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Living Well

Latest Advances in Cardiology

Last updated: Feb 03, 2016

Listen Well: Dr. Juliano speaks on heart disease in this SMG podcast

The field of cardiology is advancing rapidly, with an increasing push to find answers regarding the prevention and treatment of heart disease – the number-one killer in America. Indeed, now is an interesting time in cardiology according to Nicholas D. Juliano, MD, Summit Medical Group cardiologist.  Dr. Juliano practices at 1 Diamond Hill Road in Berkeley Heights and, at the Group’s newest location at 140 Park Avenue in Florham Park.

 “What I did for a living was essentially plumbing; opening hearts and taking care of clogs,” describes Dr. Juliano. Today, there is more focus on preventative measures for cardiovascular disease. People are becoming savvier about risks, and it’s become evident the general population understands statistics through sports talk or traffic reports. However, Dr. Juliano explains that simply examining patients and telling them that they “may or may not have heart disease” still isn’t enough to motivate some into minimizing their risks. Here, a combination of healthy lifestyle choices and preventative medicine must occur.

Evaluating the risk of heart disease has come a long way since the days of only reading blood pressure levels. “We’ve started to look at triglycerides, calculated LDL, and recognize populations at risk independent of their cholesterol,” says Dr. Juliano. Those with particularly high risk include smokers, pre-diabetics, and people with abdominal obesity, which results in an “apple-shaped” body. 

Even with these refined calculations, family history can be a difficult factor in diagnosing heart disease. Health researchers are trying to quantify family history by identifying gene markers and considering other factors, like age or pre-existing conditions in ancestors.

One identified marker that poses a great risk of heart attack is called “vulnerable plaque”. Despite the use of imaging, MRI scans, white blood cell counts, and bacteria examination, it’s still difficult to truly find out who has vulnerable plaque. “The closest tech we have now is something called intravascular ultrasound,” Dr. Juliano continues, “where we put a probe past a blocked artery while the person is still awake, and look at the artery through ultrasound.” 

If you are at risk for cardiovascular disease, consider a two-pronged approach. Aspirin and prescription medications can be very efficient at reducing inflammation and stabilizing plaque. Additionally, adopting  healthier lifestyle by changing your diet, becoming more active, quitting smoking, and avoiding carcinogenic elements where possible, can go a long way.

As the field of cardiology continues to improve and expand, a focus on prevention might be the key to potentially eliminating invasive procedures and thus, defeating  America’s number-one killer.