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Is a Google pill the only hope for cardiovascular disease detection?

Michel Accad, MD
Conditions
November 21, 2014
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Last year, Dean Dupuy, 46, an engineer at Apple, suddenly died of a heart attack while playing hockey. He experienced no warning symptoms and, with a healthy, active lifestyle, did not fit the profile of someone at risk. Too late to save him, Dupuy’s wife Victoria discovered that early coronary disease can be identified by simple CT scans. She recently launched a nonprofit organization, No More Broken Hearts, in San Jose to raise awareness of the value of cardiac screening.

I cite this story because while comprehensive screening for two of the nation’s top killers, heart disease and stroke, is entirely practical, it is rarely done.

In Silicon Valley, a great deal of attention has been drawn to the recent announcement that Google X, the research arm of the technology giant, is planning to develop a revolutionary, nanotechnology-based disease-detection pill. Specifically, the pill would send micro-particles through the blood stream to detect early cancers and imminent heart attacks and to monitor diseases like diabetes.

Google seems confident in its ability to bring this project to fruition, and I certainly hope it succeeds. But it may take years before the technology is available for general use. In the meantime, I encourage others to adopt currently available technology for cardiovascular health screening.

There is little argument that mammograms, colonoscopies, Pap smears and similar procedures have saved countless lives by detecting cancers in their early, most-treatable stages.  Unfortunately, for cardiovascular conditions, the medical community continues to focus solely on risk and lifestyle factors such as blood cholesterol levels, diet and exercise. These are fine predictors of cardiovascular disease when viewing the population as a whole, but are poor at predicting heart attack or stroke in individuals. For example, it is now well established that most patients hospitalized for heart disease have cholesterol levels in the normal range.

This singular focus on risk and lifestyle factors is a shame because ultrasound, stress testing and CT scans have been refined over the years and can now easily screen for and identify the vast majority of serious cardiovascular diseases in their early stages.

For myriad reasons, these tools have not been more widely embraced: inertia in the medical community, vested interests in the status quo, lack of awareness and reimbursement by insurance plans. But the public is ready for a change. Like Victoria Dupuy’s No More Broken Hearts, grassroots organizations are springing up around the country in response to tragedies like the one that befell her husband to try to change the way we approach cardiovascular health.

If the Google pill is still several years from becoming reality, or even if it remains a hopeful dream, I see great value in the discussion that the project is generating now. The standard approach to cardiovascular prevention has not radically curbed the heart disease epidemic; heart attacks, stroke, and sudden cardiac death remain leading causes of death and are costly in financial as well as human terms. While we need not abandon efforts to identify and manage risk factors, much could be gained if we combined risk factor management with a vigilant effort to detect heart disease in its early stages.

The technology to detect heart and blood vessel disease is available now. Shouldn’t we take advantage of it before diverting too much of our attention to the next big thing?

Michel Accad is founder, Athletic Heart of San Francisco.  This article originally appeared in the San Jose Mercury News.

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Is a Google pill the only hope for cardiovascular disease detection?
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