probability of having a CHD event in the short term or the long term) — the higher the risk, the lower the goal. Therapeutic lifestyle changes are the foundation of clinical primary prevention. Nonetheless, some persons at higher risk because of high or very high LDL cholesterol levels or because of multiple risk factors are candidates for LDL-lowering drugs. Recent primary prevention trials show that LDL-lowering drugs reduce risk for major coronary events and coronary death even in the short term."
What is "risk" and why is it important?
"Risk" is the chance that an event will happen. For vascular disease, you look at risk over 3 time frames: current (now through 2 years), 10 year risk and lifetime risk. Also a distinction is made between symptomatic disease (heart attack, chest pain, sudden death) and silent asymptomatic disease.
Your lifetime risk for vascular disease, both asymptomatic and symptomatic, is high - approaching 90% for men and 80% for women. One in three women will die from vascular disease compared to 1 in 30 for breast cancer.
Your current risk is determined by a number of factors and tests - including those provided by Heart Health Screening.
Defining your current risk is important because it determines the intensity of lifestyle changes (diet and exercise) and dietary supplements and medication needed now to reduce your risk and slow or reverse disease.
The Framingham Risk determination assesses your 10 year risk of symptomatic disease.