Cardiovascular disease (heart attack, stroke, etc) continues to be the leading cause of mortality as well as devastating decrease in quality of life for both men and women. This is despite the increasing number of medications used to treat blood pressure and cholesterol…
A growing body of research is confirming the profound effect of psychosocial stress on cardiovascular risk. The well-known INTERHEART study published in 2004 showed the likelihood of having a heart attack is increased by 42.3 times when a person has all four “traditional” heart risk factors (smoking, diabetes, hypertension and hyperlipidemia), but a not so well-known finding is this likelihood is raised to 182.9 times if psychological stress is present in addition to the four traditional risk factors!!!
The good news is there is now ample evidence that mind-body medicine strategies are effective in reducing cardiovascular risk. In order to prevent diabetes and cardiovascular disease, an integrative strategy is imperative.
The goals of our programs at the Center for Optimal Health are to help you make sustainable lifestyle changes that are necessary for optimal health. You will be assessed as a whole being, with physical, emotional, mental, and spiritual needs that will be addressed by The Center team and treated with a pioneering integrated approach, beginning with natural methods. We are able to take the art and science of prevention to a more sophisticated level, incorporating the latest research and technology.
Cardiovascular Risk Assessment
Knowing your cholesterol levels is not adequate to evaluate your risk for a heart attack or stroke. In fact, there is tremendous overlap in the cholesterol levels of patients with coronary heart disease versus those without. We all know people who have “normal cholesterol levels” who have had coronary artery bypass surgery, and we all know some who have “sky-high” cholesterol levels who have escaped the fate of heart disease. It is therefore important to go beyond the ordinary lipid panel and blood pressure measurements. At the Center for Optimal Health, we take a proactive, aggressive and comprehensive approach to cardiovascular risk assessment and reduction. This section introduces you to the cutting-edge tools we have to assess your cardiovascular risk.
Health Diagnostic Laboratory Inc
Health Diagnostic Lab, Inc.(HDL) is a comprehensive panel of advanced cardiovascular risk assessment testing including Lipoprotein Particles, Inflammation, Heart Function, Genetics, Metabolic, Omega-3 Index, and Other Factors.
Diabetes Screening Tests
A recent study showed that among patients with no prior diagnosis of diabetes who were admitted to the coronary care unit with their first heart attack, 31 percent were actually diabetic when put through an oral glucose tolerance test (OGTT), which is a much more rigorous and sensitive test for the presence of diabetes. Another 35 percent had impaired glucose tolerance (“pre-diabetes”), and only 34 percent were truly non-diabetic! We now know that insulin resistance / prediabetes is one of the strongest cardiovascular risk factor. Several studies have shown that diabetes can be prevented if prediabetes is identified and treated. Data has even emerged that efforts to prevent diabetes actually do reduce cardiovascular risk. We strongly believe that aggressive screening for prediabetes and insulin resistance is imperative.
Selected Risk Factors for Diabetes:
- Abdominal obesity
- Certain ethnicities (eg. Hispanics, American Indians, Asian Indians, etc)
- Family history of type 2 diabetes
- Birth weight under 5 lbs or over 9lbs
- Women with history of gestational diabetes or who have delivered babies with birth weight higher than 9lbs
24-hour Ambulatory Blood Pressure Monitoring
Spacelabs 90217 Ultralite Unit
Have you ever wondered what your blood pressure is outside of the medical office, in your own real life environment? 24-hour ambulatory blood pressure monitoring (ABPM) allows us to tell you exactly that. Many patients have elevated blood pressure in the medical office but otherwise have normal blood pressure. This phenomenon is known as “white coat hypertension” (WCH). An important reason to use ABPM is to exclude the diagnosis of WCH. Although WCH was initially thought to be "benign," there is now increasing evidence to suggest the prognosis for patients with WCH is at least intermediate between that for patients with normotension and that for patients with established hypertension.
