Cardiovascular Disease is the leading cause of death in the United States and most likely is the same in developed countries. These include coronary heart disease and myocardial infarcts.
There are many factors that precipitate coronary artery disease. These include: Diabetes, Obesity, Hypertension, Lipid abnormalities, and Smoking. The common denominator to all of these if from Inflammation.
As a former Cardiac Anesthesiologist, one wonders the following:
Firstly, what is the single underlying trigger that causes millions of individuals to undergo extensive cardiovascular work-ups.
These patients often require interventional cardiologists to place stents and / or cardiovascular surgeons to perform elective or emergency on – pump (using the bypass machine) OR off-pump coronary artery bypass grafts in those patients that are not candidates for the cardiologist to stent because of technical difficulties or the instability of the patient.
Many require long post-operative rehabilitation along with prescriptions for platelet altering medications that are used to maintain patency (the opening) of those vessels that were either stented or bypassed.
The use of both pharmacologic and natural supplements has been shown to alleviate such risk factors and improve outcomes in cardiovascular disease states.
For many years both those in medicine and in the public, we have been told that cholesterol was the trigger in initiating the domino effect which causes coronary artery disease and acute myocardial infarcts. This is still the current belief in traditional medicine and most physicians believe this to me true. That is why they look at cholesterol.
Cholesterol is a precursor to all hormones that are needed for normal physiology of the patient’s body to function. As you can see by the illustration of the diagram below without cholesterol your body cannot make efficient amounts or quantities of the proper hormones to enable you to function properly. Therefore, one must have the proper amount of cholesterol in one’s diet. Eliminating it would cause detrimental effects with many patients complaining that they do not feel good or well. Everyone has a different physiology!
Over the last couple of years research has shown that elevated Sugar is the root cause of inflammation leading to the blood vessels or vasculature to lay down plaque in the blood vessels.
These elevations in blood sugar sets up the inflammatory response causing the vascular endothelial bed to develop structural damage. Over time these vessels become more inflamed and additional plaque builds in the vessels until the vessel becomes blocked or occluded. Additionally, unstable lesions (lipid (fat) laden liquid filled molecules) can rupture through the endothelial cells into the lumen (the opening) in the vessel leading to an acute coronary event.
In Functional Medicine we look deeper into specific testing to determine the patients risk of having a cardiac insult. While cholesterol, LDL, Triglycerides and HDL are ordered by most traditional medical practitioners we also look other biological markers that are more important in determining the risk of an event. Yes, LDL is important, however our laboratory evaluations are more specific. These include: C-Reactive Protein ( CRP), Oxidized- LDL, LDL particle number and size, Small Dense LDL, along with HGB- A1C.
If a patient has dangerously high abnormal numbers we often will perform a deeper dive ordering a Coronary Artery Calcium score (CAC) and even a PULS test to determine if an unstable cardiac lesion can and will rupture leading to a myocardial infarct and even death. These patients would be referred immediately to their cardiologist for immediate invasive evaluation by cardiac catheterization. Thus, prevention of a catastrophic event rather than the after effect of the event.
Have you ever wondered why in traditional medicine a patient could be taking 2-4 medications just to control their blood pressure? It is because some patients do or do not possess the genes to convert the drug into its active form or the gene may not work properly. In Integrative and Functional Medicine there are ways to detect if the patient has a GENE SNP (SNIP) which is the reason why so many of these pharmacologic agents do not work. Often times many of these medications can be withdrawn slowly and replaced by either no medications or a medication along with a natural supplement that has the same benefits without the side effects.
So how does one provide prevention? By altering one’s life style, diet, exercise, proper sleep quality and quantity along with the use of pharmacologic’s and natural supplements, one can slow down or decrease further damage to the blood vessels.
Life style changes include our diet. Changing from highly processed foods which is in the standard American diet,( loaded with carbohydrates ( sugar) and preservatives ) TO a diet which is higher in good quality vegetables and meats, fish and poultry that can provide significant weight loss and a better physiology. Additionally, trans fats seen in many foods can increase all lipids and lead to damage to the blood vessels leading to a coronary insult.
It is not all about the numbers. Many physicians look at the laboratory values of patients and although they may be in the normal ranges, the patients complain that they do not feel well. We have to listen to our patients and many times we do not.
Exercise both aerobic and strength training should be performed at least 5 days a week for 60 minutes. Changes in body composition can have dramatic effects on the abnormal lipid profile and better these numbers and the patient’s physiology.
Supplements such as omega 3 fatty acids have been shown to reduce sudden cardiac death by many different physiological pathways. Additionally, kyolic garlic also has a huge impact on reversing abnormal lipids and has beneficial effects on cardiovascular disease states. These two supplements are just two that are natural and have limited if any negative side effect on the human physiology.
For a more in depth understanding of your own individual physiology, to hopefully reverse or slow the disease state the cookie cutter approach of using medications is obsolete. You as the patient should partner with a Board Certified Integrative or Functional Medicine Physician to help you with longevity and prevention of disease. For more information please make and enhancement by scheduling an appointment with our office.