Concierge Cardiology · Prevention

Cardiovascular Disease Prevention.

Personalized, physician-led cardiovascular disease prevention with direct access to your cardiology team. Proactive monitoring. Faster interventions. Better outcomes.

Rahul R. Handa, MD
Rahul R. Handa, MD, Cardiovascular & Thoracic Surgeon
928,000 CVD deaths annually in the U.S. (AHA, 2024)
Annual Deaths
Up to 80% of cardiovascular events are attributable to modifiable risk factors
Preventable
CAC scoring reclassifies 30-50% of intermediate-risk patients (MESA)
Cac Reclassification
Overview

Understanding cardiovascular disease prevention.

Cardiovascular disease (CVD) remains the number one cause of death in the United States, claiming approximately 928,000 lives annually — more than all cancers combined (AHA 2024 Statistical Update). Yet up to 80% of cardiovascular events are attributable to modifiable risk factors, making CVD one of the most preventable chronic diseases. The challenge lies in identifying at-risk individuals early, before atherosclerosis progresses silently to the point of plaque rupture, myocardial infarction, or sudden death. Traditional risk assessment relies on the Pooled Cohort Equations (PCE), which estimate 10-year ASCVD risk based on age, sex, race, blood pressure, cholesterol, smoking, and diabetes. While useful, these equations misclassify risk in many populations — overestimating risk in some and, more dangerously, underestimating it in others, particularly younger patients, women, and South Asian individuals. Risk-enhancing factors like coronary artery calcium (CAC) scoring, Lp(a), family history, chronic inflammatory conditions, and metabolic syndrome can reclassify borderline patients into categories that warrant earlier, more aggressive intervention. Our concierge cardiovascular prevention program provides a comprehensive, multi-modal risk assessment that goes far beyond a standard physical exam, combining advanced biomarkers, cardiac imaging, genetic risk evaluation, and personalized lifestyle medicine to intercept heart disease before it begins.

Why Concierge

Why concierge cardiology for this condition.

Cardiovascular prevention in a traditional 15-minute office visit often amounts to checking blood pressure and cholesterol, then prescribing a statin if the numbers are high enough. This reactive, check-box approach misses the opportunity for true prevention. Concierge cardiovascular prevention provides a 90-minute initial cardiovascular assessment integrating personal history, family history, advanced biomarkers, and imaging into a unified risk profile. Patients receive a coronary artery calcium scan for risk reclassification, carotid intima-media thickness measurement, advanced lipid and inflammatory marker testing, and genetic risk evaluation. From there, a personalized prevention plan addresses each modifiable risk factor with specific, evidence-based targets and ongoing monitoring. Quarterly follow-ups ensure that blood pressure, lipids, glucose, weight, and exercise goals are being met — not just discussed once and forgotten. For South Asian patients, who face 2-4x higher CVD risk than the general population per MASALA study data, this level of individualized, proactive prevention is especially critical.

What we monitor.

Coronary artery calcium (CAC) score with serial imaging every 3-5 years to track progression
10-year ASCVD risk calculation with reassessment of risk-enhancing factors annually
Advanced lipid panel: ApoB, Lp(a), LDL particle number, triglyceride-rich remnants
Metabolic health: fasting glucose, HbA1c, insulin resistance (HOMA-IR), waist circumference
Blood pressure: in-office, home monitoring, and ambulatory blood pressure monitoring (ABPM)
Inflammatory markers: hs-CRP, with consideration of anti-inflammatory therapy if persistently elevated
Family history assessment with genetic testing for familial hypercholesterolemia when indicated

Our management approach.

Comprehensive 90-minute cardiovascular risk assessment at intake with annual reassessment
Coronary artery calcium scoring for all intermediate-risk patients (PCE 5-20%) to guide statin decisions
Personalized exercise prescription: 150 minutes/week moderate or 75 minutes/week vigorous activity with heart rate targets
Dietary counseling: Mediterranean diet implementation (PREDIMED trial: 30% CVD event reduction)
Weight management targeting BMI < 25 kg/m2 and waist circumference < 40 inches (men) / < 35 inches (women)
Smoking cessation with pharmacotherapy (varenicline, NRT) and behavioral support
Sleep health optimization: screening for obstructive sleep apnea, targeting 7-9 hours nightly sleep duration

Expected outcomes.

Reclassification of 30-50% of intermediate-risk patients through CAC scoring and advanced biomarkers (MESA study)
Up to 80% reduction in first cardiovascular event through comprehensive risk factor modification (INTERHEART study data)
Achievement of all 7 components of Life's Essential 8 (AHA) in the majority of patients within 12 months
Identification of subclinical atherosclerosis years to decades before clinical events would occur
Measurable CAC progression slowing with aggressive risk factor management over serial 3-5 year imaging

Related concierge services.

Advanced Lipid Management
Executive Cardiac Screening
Family Cardiac Risk Assessment

Prevent heart disease before it starts with a comprehensive concierge cardiovascular risk assessment.

Direct physician access, proactive monitoring, and personalized care plans. Concierge cardiology starting at $295/month.

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