ABPM can also be used to evaluate patients with dizzy / fainting spells or suspected orthostatic hypotension (significant drop of blood pressure upon assuming an upright position). And it can assist in refining management strategies in patients whose BP is apparently poorly controlled. The 24-hr BP profile provided by ABPM allows for an assessment of drug effects on BP, such as peak and duration of medication effect. ABPM can also identify patients with significant pre-awakening surges in BP -- such patients have a higher cardiovascular risk in the early morning hours. Detection of morning BP surges by ABPM argues for a shift in the timing or change in the type of antihypertensive medications to improve the coverage during this critical time period.
Blood pressure normally follows a diurnal rhythm, with lower readings at night. Recent studies have shown that the failure of nocturnal BP readings to decline is associated with a higher risk of heart failure and diabetes; thus, the ability to capture nocturnal BP readings with ABPM is valuable in defining an individual’s cardiometabolic risk profile. Emerging evidence supports ABPM as a better overall predictor of end-organ damage, cardiovascular events, and mortality than clinic BP readings. Here at the Center we utilize the state of the art in ABPM equipment, the 90217 by Spacelabs, which gives us an accurate and detailed report so that we can provide you with the best recommendations to minimize your cardiometabolic risk.
MCG (MultiFunctional Cardiogram) - Revolutionizing Heart Disease Detection
The Center for Optimal Health is proud to be the first center in California to offer MCG testing. In keeping with our proactive approach to health, a simple, non-invasive and highly accurate heart disease screening test is a most welcome addition to our services.
MCG analysis process is part of an emerging trend in medicine: the clinical application of advances in computational biology. By combining mathematical modeling and functional measurements of the heart’s electrical activity with an extensive empirical digital database MCG is able to detect coronary ischemia within 90% of the accuracy of an angiogram, using a method that is rapid, non-invasive, and does not involve radiation exposure or physical stress.
Where traditional ECG (electrocardiogram – aka EKG) technology has taken a reductionistic approach – simplifying the cardiac system by plotting ECG signals as a virtual dipole in a voltage-over-time graph – MCG takes an integrative approach, building upon a mathematical model that embraces the complexity of the cardiac system, including the interaction between heart muscle and blood flow. The holistic perspective with which the MCG evaluates the cardiac system fits perfectly with our Center’s whole person approach to health.
Premier Heart developed the MCG technology through extensive in-house research and validated the ability of MCG to detect coronary artery disease through rigorous double-blind clinical trials encompassing over 1000 patients at leading heart centers around the world. An analysis of trial data shows the accuracy of MCG testing approaches that of coronary angiography, regardless of age, gender or ethnicity.
A large number of patients with clinically significant coronary artery obstruction remain asymptomatic up until their first heart attack — at this point it is too late to reverse the damage done to the heart. Evaluation with MCG can detect coronary disease in its earliest stages, allowing intervention before damage is done. If testing reveals early-stage CAD (coronary artery disease) lifestyle changes and medication can be instituted to help avoid a potentially life-threatening heart attack.
Clinical trials and real-world experience has shown the MCG system to be superior in sensitivity and accuracy when compared to other common clinical techniques such as stress tests, nuclear perfusion imaging and CT angiography. In other words, MCG can potentially detect coronary artery disease in cases where regular exercise stress testing would miss it. The regular EKG is good at picking up arrhythmias present at the time of the EKG but is very poor at identifying ischemic heart disease.
While MCG analysis is more accurate than other diagnostic techniques it is not 100% accurate. Clinical studies have shown that for diagnosis of ischemia due to coronary artery disease the MCG has a sensitivity of 90% with 7±2% false negative results. Specificity is 85% or better, with 15±3% false positive results. It is possible for a MCG to report a negative result for a small subset of patients with coronary artery disease. Likewise it is possible for a MCG to report a positive result for a subset of healthy patients. For each individual, the MCG results need to be interpreted in the context of the whole person – including lifestyle, symptoms and laboratory testing.
Cardiovascular risk reduction is an integral part of the whole-person wellness plan we offer to all our patients at the Center for Optimal Health. The MCG technology allows us to screen for coronary heart disease with a high degree of sensitivity and accuracy while avoiding radiation exposure. The MCG test is performed while you rest in the comfort of our Center. The procedure lasts less than 30 minutes and does not require any special preparation. This simple test may be one of the best things you will do for your cardiovascular health!
Click here to read more about the clinical research supporting the MCG technology.