Spring 2023

Playing the long game for heart health

M Health Fairview cardiologist Daniel Duprez, M.D., Ph.D., explains how a prediction tool developed at the U can help identify heart disease before it’s too late

As the leading cause of death for men, women, and people of most racial and ethnic groups in the United States, heart disease remains a frustratingly elusive foe. Traditional models for assessing cardiovascular health often fail to uncover signs of early disease in asymptomatic individuals, and many people aren’t diagnosed until an emergent event like a heart attack.


M Health Fairview cardiologist and University of Minnesota Medical School professor of medicine Daniel Duprez, M.D., Ph.D., has spent years in search of a better way to spot signs of early cardiovascular disease.

Now he’s proving how a prediction tool developed at the Rasmussen Center for Cardiovascular Disease Prevention, founded in 2000 by world-renowned U of M cardiologist Jay N. Cohn, M.D., can identify evidence of early disease long before symptoms appear—giving those at risk more time to take action before it’s too late.

What is the traditional approach to predicting cardiovascular events? 

One of the most common models, the Framingham model, is based on research that was first conducted more than 70 years ago. This research was used to create the “risk calculator” that many are familiar with—looking at age, sex, blood pressure, cholesterol, smoking, and so on.

And what are its limitations? 

Well, risk factors for heart disease have changed over the years; smoking is less widespread, while obesity and type 2 diabetes are much more prevalent. And data has shown that these risk algorithms may fail to identify individuals who have a low short-term risk but a significant lifetime risk for cardiovascular disease.

How does the Rasmussen disease score differ from the “risk calculator” approach? 

The Rasmussen disease score provides a long-term prediction of cardiovascular disease, whereas the risk calculator approach is typically used to estimate risk over a short period of time. We calculate the disease score based on the results of 10 noninvasive tests that provide a comprehensive assessment of vascular and cardiac health. These tests can uncover signs of disease in people who are asymptomatic, allowing us to make early interventions.

How can this approach to identifying cardiovascular disease help patients advocate for their health?

Our approach is comprehensive, and it’s not rushed. In addition to the 10 tests, every patient takes part in an in-depth interview covering their family history, medical history, health habits, and nutrition.

This helps identify the lifestyle changes that could significantly reduce their long-term risk of heart disease. Then we make a plan for medical follow-up based on their disease score. When it comes to heart disease, prevention really is the best—and cheapest—approach.


Undetected cardiovascular disease can have severe consequences, like heart attack and even death. Daniel Duprez, M.D., Ph.D., who holds the Donald and Patricia Garofalo Chair in Preventive Cardiology at the University of Minnesota Medical School, is proving that an unconventional prediction tool known as the Rasmussen disease score can identify heart disease long before symptoms appear. The 10-part Rasmussen test, developed at the U, includes a fundoscopic exam of the eye, which can reveal arteries affected by hypertension.

Here, hypertension has caused blood vessels in the eye to dilate and compress veins nearby, a sign of early heart disease that could lead to more severe consequences in the future.