"Eradicating Heart Attacks with Screening for Early Detection and Treatment of Asymptomatic Atherosclerosis: The SHAPE Initiative"

Dr. Morteza Naghavi
President and Chief Executive Officer,
Fairway Medical Technologies, USA
Chairman, Society for Heart Attack Prevention and Eradication (SHAPE)


Abstract

In the United States, the word “healthcare” in ”healthcare system” is a misnomer. Most of our rapidly rising medical care expenses are spent on “sick care”, i.e., treating late stage symptomatic diseases that could have been detected and treated earlier. In the past 30 years, while major developments occurred in the treatment of symptomatic cardiovascular disease (CVD), most notably heart attack and stroke, very little innovation has occured in the early detection and primary prevention of these fatal events. In fact, since the initial wave of “risk factor” awareness in the 1970s (cholesterol, blood pressure, smoking, etc.) and the birth of statins in the 1980s, there have been no ground breaking advances in the primary prevention of CVD. With the much debated rising healthcare costs and the sweeping legislation of “Obamacare”, there is now an unprecedented opportunity to turn cardiovascular healthcare into its true definition of health care by mandating preventive care. Early detection of asymptomatic atherosclerosis with novel noninvasive tools such as coronary CT and carotid ultrasound as recommended by the SHAPE -Screening for Heart Attack Prevention and Education- Task Force, and intensive treatment of those classified as High Risk or Very High High Risk (the Vulnerable Patient), have the potential to advance primary CVD prevention to the point of eradicating heart attacks. In 2009, the Texas Heart Attack Preventive Screening law was passed as the first preventive screening initiative after mammography. Although the Texas law serves as a monumental milestone towards the eradication of heart attacks, and has set the stage for other states and countries to follow, it is far from enough. Additional policy reforms must be seriously considered by the legislative and executive bodies to kill the number one killer:

  1. Provide more reimbursement incentives for preventive healthcare technologies.
  2. Empower primary care physicians to utilize state-of-the-art preventive diagnostic technologies.
  3. Enforce “pay for benefit” strategy instead of the existing “pay for service”, and exercise it in all layers of medical care (primary, secondary, and tertiary).
  4. Give incentive and funding priorities through NIH, NSF, and other federal research funding agencies to fund proposals with innovative technologies focusing on primary prevention.
  5. Empower consumers to take charge of their health. Make available Over the Counter safe and effective drugs such as statins.
  6. Give economic incentive (such as tax breaks) to the medical industry for any future products they bring to the market focusing on primary prevention.
  7. Give economic incentive (tax breaks) to people to reduce their burden of CVD risk, e.g., weight loss, stop smoking cessation, cholesterol and blood pressure lowering.
  8. Increase the tax on smoking, both consumers and providers.
  9. Shift cardiovascular prevention from the hospital and doctors’ offices to home and the work place; give incentive to home health monitoring companies and reduce legal barriers for mass adoption of telemedicine and telehealthcare.
  10. Proclaim atherosclerosis as a disease, and create a worldwide mandate to pay for screening and treatment of asymptomatic atherosclerosis.

In conclusion, heart attacks can be eradicated in the 21st century if the medical community, including academia, industry, and healthcare policymakers, shift their investment from sick care to healthcare.

Biography

Dr. Naghavi is an innovative medical doctor, entrepreneur and researcher with interests in preventive cardiology, medical technology, and home healthcare. He graduated as a M.D. from Tehran University and was trained as a cardiovascular physician scientist under distinguished cardiologists Dr. S. Ward Casscells III and Dr. James T. Willerson at the Texas Heart Institute and the University of Texas Health Science Center in Houston. Dr. Naghavi is internationally recognized as a leader in heart attack prevention initiatives. Through his years of efforts in advancing the field of preventive cardiology, Dr. Naghavi founded the Society for Heart Attack Prevention and Eradication (SHAPE) and is the Executive Chairman of the SHAPE Task Force, an international non-profit coalition to overhaul the traditional (ineffective) methods of identifying individuals at risk of a near future heart attack. In 2009, the SHAPE organization helped pass Texas legislation HB1290 as the first heart attack preventive screening law in the United States. Dr. Naghavi has a number of collaborative academic research projects including NIH and NSF funded studies. He has numerous publications in scientific journals, most notably two major consensus statements (Part I and Part II) and the SHAPE Guidelines. He is also the editor of “Asymptomatic Atherosclerosis: Pathophysiology, Detection and Treatment”, the most comprehensive textbook on risk assessment of the Vulnerable Patient. Along with academic activities, Dr. Naghavi is also an inventor and entrepreneur with over 30 patents and 5 companies including Volcano Corporation (NASDAQ: VOLC) and CardioNexus Corporation (in partnership with Panasonic Healthcare). He is currently the President and CEO of Fairway Medical Technologies and managing partner at IN3 Ventures. Dr. Naghavi and colleagues are passionate about transforming new ideas into healthcare solutions, and welcomes innovative proposals from physicians, engineers, and entrepreneurs.

Email: morteza.naghavi@fairwaymed.com

  1. Naghavi, M. Asymptomatic Atherosclerosis. Pathophysiology, Detection and Treatment. ISBN: 978-1-60327-178-3. Springer Inc. Editor: Morteza Naghavi, M.D., Co-Editors: Mathew Budoff, M.D., Daniel Berman M.D., Erling Falk, M.D., Ph.D., Zahi Fayad, M.D., Harvey Hecht, M.D., Khurram Nasir, M.D., Prediman K. Shah, M.D.
  2. Ahmadi, N., Budoff, M., Naghavi, M., et al. Low Fingertip Temperature Rebound Measured By Digital Thermal Monitoring Strongly Correlates with the Presence and Extent of Coronary Artery Disease Diagnosed by 64-Slice Multi-detector Computed Tomography. Journal of Cardiovascular Computed Tomograpy. Int J Cardiovasc Imaging. 2009 Oct;25(7):725-38.
  3. Ahmadi, N., Budoff, M., Naghavi, M., et al. Vascular Function Measured by Fingertip Thermal Reactivity is Impaired in Patients with Metabolic Syndrome and Diabetes Mellitus. Journal of Cardiometabolic. J Clin Hypertens. 2009 Nov;11(11):678-84.