I started specializing in preventive cardiology about 15 years ago. Prior to this I did general medicine in addition to optimal aging medicine, wellness, and the treatment of severe chronic diseases. One thing I noticed is that almost no one did preventive cardiology. All that I was seeing were prescriptions for blood pressure medications and cholesterol drugs, but not much else. I saw some practitioners encouraging diet and exercise and even offering specialized diet plans and supplements but soon realized that was not enough.
Arterial Plaque Can be Reversed
Early on in my career, about year #2 in my internship, was the first time I witnessed plaque going away in coronary arteries. The textbooks said that this could not happen and I believed too. Ever since I saw this and became fascinated with the prospects of reversing atherosclerosis and improving patients lives, and especially keeping them out of the hospital.
The main deficit I saw was a lack of proper testing in the gathering of objective data. I started seeing a lot of guessing and crossing of the fingers with very little follow-up testing to prove treatments were working. Here is an example: you go to the doctor and your cholesterol is high enough to concern the doctor. You are prescribed a cholesterol medicine (statin typically) and told to come back in six months to recheck your levels. There is almost no discussion about the side effects or the the data for or against the drug.
You come back in six months and your levels look good and you are given refills for 12 months and told that if you ever get symptoms to come back or go to the Emergency Room. This is a case of assuming that because the cholesterol is lower it is helping a prevent heart attack caused by atherosclerosis. Atherosclerosis is a buildup of cellular debris and cholesterol within the artery wall. There is no before and after measurement of arterial plaque, however. It is a “cross the fingers and hope” scenario. The problem with this approach is that some patients are overtreated and some patients are massively undertreated. The Heart and Lung Institute did a study a few years back that showed that 50 percent of patients admitted to the hospital for heart attack had normal cholesterol. This is because only approximately 25 percent of heart attacks can be prevented by statins and that is being generous. Another way of saying this is that you are only making a small dent in the plaque by only taking a statin.
The NatureMed Approach to Heart Health
There are many more factors that lead to plaque buildup beyond cholesterol. Other than diet and lifestyle there are number of risk factors that can only be found by doing advanced blood testing. Some indicate different types of inflammation, identify metabolic byproducts that damage the arterial wall, look at hormone levels, vitamin levels, and even the size and number of the cholesterol particles. Doing a complete workup is critical.
I consider that the workup is the most important part of the visit. The treatment is about an hour and over the years I’ve depended on things that work.
I will give detailed exercise and diet advice which is always personalized, measure plaque in coronary arteries and the carotid artery, do a very comprehensive blood panel and screen for other contributors such as sleep problems, stress and depression. I consider each patient to be a unique case. It’s never a one size fits all as people should not be treated like that. The phrase I use with patients is “why guess when you can know.” Why would I possibly want to guess whether someone is getting better and at less risk of heart attack or stroke when I can do testing which tells me with a large degree of certainty?