Heart Disease Prevention in Southlake, TX

Almost everything that causes a heart attack is visible and treatable years ahead of time. We calculate your actual risk, refine it with the tests that add real information, and treat early rather than waiting for an event to make the decision for us.

Calculating your risk

We use a validated 10-year risk estimate built from age, sex, blood pressure, cholesterol, smoking status and diabetes. That gives a starting point and, more usefully, a number we can watch move over time.

Standard calculators undercount several groups. A family history of early heart disease, chronic inflammatory conditions such as rheumatoid arthritis or psoriasis, chronic kidney disease, HIV, and a history of preeclampsia or gestational diabetes all raise risk beyond what the calculator shows. We ask about every one of them, and the pregnancy history in particular is almost never asked about by anyone.

Tests that add real information

• Lipoprotein(a). Genetic, common, invisible on a standard panel, and worth checking once. It never changes, so once is genuinely enough, and it often explains a family history that otherwise makes no sense.
• Coronary artery calcium score. The best tiebreaker available when your risk is borderline and you are on the fence about starting a statin. A score of zero lets us defer with confidence and recheck in five years.
• Apolipoprotein B. A better count of the particles that actually form plaque, useful when triglycerides are high or LDL looks deceptively fine.
• hs-CRP. Occasionally helpful for refining an intermediate estimate, less useful than the three above.

What we treat

Blood pressure and cholesterol are the two levers with the strongest evidence, covered in depth on our high blood pressure and high cholesterol pages.

Smoking cessation outranks everything else if it applies to you. We prescribe medication for it, varenicline or bupropion combined with nicotine replacement, rather than offering advice and a pamphlet. Combining a medication with counseling roughly triples the odds of quitting compared to willpower alone.

If you have type 2 diabetes, certain medications lower cardiovascular events independently of their glucose effect, and choosing those is part of the prevention plan rather than a separate decision.

Untreated sleep apnea drives atrial fibrillation and resistant hypertension, so we screen for it in anyone whose numbers will not come down.

Exercise, specifically

The single largest gain is between doing nothing and doing something. Going from sedentary to 90 minutes a week of walking produces a bigger relative benefit than going from 150 minutes to 300.

Aim for 150 minutes a week of moderate activity plus two sessions of resistance work. If that sounds like a lot, start at twenty minutes on three days and build. We would rather set a target you hit than one you abandon in February.

Family history and when to look harder

If a first-degree relative had a heart attack or stroke before 55 in men or 65 in women, tell us at your first visit. That single fact changes screening age, changes whether we check Lp(a), and changes the threshold for a calcium score.

Familial hypercholesterolemia is underdiagnosed and treatable. An LDL above 190 in an adult, or a strong family pattern of early events, should prompt a conversation about it rather than another year of watching.

Follow-up

Risk gets recalculated at each annual physical. Numbers drift, life changes, and a plan set at 44 should not still be running unexamined at 53.

Prevention is delivered through our preventive screening program. Learn more about our primary care Southlake practice.