Integrative Cardiology: Lifestyle and Natural Approaches to Heart Health

The major risk factors for heart disease (sometimes called cardiovascular disease) are high blood pressure, high cholesterol, and smoking. According to the CDC, about 47% of people in the USA have at least one risk factor for heart disease making prevention an important priority. Integrative cardiology takes a holistic approach to helping people manage their risk of heart disease by addressing the underlying factors associated with heart disease and personalizing the treatments based on each individual's specific health needs. 

Integrative cardiology approaches recognize that lifestyle factors play a significant role in heart disease. By combining medical treatments with lifestyle modifications, such as incorporating nutrition, and mind-body practices, individuals can effectively manage their heart disease risk. Early detection of individuals at risk for heart disease is crucial in minimizing potential complications. This article will delve into integrative cardiology, including functional screening methods, and explore how various integrative health approaches can contribute to improving heart health and managing associated risks.

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What is Cardiology?

Cardiology is a sect of medicine that focuses on the heart and vascular system. It deals with diagnosing and treating disorders of the cardiovascular system. Cardiology specializes in the structure, function, prevention, and treatment of this system. Some of the diseases include congenital heart defects, coronary artery disease, arrhythmia, and heart failure. 

A cardiologist is a highly trained doctor who specializes in treating heart and blood vessel diseases. These practitioners diagnose and manage a wide range of conditions, including heart failure, high blood pressure, heart attacks, and heart rhythm disorders. Cardiologists order tests, prescribe medications and recommend lifestyle changes to improve cardiovascular health. They also treat issues with heart valves, blood vessels, and congenital heart conditions. Cardiologists can help prevent future heart issues. 

What is Integrative Cardiology?

Integrative cardiology combines conventional cardiology with complementary approaches to provide personalized and effective treatment. It focuses on choosing the most appropriate treatments for an individual's specific health needs and risks. Integrative cardiology incorporates conventional therapies like medications and procedures when necessary while also integrating functional approaches such as mind-body medicine, nutrition, supplementation, and exercise. Integrative cardiology emphasizes healing and prevention and uses a holistic approach to care. 

Conventional cardiology is excellent at addressing acute heart problems. However, according to the American Board of Physician Specialities, many cardiologists have limited training in lifestyle interventions. Lifestyle changes can prevent the majority of premature heart attacks and strokes. Integrative medicine training equips cardiologists to address the root causes of heart disease, such as a sedentary lifestyle, stress, poor nutrition, and inadequate sleep, rather than just treating the symptoms.

Integrative medicine recognizes the inherent healing power of the human body. For example, even small amounts of physical activity can have significant benefits for individuals with coronary artery disease. Integrative cardiology aims to provide comprehensive care that goes beyond medications and procedures, considering lifestyle factors like exercise. By embracing integrative medicine principles, cardiologists can enhance their ability to prevent and heal heart disease and improve patient outcomes.

Functional Medicine Labs to Test Commonly Used in Integrative Cardiology

Functional medicine labs offer an in-depth evaluation of an individual's risk for cardiovascular disease (CVD) and are commonly used in integrative oncology. This comprehensive assessment helps integrative practitioners identify potential risk factors at an early stage. With this knowledge, personalized treatment plans can be developed to manage or even prevent the occurrence of CVD effectively. Here are some functional labs that are commonly used: 

Advanced Lipid Panels

The NMR LipoProfile test offers a more comprehensive analysis of an individual's cholesterol levels compared to standard lipid panels. This advanced blood test evaluates the size and density of lipoprotein particles, providing a more precise assessment of CVD risk. It is employed alongside other lipid measurements to assist in the management of lipoprotein disorders linked to CVD.

BostonHeart Diagnostics Panels

These panels are highly valuable in evaluating the risk of heart disease by examining various markers of cardiac health, such as a standard lipid panel and hs-CRP (high-sensitivity C-reactive protein). The marker hs-CRP can provide information about the inflammation levels in the body, which can contribute to the development of certain types of CVD, like atherosclerosis. Additionally, there are two distinctive tests, the HDL Map and the Cholesterol Balance. By analyzing the data obtained from these panels, healthcare providers can assess an individual's specific risk for heart disease and gain valuable insights for developing appropriate treatment plans.

Markers of Oxidative Stress

This blood test focuses on measuring oxidized LDL, which can indicate the level of damage to tissues and cells in the body caused by free radicals. Increased levels of oxidized LDL have been linked to various conditions such as accelerated atherogenesis, coronary artery disease (CAD), acute myocardial infarction, stable and unstable angina, metabolic syndrome, impaired glucose tolerance, insulin resistance, and untreated overt hypothyroidism.

