What to Look for in a Heart Disease Doctor
Your relationship with your cardiologist matters. Here’s how to find the perfect match.
Call us sappy, but we’re in the mood to give our hearts a little love right now (and not just because February is Heart Health Month). Maintaining good heart health is essential to living a long and robust life, as evidenced by this sobering statistic: heart disease is the leading cause of death in the United States for both men and women. More than 600,000 Americans die from it every year.
No one knows heart health better than a cardiologist, so we tapped Michael Blaha, M.D., director of Clinical Research for the Prevention of Cardiovascular Disease at John Hopkins Medicine in Baltimore, to explain how to find the right doctor and develop a lasting expert-patient relationship.
HealthCentral: What are some signs it might be time to look for a cardiologist?
Dr. Blaha: Heart disease affects more than 95 million Americans and is the leading cause of death in the U.S., so I’d first recommend that you understand the state of your heart health. Do you have a family history of heart disease? Are you getting your cholesterol checked regularly and leading a healthy lifestyle? If you are over the age of 20, you should be getting your cholesterol checked every 4-6 years by your healthcare provider, as recommended by the American Heart Association (AHA), which will give you one good indication of heart health and if it’s time to manage it with a cardiologist.
There aren’t any physical symptoms of high cholesterol until it’s too late—when the plaque caused by low-density lipoprotein (LDL, or “bad” cholesterol) has built up enough in the walls of arteries to rupture into the bloodstream and cause a heart attack or stroke. If you have family history of heart disease, have experienced chest pain, high blood pressure, diabetes, or high cholesterol, it is likely a good time to see a cardiologist.
HC: How should someone go about finding a doctor who will be a good fit for them?
Dr. Blaha: Ideally, patients are referred to a cardiologist by a primary care doctor who knows their medical history and preferences, which is why it is important to regularly check your cholesterol and talk about heart health with your general practitioner.
When deciding if a cardiologist is the right doctor for you, remember that communication is paramount in the best provider-patient relationships, so keep an open dialogue! Think of your doctor as a partner in your heart health journey—they need to hear exactly what you’re experiencing to make the appropriate treatment recommendations. If you feel rushed during doctors’ appointments and are not able to voice certain questions or concerns, it is likely not the doctor for you.
HC: What questions should you be asking your heart disease doctor?
Dr. Blaha: Be open with your doctor about the risk factors you are experiencing and your medical profile, along with any medications you are currently taking. From there, you can ask questions about your condition: what it is and how to treat it.
Typically, a cardiologist will recommend healthy lifestyle changes, or when exercise and a healthy diet aren’t keeping cholesterol levels at bay, will prescribe a class of medicines called statins, which are proven safe and effective in the treatment of high cholesterol. Ask questions about your options for statin therapy and what to expect. There are several statins available, but not all statins are the same—what works for one patient’s unique needs may differ for another.
HC: What questions should you expect your doctor to ask you?
Dr. Blaha: Your cardiologist will likely work to identify all the risk factors you have for heart disease, assessing your medical history and lifestyle (i.e. diet and exercise routine). Age, medical history, current medications, and ethnicity are all among the multiple factors you and your healthcare provider should consider when determining which statin option best meets your needs. You should expect your doctor to ask questions about any tests or past procedures as well. All this information will give them insight into the unique treatment plan for you.
HC: What are your suggestions for maintaining open communication with your cardiologist? How often should you be seeing them, and what information should you be sharing with them regularly?
Dr. Blaha: Don’t let the conversation stop after the first visit! If you are already on a statin for high cholesterol and are experiencing challenges, it is important to let your doctor know, as 50% of people stop taking their statin within one year of starting it. This can be very dangerous—high cholesterol can’t be felt, so you should not stop taking your statin without talking to your doctor. Ask your doctor how regularly you should visit, so you can maintain honest conversations about your statin therapy, how you are feeling, if you are remembering to take your statin every day.
Remember that not all statins are the same intensity or metabolized the same way, and even the same statin can be processed differently in the body from person to person. The moral of the story is: if you’re unhappy with one statin, talk to your doctor about another statin that is better suited for you. For example, Livalo (pitavastatin) is one treatment option.
HC: What role does a cardiologist play in helping to craft a treatment and prevention plan for heart disease?
Dr. Blaha: Your cardiologist is a partner in crafting a treatment and prevention plan for heart disease, and the more information you both have, the better the partnership. If you are not satisfied with your current treatment plan, speak up. For example, if you are having trouble taking statins for high cholesterol, or are considering stopping your statin altogether, start a conversation with your doctor about treatment options.
Research shows that people who request a specific prescription treatment from their doctor usually receive it—doctors want to find ways to help patients stay on life saving medications! So, when crafting a plan to stay on a statin, if there is a specific statin you want to try, ask your doctor if it may be right for you and work with them to create an individualized plan that fits your needs.
- Heart Disease in the U.S.: Centers for Disease Control & Prevention. (n.d.). “Heart Disease Facts.” cdc.gov/heartdisease/facts.htm