
With Pamela Decker, MD, cardiologist with Kaiser Permanente
What do high cholesterol, high blood pressure, diabetes, excess weight, inactivity, and smoking have in common? All are risk factors for heart disease. But unlike age and family health history, which you cannot control, these risks can be managed, or even avoided by practicing a healthy lifestyle and taking prescribed medications.
“One of our biggest challenges in health care is inspiring people to take better care of themselves,” says Pamela Decker, MD, a board-certified cardiologist at Kaiser Permanente Colorado. “Most people are aware of controllable risks for heart disease. But despite our repeated urgings to practice a healthy lifestyle, many struggle with where to start, or hit barriers in trying to overcome excess weight, inactivity, and smoking. That’s why we have a team approach to help jump-start a lifestyle improvement goal.”
Importance of partnership
Dr. Decker’s dream is to see patients become more involved in their health. “Health care has changed tremendously in the past decades,” she continues. “We have become much more aware of the importance of prevention. Not every health condition can or should be treated with a pill or procedure.”
To understand one’s own health risks, Dr. Decker suggests patients become partners with their doctors in managing their health. “Once a person is willing to make this commitment, we have every tool in the book to help him or her succeed,” she says.
These tools include classes, online information, and interactive tools to live healthy and learn about prevention. Many health care providers like Kaiser Permanente also support Weight Watchers® and other programs to help patients achieve – and maintain – a healthy lifestyle, so be sure to ask what deals and incentives you can take advantage of.
Helping a person identify and avoid harmful behaviors and conditions is generally the role of primary care physicians; but once they identify patients with heart disease risks, primary care doctors are likely to refer patients to a program or specialist for help.
A unified effort
Patients can benefit from an integrated system – a system that helps coordinate care and assists primary care physicians and specialists communicate with each other. At Kaiser Permanente, doctors utilize an electronic medical record, sophisticated messaging systems, and teams of specialty nurses to enhance communication and coordinate care. “When patients are referred to me, I can review their information ahead of time,” Dr. Decker says. “So, before I even meet them, I am aware of their issues, blood pressure and cholesterol levels, any other risks, prescriptions, and test results. This makes our time together more productive.”
“Our cardiology department has several very effective teams that help patients who have had one hospitalization for heart attack or heart failure avoid another,” Dr. Decker continues. “We also believe it is essential to identify patients who are at risk for their first cardiac crisis and help them prevent it.”
Along with practicing a healthy lifestyle, Dr. Decker wants people to be aware of how certain risks affect men and women differently. “Diabetes and smoking are risk factors for men and women, but they are much stronger risks for women,” she explains. “Also, women’s hormones offer some protection from heart attacks up through menopause, but afterward, their risks accelerate and can even surpass men’s risks.”
“I tell my patients that to be forewarned is to be forearmed,” Dr. Decker adds. "The earlier you start to pay attention to your health and make positive lifestyle choices, the better. On the other hand, as long as you’re alive, it’s never too late.”
To learn more about managing heart disease risks, visit KaiserPermanente.org.
Dr. Decker received her medical degree from the University of Pennsylvania Health Sciences Center, and completed an internship in internal medicine at Beth Israel Hospital in Boston, Mass., and a fellowship in cardiovascular medicine at the Hospital of the University of Pennsylvania. She is board certified in internal medicine with a subspecialty in cardiovascular disease.
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