Risk Screening and Preventive Cardiology

Heart and vascular diseases are critically important not only when they manifest but also long before any symptoms appear. One of the greatest strengths of modern cardiology is the ability to detect risk at an early stage and take control of the process.
Preventive cardiology is a scientific approach designed to determine an individual’s future risk of serious events such as heart attack, stroke, heart failure, and sudden death; eliminate risk factors; and prolong healthy life expectancy.

Each topic in this section highlights early warning signs and preventive strategies that hold vital importance both for individuals and for public health.

Sudden Cardiac Death Risk Screening

Sudden cardiac death often occurs without any warning, most commonly due to silently progressing coronary artery disease.
Risk screening evaluates the following:

• Family history of sudden death at a young age
• Structural heart diseases (hypertrophic cardiomyopathy, valve disorders, etc.)
• Arrhythmias
• Coronary artery blockages
• Severe stress, smoking, and uncontrolled hypertension

For selected patients, tests such as ECG, echocardiography, Holter monitoring, advanced imaging, and coronary calcium scoring are used to determine risk level.
The goal is to identify the risk of sudden death before it occurs and plan appropriate treatment.

This screening is particularly life-saving in individuals with a high risk of heart attack at a young age.

Stroke Screening

Narrowing or blockage of the arteries supplying the brain is the second most common cause of death and disability after heart attack.
Stroke screening focuses on:

• Plaque buildup in the carotid (neck) arteries
• Early stages of atherosclerosis
• Whether blood flow to the brain is reduced
• Conditions that impair circulatory connection between the heart and brain

Color Doppler ultrasound, ECG, echocardiography, and when necessary, advanced CT or MRI imaging are used in this evaluation.
Assessing stroke risk is especially important for individuals with hypertension, diabetes, smoking habits, or a family history of stroke.

Cholesterol and Metabolic Syndrome Assessment

Atherosclerosis is at the core of most heart diseases, and two major drivers of this process are cholesterol disorders and metabolic syndrome.

Metabolic syndrome is defined by the presence of the following:

• Abdominal obesity
• High blood pressure
• Impaired blood glucose regulation
• High triglycerides
• Low HDL (“good”) cholesterol

This constellation dramatically increases the risk of heart attack and stroke.
With early diagnosis, medication, nutritional adjustments, and lifestyle modifications can significantly reduce risk.

Diabetes and Its Relationship With Heart Disease

Diabetes is not merely elevated blood sugar; it is a chronic disease that directly damages the vessel walls.
In individuals with diabetes:

• Atherosclerosis begins at an earlier age,
• Vessel blockages are more common,
• Heart attacks occur more silently,
• Stroke risk is higher.

Therefore, cardiology evaluations for diabetic patients should be performed routinely, not only when symptoms occur.
Good glycemic control significantly reduces the risk of cardiovascular events.

Smoking and Cardiovascular Effects

Smoking is the most significant—and entirely preventable—risk factor for heart and vascular disease.
It damages the inner lining of blood vessels, accelerates inflammation, increases clotting tendency, and reduces oxygen-carrying capacity.

Effects of smoking include:

• A 2–4-fold increase in heart attack risk
• A significant rise in sudden death risk
• Blockages in leg arteries
• Narrowing of brain arteries
• Reduced vessel patency after stent or bypass surgery

The benefits of quitting occur rapidly:
Within the first year, heart attack risk decreases by 50%, and within a few years, it approaches that of a non-smoker.

Nutrition Habits and Heart Health

Nutrition strongly influences cholesterol levels, blood pressure, glucose regulation, and vascular health.
Heart-healthy dietary approaches include:

• Reducing saturated and trans fats
• Increasing fiber-rich foods
• Limiting simple sugars and excessive salt intake
• Regular consumption of omega-3 sources
• Maintaining a healthy body weight
• Reducing alcohol and processed foods

These dietary adjustments not only help prevent heart disease but also support the control of risk factors such as hypertension, high cholesterol, and diabetes.