Can technology eliminate cardiovascular disease? 5 leaders weigh in

Advances in technology make it easier to detect and treat cardiovascular diseases, which begs the question: Could medicine reach a point where it could eliminate it?

Here, five cardiology leaders weigh in on the possibilities of ending cardiovascular disease:

Gopi Dandamudi, MD. Executive Medical Director of the Center for Cardiovascular Health at Virginia Mason Franciscan Health (Seattle): With the introduction of artificial intelligence, we expect to analyze and prioritize high-risk cardiovascular patients quickly. While we are still in the early stages of implementation, I expect in the next 100 years it will be refined enough to continuously predict patient needs and optimize patient care. While these tools enhance our ability to prevent, treat and ultimately decrease cardiovascular disease, it's unlikely to make it obsolete. Holistic cardiovascular care must also consider additional risk factors such as genetics, human behaviors, impact of aging and environmental factors that may evolve over time. As has always been the case, our approach to care will adapt with these changes.

Rick Stouffer, MD. Chief of Cardiology at UNC Health (Raleigh, N.C.): There are a few things that won't change. One is that exercise will still be prescribed but rarely followed. Second is that the widespread availability of cheap, non-nutritious calories will continue to be a scourge. Third, patients will continue to engage in behaviors that are detrimental to their health. While specific behaviors might change (e.g. less cigarette usage), other harmful behaviors will arise. And no matter how much progress we make, people will still die from heart disease.

Ram Kumar Subramanyan, MD, PhD. Division Chief of Pediatric Cardiothoracic Surgery at Children's Nebraska (Omaha): Nearly 40,000 children are born each year in the United States with a developmental defect in their heart. As such, I cannot envision a situation whereby congenital heart defects will ever become obsolete, regardless of technological advancements.

That said, technological advancements are likely to substantially influence our approach to congenital heart defects, as they have already done. Today, technology limits our ability to detect congenital heart defects before 20 weeks of pregnancy. Additionally, not all pregnant women who carry fetuses with heart defects are correctly diagnosed. Technological advancements could increase our ability to precisely detect congenital heart defects much earlier in pregnancy in the vast majority of pregnant women. Technological advancements will almost certainly allow us to better — surgically and medically — treat congenital heart defects, such that effective cure can become a reality for the majority of these defects. With ongoing refinement in fetal and genetic technology, one can envision a future where congenital heart defects are corrected in the womb even before the child is delivered.

Mitchell Weinberg, MD. Chair of the Department of Cardiology at Staten Island University Hospital (New York City): There are many different types of problems with the heart, and they are not always related to one another. I think we would be able to address some of the major killers within heart disease such as atherosclerosis. We know many risk factors that cause disease and have advanced preventions so some people receive treatment far earlier in their life and are never exposed to things like high blood pressure. What becomes challenging is there's more to it than standard risk prevention. People have genetic predispositions to disease, and so that is where our understanding of genomics and our ability to impact people's genetic makeups could play a role. We would have to make major advancements on many different fronts, but I would say it's possible.

Jonathan Weinsaft, MD. Chief of Cardiology at Weill Cornell Medicine and NewYork-Presbyterian (New York City): I am absolutely certain that the cardiology that we practice today is not going to be the cardiology that we practice in 50 years. That's one of the reasons we always have to remain curious, open minded and have an open perspective in terms of where we're going. I do think that we're going to get markedly better and that we are going to transform our therapies for given areas. I do think that we're on the cusp of being able to cure atherosclerosis. I do think that we may be in a place where we can develop marked improvements in heart failure without any interventional therapies, or we could potentially replace more aspects of valvular heart disease in the absence of interventional therapies. But certainly we're not there yet.

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