Heart Health

Heart disease is the most common cause of death in the United States. This is true for men AND women. And for most people, the first sign of heart disease is a heart attack ~ where 1 in 10 die. Even though that statistic makes it seem that people just wake up one day with heart disease, there actually is a very long phase prior to a cardiovascular event like a heart attack or stroke where there are significant changes within the vascular system. These changes can start decades before there is any sign of cardiovascular disease. the sooner we can detect these changes and reverse the damage, the better we can prevent events such as heart attacks.

In the last 10 years or so, there have been major advancements in the field with a dramatic increase in our knowledge of vascular biology – not only what is happening within the tubes of the arteries, but more importantly what is actually happening within the walls of the arteries that lead to plaque development or atherosclerosis. Unfortunately, these advancements have not made it to mainstream medicine, but are readily available. These cutting edge diagnostics allow for a more accurate and comprehensive assessment of a patient’s risk for heart disease, and lead to very targeted recommendations to prevent the progression to a cardiovascular event such as a stroke.

Cardiovascular (CV) disease is a term that encompasses several different disease entities: Hypertension (high blood pressure), high cholesterol, Atherosclerosis, peripheral artery disease. Heart attacks and strokes are what we call a Cardiovascular Event (CVE). All of these diseases are rooted in poor health of the vascular system, and most often, these unhealthy changes occur over time due to dysregulated sugar metabolism including diabetes, pre-diabetes, and obesity. We refer to this now as Cardiometabolic disease, or cardiometabolic syndrome. This means that the long phase of the silent development of CV disease is largely related to lifestyle choices like diet and exercise.

Determining your risk for heart disease is like gathering and putting together a 500 piece jig-saw puzzle. We know that cholesterol levels are a very important driver of the development of heart disease, but it goes far beyond what your total cholesterol level is. Optimal blood pressure management is also a major contributor to increased risk of a CVE. These together with other traditional risk factors such as age, gender, smoking history tell us only half the story. The other half of your risk for heart disease lies in your genetics. Thankfully, we now have the capability in assessing your genes as they relate to cardiovascular health and utilizing this information as key leverage points to optimize your health.

While determining your predisposition for heart disease is extremely important, determining where on the spectrum of cardiometabolic disease you are is the key to reversing the process and preventing heart disease. The development of plaques within the arterial wall is a direct result of altered vascular biology. Changes occur within the arterial wall. These changes are initially an appropriate response to an insult, such as high blood pressure, or high blood sugars. However, when these insults do not go away, these adaptive responses of the arteries turn to a maladaptive response that propagates further damage and thus creates more disease. It is a snowball effect that increases inflammation and oxidative stress. By using various testing methods and biomarkers, we can better identify the progression of atherosclerosis and make appropriate interventions.