HEART TO HEART

A simple pulse wave test could be a lifechanger for a group of people unknowingly on a path to cardiac disease.

- NICKY PELLEGRINO

Predicting the risk of a cardiovascular event generally involves doctors looking at factors such as someone's cholesterol levels and blood pressure, as well as medical history, age and weight. Even when all of that is assessed, many people are missed. The risk prediction tool doesn't put them at the threshold where they are identified as needing preventive treatment and the first symptom of vascular disease may be a heart attack or stroke.

GP William Ferguson believes we need to do better. In his West Auckland practice, he has conducted an informal trial of a piece of equipment he is convinced can make a difference.

A pulse wave analysis (PWA) machine is similar to a traditional blood pressure monitor (an inflatable cuff on the arm) but gives additional information. It analyses the shape of the pulse wave coming from the heart - the greater the reflected wave, the stiffer the blood vessels are and the higher the risk of a problem.

It also monitors central blood pressure, which has been shown to be a better predictor of vascular disease than peripheral blood pressure.

Ferguson tested a PWA machine on three groups of patients. One group was very healthy and considered low-risk, one was known to have arterial disease, and the third was somewhere in the middle.

"We didn't really know how seriously we should take their cardiovascular risk, which, of course, is the central problem," says Ferguson.

The test showed that many of the people in that intermediate zone had signs of vascular disease and were unknowingly on track to a heart attack or stroke.