Heart disease is the number one killer of men and women in the U.S. One in three deaths in the U.S. is due to heart disease. Heart disease prevalence is expected to double in the next half century. Experts suggest that when you look at current data, overweight teens will directly contribute to increased rates of heart disease, as they move into young adult and beyond.
The current medicine model here and in many countries is to “treat disease when it happens.” That means that most cardiac patients are seen by the doctor if and when they have symptoms or health events, and treatment then focuses “on the heart.” Cardiac specialists are left trying to keep you alive with disease, or holding disease in check with a singular focus on one organ, the heart. Some traditional doctors have been questioning that approach. Why? In the case of one cardiologist who recently presented at the IHS 2017, “our blood vessels are on fire” and treating generalized inflammation requires a whole-body approach.
Regina Druz, M.D., F.A.C.C., F.A.S.N.C., A.F.M.C.P., chief, Division of Cardiology, St. John Episcopal Hospital, an integrative cardiologist, is one of those doctors. She focuses on the root cause of vascular disease namely inflammation, oxidative stress, and auto-immunity. Integrative cardiologists manage heart disease by integrating genetic, environmental, nutrition, behavioral, and exercise strategies into the management of cardiovascular disease. Prevention is the first goal; halt, cure, or treat if disease is present, is the secondary goal. Welcome to functional cardiovascular medicine and, from her perspective, “healing the vessels on fire” but more importantly, preventing the fire from starting if possible with early personalized intervention.
Traditional cardiac medicine is disease-centric and uses screening methods like body mass index (BMI), patient and family history, waist size, blood pressure, blood and urine tests, to identify disease. Evaluation of organ and vascular function is the next step, followed by treatment (drugs and/or more invasive therapy like revascularization or open heart surgery). The goal is to identify patients with vulnerable plaque that can rupture and cause a heart event (heart attack or stroke). If a patient is lucky, disease is caught early on.
There is however, another angle to managing cardiac health. If you prevent disease then you engage in a vascular-saving effect. You get ahead of the disease process and really keep the patient in optimal condition so that diseases develop much later, if at all. That also involves looking at the whole body, as, for example, gut microbe balance also means less inflammation and less risk of cardiac disease.
Integrative (Holistic) cardiology aims to marry the medicine-invasive traditional approach with functional (patient-focused) approach. That clinical philosophy is important because the current treatment philosophy can’t cure or undo events that take place (heart attack, stroke, serious vessel plaque and blockages). You are simply stabilized and hopefully the disease is held in check. One major goal of functional cardiology is to get to the root cause and eliminate endothelial dysfunction.
What single therapy can prevent 75-80 percent of vascular disease? Lifestyle efforts including diet, exercise, healthy sleep patterns, and stress reduction. Focusing on lifestyle can help to limit inflammation, oxidative stress, and autoimmune reactions. This approach can actually be relatively cheap, durable, and strategic compared to long term use of expensive drugs that treat disease.
Dr. Druz and others point to three very specific and prevalent conditions that raise levels of inflammation: obesity, opioid abuse and depression. There is also a strong link between rheumatoid diseases and heart disease risk — again, inflammation is at play. Even before diabetes is diagnosed, persistent levels of high blood sugar instigate inflammation. Non-alcoholic fatty liver disease (NAFLD) is on the rise and has an inflammatory component as well.
A number of lifestyle factors that increase the risk of a first heart attack include: smoking, low consumption of fruits and vegetables, low levels of physical activity, higher alcohol consumption, hypertension, diabetes, a large abdomen, higher circulating blood lipids, and psychosocial issues. All of these can independently or together fuel and then push levels of inflammation. Having all nine risk factors raises the risk of a first heart attack by 90 percent. Our vessels are indeed on fire.
Dr. Druz and other functional cardiologists, as well as generalists and other specialists use the Functional Medicine Matrix. This guide was created by The Institute for Functional Medicine. It focuses on inflammation, oxidative stressors and autoimmune components (gut microbe balance is a contributor as well) and also highlights the “mental, emotional, and spiritual” domain that additionally contributes to inflammation and requires recognition and personalized solutions.
“Collective health has improved over the last 30 years, but personal health has declined.” Traditional medicine currently defines health as disease free. Functional medicine and integrative practitioners define health as an ongoing state of wellness. There is a great divide and your health at stake, in a sense, between those two perspectives.
The average man will go to a doctor once symptoms appear. He likely hasn’t been well for a while, but because he was symptom free, he assumed he was disease free. That is NOT living in a state of wellness. Once medications like statins hit the market, most people found an easy solution to a serious disease and a replacement for healthy behaviors. Americans are comfortable popping pills and expect the pills to intercept their poor lifestyle habits, unlike the European health care model which emphasizes prevention and wellness (the cornerstones of functional medicine).
Dr. Druz uses an approach to the patient, GENES, which takes into account a person’s Genotype, Environment, Nutrition, Exercise, and Supplements. She creates a personalized therapeutic program for her patients based on GENES. Obviously, younger patients have a better chance at preventing “the fire,” though successful intervention can also occur at any age or stage of disease. She uses state- of-the-art traditional medicine to diagnose risk and cardiac disease, but she integrates GENES with traditional medication protocols. Not surprisingly, she is a big fan of the “food is medicine” mantra.
The aim in health should be a disease-free state of optimal wellness. Do you need to “get rid of something (toxins, allergy-inducing exposures, a poor diet, or stress)?” If you also have a family history of cardiac disease, strong risk factors for disease, or simply want to plot a course of wellness, integrative-functional medicine may be a good fit for you.
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Amy Hendel, also known as The HealthGal, is a Physician Assistant, nutritionist and fitness expert. As a health media personality, she’s been reporting and blogging on lifestyle issues and health news for over 20 years. Author of The 4 Habits of Healthy Families, her website offers daily health reports, links to her blogs, and a library of lifestyle video segments.
Known as The HealthGal, expert contributor Amy Hendel is a popular medical and lifestyle reporter, nutrition and fitness expert, columnist, and brand ambassador, as well as a health coach. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, you can find her on Twitter @HealthGal1103 and on Facebook at TheHealthGal. Her personal mantra is “Fix it first with food, fitness, and lifestyle.”