TMAO

TMAO (trimethylamine N-oxide) is a compound produced by specific gut bacteria during the digestion of certain animal-based foods. Research has shown a connection between elevated TMAO levels and a heightened risk of developing cardiovascular disease. By conducting a blood test, healthcare professionals can measure the levels of TMAO in an individual's body. Based on these results, personalized dietary recommendations can be provided to help manage TMAO levels and reduce the risk of heart disease.

Diabetes Panel 

Individuals who have diabetes are at an increased risk of developing heart disease. This is a comprehensive panel that consists of several markers of diabetes. These tests include blood sugar, fasting insulin, and hemoglobin A1c. Elevated levels of these markers indicate diabetes type two. Understanding these factors can help providers effectively manage diabetes and diminish the risk of heart disease. 

Omega Panel

Increased levels of omega-3 fatty acids have been linked to a reduced risk of cardiovascular issues. The red blood cell omega-3 & 6 blood test is a valuable tool that helps measure these levels and offers personalized recommendations on how to enhance omega-3 intake through dietary changes or supplementation. By assessing the omega-3 levels in red blood cells, healthcare professionals can provide targeted guidance to improve cardiovascular health and support overall well-being.

Comprehensive Metabolic Panel (CMP) 

The CMP evaluates various aspects of a patient's metabolism, kidney and liver function, electrolyte levels, and blood glucose. This test measures 13 different substances in the blood, providing valuable insights into an individual's chemical balance and overall metabolism. It is a commonly used lab test that assesses several vital body functions, including kidney and liver health, blood sugar levels, calcium levels, blood protein levels, electrolyte levels (such as sodium, potassium, and chloride), protein levels, and fluid balance. For individuals at risk of arrhythmia or experiencing symptoms like palpitations or irregular heart rhythms, evaluating electrolyte levels such as potassium, sodium, and calcium becomes crucial, and the CMP offers this essential information.

Thyroid Panel 

The Thyroid Panel examines eight thyroid hormones and antibodies to assess the functioning of the thyroid gland and detect any related conditions. Thyroid problems can be connected to heart conditions, including certain heart diseases like arrhythmias. By conducting a comprehensive thyroid panel, healthcare providers can ensure optimal thyroid function and address any associated heart concerns.

Additional Labs to Check  

Other tests may include cardiac catheterization, chest X-ray, cardiac MRI, cardiac CT, coronary angiogram, stress tests, electrocardiogram (EKG), echocardiogram, transesophageal echocardiogram (TEE), Holter monitor, event monitor, and implantable event recorder/implantable loop recorder. Each test serves a specific purpose in assessing different aspects of heart function and identifying potential abnormalities or conditions. The selection of tests depends on the patient's symptoms, medical history, and the cardiologist's clinical judgment.

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Complementary and Integrative Medicine Lifestyle and Natural Approaches to Heart Health

Functional medicine utilizes an integrative approach to healthcare, focusing on the underlying root causes of disease rather than just treating symptoms. In relation to heart health, functional medicine offers various treatments that target the factors contributing to the condition's development. Prevention is a key aspect of functional medicine for heart health. This involves adopting a healthy lifestyle, including choosing heart-healthy foods, regular exercise, clinically relevant supplements, and other integrative approaches such as mind-body medicine. It is important to collaborate with a qualified functional medicine practitioner if you want to incorporate these approaches to improve your heart and overall health. 

Heart Healthy Diet 

Including heart-healthy foods can be helpful in managing and preventing heart disease. These foods can decrease the risk factors by decreasing cholesterol levels and blood pressure and improving weight. The main idea of a heart-healthy diet is to focus on whole, unprocessed foods and increase the intake of fruits, vegetables, whole grains, lean proteins, and healthy fats. Limiting added sugar is also important, along with including fiber. If you're looking to follow a specific nutritional plan, diets such as the Mediterranean or DASH diet have been shown to improve heart health by reducing inflammation, improving blood vessel function, and lowering the risk of heart disease. It's also important to limit alcohol intake, choose healthy cooking methods, and incorporate heart-healthy fats.

Supplements and Herbs for Heart Health

Supplements can support heart health, but they should be used with caution and guidance from a healthcare provider. Omega-3 fatty acids, Coenzyme Q10 (CoQ10), magnesium, vitamin D, garlic, hawthorn, berberine, fiber, sterols and stanols, and red yeast rice are some supplements that may benefit heart health. However, supplements are not supposed to be a substitute for a healthy lifestyle. Working alongside a healthcare provider is important to determine appropriate supplements and dosages and to ensure they don't interact with medications. A heart-healthy diet and lifestyle should always be prioritized for maintaining heart health.

Omega 3s

Omega-3 fatty acids, present in fatty fish, flaxseeds, and chia seeds, have beneficial effects on heart health. Specifically, they have been shown to lessen inflammation, lower triglyceride levels, and improve heart health.

