Paths to a Healthy Heart-Blending conventional and functional approaches
Sadly, cardiovascular disease remains the leading cause of death in the United States.
Several modifiable risk factors are responsible for this grim trend. The first and most modifiable being dietary factors. The standard American diet has not done well for the health of the population. Other modifiable risk factors include tobacco use, drug use, high BMI, high LDL cholesterol, high fasting blood glucose, air pollution and low physical activity.
- Get Active
- Eat Better
- Lose weight
- Stop smoking
- Control Cholesterol
- Moving blood pressure < 120/80
- Reduce blood sugar
Specifically, getting 150 minutes per week of moderate movement or 75 minutes of vigorous exercise. Eating 4-5 cups of fruits and vegetables per day. Getting a BMI less than 25, a total cholesterol less than 200, blood pressure <120/80 and a fasting blood sugar less than 100.
A large meta-analysis looking at over 12 million patients assessed the impact of Mediterranean diet on cardiovascular health. This study found a 30-40% reduction of heart attack, stroke and diabetes, as well as reductions in cancer and dementia. Given this, and that dietary factors are the leading modifiable risk factor, it makes sense to adhere to a diet rich in vegetables, olive oil, low toxin fish and nuts. Another large study looking at the use of fish oil or omega-3 fatty acids found a reduction in heart attacks and coronary death.
When taking a functional medicine approach to cardiovascular risk reduction, nutrition takes center stage. In addition, a functional approach can be effective in improving cardiovascular and overall health. Looking not just at LDL/HDL and triglycerides, but advanced lipid panels that assess cholesterol are part of the functional medicine approach to vascular heath. The smaller LDL particles are more damaging to arterial walls, whereas the larger and fluffier HDL particles are more protective, so assessing their size and quantity is key. Inflammation markers like hsCRP and LpPla2 point towards potential plaque formation in the vascular system. In addition, homocysteine can be damaging to vascular health, so lowering and monitoring this marker is important.
Another marker, Lipoprotein, Lp(a) is harmful to arterial health and may actually be worsened by taking medications like statins. Lp(a) is more determined by someone’s genetics. Given this, Lp(a) evels need to be checked if anyone is going to be placed on statin therapy. Patients with elevated Lp(a) levels may do better taking nutraceuticals like CoQ10 or fresh ground flax seeds or bio-identical hormone therapy. Lastly, a relatively inexpensive and effective way to assess for cardiovascular health is getting a coronary calcium score, which is a CT scan focusing on the heart and visible plaque formation. If plaques are found, then more aggressive measures to lower inflammation, resolve plaque formation and balance cholesterol are needed. For patients with evidence of plaque on blood work may do well to get a Cardiac CT Angiogram.
If you are interested in assessing and improving your vascular health, please contact my office.
As Always-Be Well,
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