COVER STORY

We have a solution

Since our inception, the goal of HDL, Inc. has been to reverse the alarming global growth in cardiovascular disease.

By Tonya Mallory, President & CEO, Co-founder, Health Diagnostic Laboratory, Inc.

The American Heart Association (AHA) has taken notice: we aim to detect the level of cardiovascular (CV) risk, prompt effective treatment and corrective action from both physician and patient, and thereby reverse, or at very least, impede the disease course in order to help patients back to a healthy state and avoid future events. Recently a flurry of articles and press releases announced the strategic partnership between HDL, Inc. and the AHA. In past years, the focus of the AHA was on diagnosing events and exploring treatments; with the growing recognition of the importance of disease prevention, they have aligned their efforts with those of HDL, Inc ¹. I am confident that the endorsement of the HDL, Inc. disease management model by the AHA will add additional evidence of its efficacy for physicians dedicated to improving patient outcomes.

In reviewing the new AHA’s FACT SHEET: Heart Disease and Stroke as Preventable Diseases², I was elated to see their newfound focus on prevention. It is critical, however, to remain focused on the alarming statistics that demonstrate the challenges we continue to face:

Only 18% of U.S. adults follow three important measures recommended by the AHA for optimal health: not smoking, maintaining a healthy body weight, and exercising at moderate-vigorous intensity for ≥30 minutes, 5 days/week.
In 2009, adult obesity rates rose in 28 states, and in more than two thirds of states, obesity rates exceeded 25% of all adults. No state had a rate lower than 20%.
The number of overweight preschoolers jumped 36% since 1999-2000. Nearly 1 in 6 children and adolescents ages 2-19 are considered obese. Sadly, one study has shown that obese children’s arteries resemble those of a middle-aged adult.
Still, over 3,800 children age <18 try a cigarette for the first time each day.
One in three U.S. adults has high blood pressure, but 36% do not have it under control.
A sedentary lifestyle contributes to coronary heart disease (CHD). It is estimated that $5.6 billion in heart disease costs could be saved if 10% of Americans began a regular walking program. Still, 33% of U.S. adults report that they do no vigorous physical activity.
At least 65% of people with Type 2 diabetes die from heart disease or stroke. Unfortunately, diabetes prevalence increased 90% from 1995-1997 to 2005-2007 in the 33 states that tracked data for both time periods.
About 25.4 million American adults have diagnosed or undiagnosed diabetes and the prevalence of pre-diabetes in the adult population is nearly 37%. Diabetes disproportionately affects Hispanics, blacks, Native Americans, and Alaskan Natives.
Approximately 44% of U.S. adults have unhealthy total cholesterol levels of ≥200 mg/dL. A 10% decrease in total blood cholesterol levels populationwide may result in an estimated 30% reduction in the incidence of CHD.

A tool for change

A recent paper by the AHA outlines the value of prevention and early clinical intervention on our nation’s public health¹. The ultimate goal that we share is to increase the number of years with good quality of life and decrease those that include disease and disability ¹. At HDL, Inc., we continue to look for ways to evaluate our efforts and determine how they can be improved.

As an example, in a recent small survey of 61 naïve patients (meaning they had never had advanced testing nor were they aware of any health issues) we found, via HDL, Inc. advanced testing, significant risk for cardiovascular disease (CVD). After just 14 weeks of working with our health coaches and their personal physicians, dramatic improvement in these patients’ health was evident (Fig. 1). The most significant clinical changes after this period of HDL, Inc. health coach counseling and physician intervention were: 25% drop in number of patients with diabetes (contributing to the small increases in % insulin resistance and % pre-diabetic), 21% improvement in vitamin D levels, and 13% drop in number of patients with active cardiac disease. These improvements are

In just 14 weeks, the number of patients with diabetes dropped by 25%.

substantial given the short study period of only 14 weeks, and show the tremendous impact of creating new diet and lifestyle patterns with health coach/practitioner guidance. This program will continue through 25 weeks with follow-up testing at that time. The analysis thus far provides evidence in support of our model and provides insight into specific risk factors requiring prioritization by the healthcare team working with these patients. Future studies will include much larger samples over longer assessment periods and consider a variety of demographic, anthropometric, and other variables.

If current U.S. trends continue, annual health service costs are projected to increase by $48 million, by 2030. Even a modest 1% reduction in BMI could prevent 2.4 million cases of type 2 diabetes³. The cost-effective, actionable means offered by HDL, Inc., to detect CV risk, promote intervention, and motivate change provide a critical tool for preventing chronic disease. We envisage that our ongoing commitment to testing the effects of intervention strategies on individual outcomes will provide an important platform for future progress.