Early heart treatment can reverse damage

University of Minnesota researchers have discovered that treating people who have early cardiovascular abnormalities, but show no symptoms of cardiovascular disease, can slow progression and even reverse damage to the heart and blood vessels.

In a recent double-blind study, researchers enrolled 76 asymptomatic subjects with early markers for cardiovascular disease, based on a 10-factor scale called the Rasmussen Disease Score. During the first six months of the study, 38 subjects received a placebo, and the other 38 subjects took 160mg of Valsartan, a drug that blocks a hormone that is detrimental to the blood vessels and the heart. During the next six months, both groups took Valsartan.

Those who took the drug for the first six months significantly reduced their Rasmussen Disease Score compared with those who took the placebo. At the 12-month mark – after both groups were taking the drug – every patient showed better Rasmussen Disease Scores, effectively demonstrating that Valsartan can slow progression and even reverse early cardiovascular disease in asymptomatic high-risk patients. The findings of the study are published in the Aug. 28, 2007 issue of the Journal of American College of Cardiology.

“Cardiovascular disease is the No. 1 killer in our society – not only in the U.S. but in the rest of the world,” said Daniel Duprez, M.D. professor of medicine, and the principal researcher. “These patients have no symptoms, so most of them would have waited to seek treatment. Asymptomatic people are still treated based on risk factors, such as elevated blood pressure and cholesterol, but not on a personalized assessment of the presence of early cardiovascular disease. This is the first study that shows if you interfere early, you can cause regression of these cardiovascular abnormalities.”

Most cardiovascular diseases are a result of a progressive problem that can be detected long before symptoms develop. Identifying individuals with early indications of disease can help doctors target the problem with lifestyle counseling and drug treatment to prevent future damage, Duprez said. That's why the concept and validity of the Rasmussen Disease Score is a significant step toward the management of cardiovascular disease.

The Rasmussen Disease Score, developed by Jay N. Cohn, M.D. and director of the University's Rasmussen Center for Cardiovascular Disease Prevention, helps doctors identify early cardiovascular abnormalities that tend to lead to symptomatic cardiovascular disease.

The 10 tests in the Rasmussen Disease Score include: large and small artery elasticity; resting and treadmill exercise blood pressure; carotid artery initial-media thickness; retinal vascular photography; micro-albuminuria; electrocardiography; echocardiography; and plasma B-type natriuretic peptide blood levels.

This battery of tests together with a medical exam and counseling is performed in two hours in one location. The University of Minnesota Medical Center, Fairview is the only facility in the world that provides this screening process.

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