Egan, Wilson plan attack on coronary risk factorsby Heather WoolwinePublic Relations A new prevention-based cardiology clinic opening Sept. 7 hopes to lower the state’s high prevalence of diabetes, hypertension, coronary disease and stroke. With the help and vision of MUSC Medicine’s Brent Egan, M.D., Peter Wilson, M.D., Endocrinology, Diabetes, and Medical Genetics, and Cardiology’s Marian Taylor, M.D., the clinic’s mission is prevention of heart attacks and other cardiovascular problems. “The stars line up pretty poorly for South Carolina,” Egan said. “Cardiologists have typically focused on treatment of heart attacks and the prevention of second heart attacks. With this clinic, however, we will continue the work to prevent heart attacks and place a greater emphasis on identifying patients at increased risk before that initial event. The unique aspect of the MUSC clinic will be the multi-disciplinary approach that we are taking.” Setting it apart from previous prevention efforts, the new clinic institutes a multi-disciplinary group from cardiology, endocrinology, clinical pharmacology, vascular surgery, cardiac surgery, radiology and other members of the MUSC Heart and Vascular Center. Egan and Wilson overlap in terms of expertise, with Egan’s specialty in hypertension treatment and Wilson’s focus on lipids and diabetes. Taylor also directs the Cardiac Rehabilitation Program. “In endocrine, we have a certified diabetes educator who works with patients on a regular basis,” Wilson said. “That individual may be a nurse, a nutritionist, or someone else other than a physician. We’d like to incorporate a similar model into the new cardiology clinic in terms of cardiovascular educators.” “Although we have excellent physicians and facilities to treat cardiovascular disease, prevention is the cornerstone for reducing the incidence of this problem,” said Michael Gold, M.D., Ph.D., MUSC Cardiology and Heart and Vascular Center director. “About 50 percent of South Carolinians will die from cardiovascular disease, so this is a huge problem.” Another startling statistic mentioned by Egan and Wilson was 80 percent of heart attack victims had at least one major risk factor prior to a heart attack. Greater attention to the detection and effective treatment of those risk factors could prevent many heart attacks. Physicians and cardiac specialists struggle to keep up with rising national obesity and hypertension rates, as those figures place almost 40 percent of the population at increased risk for cardiovascular disease. Wilson and Egan see clinics like the new prevention clinic at MUSC as a means to bring the percentage back down and thus decrease the risk of cardiovascular disease the average individual faces. Both agree that prevention education must focus on how to change people’s habits. “South Carolina’s biggest problem is fast food and sweet drinks, including tea, cola, soft drinks and juices,” Wilson said. Initially the clinic will take on tougher cases, like patients who suffer from numerous risk factors and who have encountered difficulty controlling blood pressure or diabetes. “We want to help these patients to minimize their medical expense, increase their access to diagnostic tests, and provide them with comprehensive management of their risk factors, all in one place,” Egan said. “We also want to operate on a concept reminiscent of a limbo bar,” Wilson said. “As we work with our patients, we want to get them closer to the bars created for cholesterol, blood pressure, etc., and as things progress, we want to continually set goals for them that result in lower bars.” Both Egan and Wilson said the clinic is not meant to replace primary physician care and will be referral- based. “We haven’t had a centralized place to take increased-risk patients who have not suffered from a cardiac event yet,” Wilson said. “Now we do.” In terms of the clinic’s future, in addition to providing what they believe to be a much needed service on the MUSC campus, Egan and Wilson hope to present the clinic as a model or algorithm to share with providers all over the state. “It would be wonderful to see this program expand to include clinical trials and educational opportunities for fellows, students and residents so they may take their knowledge and disseminate it throughout South Carolina,” Egan said. “We may begin as one clinic impacting a few patients, but the potential is there to impact the state and even the nation.” Anyone with multiple cardiac risk factors, known cardiovascular disease, or difficult-to-treat hypertension or hypercholesterolemia is an ideal candidate for the new prevention clinic. For more information about the clinic, call 792-1414. Friday, Sept. 3, 2004
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