Coenzyme Q10 (CoQ10)

Coenzyme Q10, an antioxidant, plays a role in energy production within the body and has the potential to enhance heart function and decrease the likelihood of heart failure.

Magnesium

Magnesium is a necessary mineral that is essential for various bodily functions. It is needed for heart health and has been found in studies to have potential benefits in reducing blood pressure and enhancing heart function. 

Vitamin D

A deficiency in this vital nutrient has been associated with several diseases, including a higher risk for heart disease. It is essential for its role in bone health and heart health. When a deficiency is present, it alters the blood calcium levels, which could create heart rhythm issues.

Garlic

Garlic, used as an herbal supplement, has been shown in research to lower the overall risk of heart disease and lower blood pressure. It has specifically been shown to reduce lipid levels after 1-3 months of use.

Hawthorn

Hawthorn is a medicinal herb that has been shown to improve blood flow and reduce high blood pressure, making it a common herb used for heart health. 

Berberine

In certain studies, berberine, a compound present in various plants like goldenseal and barberry, has demonstrated promising effects on heart health. It has been associated with lowering cholesterol levels, reducing blood pressure, and enhancing insulin sensitivity.

Fiber

Fiber, a vital nutrient found in fruits, grains, vegetables, and legumes, plays a significant role in promoting heart health by limiting the absorption of cholesterol from food. It is recommended to consume a daily intake of 25 to 30 grams of fiber, while men under 51 years old should aim for 38 grams. While obtaining fiber from a well-balanced diet is preferable, fiber supplements can be a great complementary option.

Sterols and Stanols

These plant compounds have the ability to decrease cholesterol absorption in the intestines by blocking their absorption. Seeds, nuts, and whole grains are examples of natural food sources rich in sterols and stanols. However, obtaining sufficient amounts of these compounds solely from food can be challenging, which is why supplements are often recommended. The recommended dose is 2 grams of sterols and stanols daily to help lower LDL cholesterol by 8-10%. It's important to note that sterols and stanols do not affect HDL or triglyceride levels. If you are already taking a cholesterol-lowering medication, make sure that you contact your healthcare practitioner before incorporating sterol or stanol supplements, as there may be potential interactions.

Red Yeast Rice

Red yeast rice is a supplement with a long history of use in TCM or Traditional Chinese Medicine. It is created by fermenting rice with Monascus purpureus yeast, resulting in the production of a compound called monacolin K. This compound resembles the active ingredient in certain cholesterol-lowering medications. While some studies have indicated that red yeast rice may reduce total cholesterol, triglycerides, and LDL cholesterol levels in individuals with high cholesterol, the evidence remains inconclusive.

Exercise for Heart Health

Incorporating exercise into your life on regular bases can help improve your overall heart health. Engaging in moderate exercise regularly can stimulate the production of nitric oxide (NO). NO is a molecule in the body that is important for healthy blood vessels and the function of the cardiovascular system. Research shows that moderate exercise can release NO from the endothelium, the inner lining of the blood vessels. This can improve vasodilation which can improve blood flow and lower blood pressure. Exercise has also been shown to regulate blood sugar levels. A deficiency in NO can lead to type 2 diabetes as it is involved in insulin signaling. Overall, exercise can help with NO production, thus regulating blood sugar, reducing insulin resistance, and improving glucose regulation. Incorporating regular exercise into your routine can effectively support heart health and manage conditions like hypertension and diabetes, major risk factors for heart disease. 

Mind-Body Approaches for Heart Health

Mind-body approaches such as yoga and meditation are practices that can greatly benefit heart health. Yoga involves physical poses, breathing techniques, and meditation, all aimed at promoting balance and uniting the mind, body, and spirit. It helps increase vagal tone, which stimulates the vagus nerve and the parasympathetic nervous system, leading to stress reduction, improved digestion and metabolism, and boosted immunity. Meditation, on the other hand, focuses on integrating the mind and body, promoting calmness and overall well-being. Meditation can reduce stress, regulate negative emotions, and promote mindfulness. Both of these mind-body approaches have been shown to lower blood pressure, reduce inflammation, and improve heart health. Studies have demonstrated their effectiveness in managing conditions like hypertension, diabetes, and cardiovascular disease. These practices can provide a low-cost and accessible way to support heart health and overall well-being.

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Summary

Integrative cardiology is a specialization in the medical field that focuses on improving the function of the cardiovascular system and overall health. This field of cardiology can incorporate conventional therapies such as medications along with functional approaches such as clinical nutrition, quality supplements, exercise, and mind-body medicine. The goal of integrative cardiology is to provide personalized and effective treatment that addresses the underlying factors of heart health. Those with risk factors for heart disease should collaborate closely with a qualified healthcare provider to assess their condition. By actively managing these risk factors, individuals can improve their heart health, lower their chances of heart disease and enhance their overall health.