Dr. Loh: Providing cardiometabolic health screenings
For all of us following the news about new and novel medications being developed for the treatment of maladies that afflict so many of us, this seems to be a golden era. Granted, the costs of these drugs can be eye watering, but at least we can know that once developed and validated, they will eventually become generic and more affordable and thus more readily available for conditions that are not going away.
Sometimes these conditions are obvious, like the epidemic of cardiovascular disease, diabetes and overweight, but many of these are silent, like high blood pressure, progressive kidney diseases, blood fat abnormalities and others, that lurk in the background until the conditions declare themselves and much damage has already been done, unless we find out about them before and do something to mitigate their impact.
Forty years ago, when the Ventura Heart Institute was first proposed by me to the hospital in which I had my practice, the guiding principle was prevention, and the action was education and clinical research. VHI conducted public screening programs at the hospital and education programs for both the public and for clinicians in the form of continuing medical education, with themes focused on the prevention of cardiovascular disease by lifestyle and pharmacologic means based on state-of-the-art knowledge at the time. And hand in hand with that state-of-the-art knowledge was engagement in clinical research, an integral part of my professional life beginning with my research training at the National Institutes of Health and continued during my time as a cardiologist at Cedars-Sinai before coming to Ventura County to enter private practice in cardiovascular disease management.
Over the decades things change, such as the Ventura Heart Institute no longer being in a hospital setting, and the education opportunities for the public and healthcare professionals became more limited without hospital support, but the research work remained. After a brief hiatus, clinical research has again become an important focus of my professional life, with much larger goals and areas of interest beyond cardiovascular diseases.
With the support of a global clinical research company, Care Access, we just built a dedicated research facility on the Los Robles Hospital campus but have no formal ties to the hospital itself. That being said, the Cardiovascular Institute at Los Robles Regional Medical Center conducts devices research and Care Access conducts new medications clinical research, and together we are forging a symbiotic research effort to bring new therapeutic options to our communities and beyond.
In the past, research work has had difficulties engaging underrepresented patient populations engaged in these programs developing new treatments. This is even more important since many of these conditions of interest may disproportionately impact those patient groups, so accurate characterization of the impact of these new therapeutic agents in patients who may benefit most may miss the mark. The answer is to make clinical trials more accessible to underserved populations into these clinical programs, but the dilemma is how to efficiently do it. The goal is to get all eligible patients to participate so that the clinical data is applicable to all of us, not just those who were able to join a clinical trial.
More innovative models can help reach patients who may not have otherwise participated in clinical research. Patients go where their trusted doctors are. And those doctors, even if previously experienced in clinical research, may not currently be in an environment that allows them to refer their patients or even participate themselves in these programs. And none of them, and certainly not in this healthcare environment, build out more space, buy more specialized equipment, or hire more staff than they need.
Care Access partners with healthcare providers and community organizations to supply expertise, staff, and equipment — everything from traveling trailers to tents to set up onsite community screening events that enable research to happen where it is needed.
Care Access has embarked on a yearlong (or more) no cost and no obligation project to screen 200,000 people around the country, including traditionally underrepresented populations, as possible. The goal is to look for patients who may have silent risk factors that have no symptoms, but if present may lead to grave illnesses if unrecognized early. These tests will include Lp(a), a blood fat six times more dangerous than so-called bad cholesterol, LDL-C, as well as tests for diabetic risk and kidney disease. We will give the results to the patient, and if they’d like, to their personal clinicians so they can take care of those problems now, hopefully before progression of disease becomes too late.
Why are we doing this? We have looked at the disease states of greatest potential interest in the cardiovascular and metabolic disease space and determined that if we can identify at-risk patients ahead of time, it will first, help the patient by making the patients and their doctors aware and thus enabled to intervene sooner, but second, allow us to help match patients to clinical trials that could lead to medications that benefit them and generations of others to come.
So we are outreaching to hospitals, clinics and large medical practices to offer no cost screenings for these high risk cardiometabolic risk factors. In fact, there is a stipend for people to participate in the screening, and no obligation to join a clinical program even if found to be eligible. We figure that enough people, if made aware of their underlying risks, which often run in families, may want to help us sort out if new therapies will help them or their families down the road.
If you are possibly interested in getting screened, I have and will be reaching out to local hospitals, clinics and practices, and if they agree to participate (at no cost to them), they will let their patients know through their internal channels when and where they will be having their first of what I hope will be several joint screening events at their facility over this coming year. Since our initial efforts will be in the cardiovascular and metabolic arenas, we’re starting this month, Heart Month, but Care Access will be running these all year and at many sites around the country. And early markers of cognitive decline such as Alzheimer’s are on our roadmap for future screenings.
If you just want to participate directly, you can come to the new Care Access research office in Thousand Oaks and we will take care of it. But you will need to schedule it by going to http://myfreehearttest.com/drloh and we will get your test scheduled.
Irving Kent Loh, M.D., is a preventive cardiologist and the director of the Ventura Heart Institute in Thousand Oaks. Email him at drloh@venturaheart.com.
This article originally appeared on Ventura County Star: Dr. Loh: The importance of cardiometabolic health screenings
