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Cardiometabolic Disease

Cardiometabolic Disease is a constellation of health issues involving metabolic dysfunction and cardiovascular conditions. Cardiometabolic disease treatment can be complicated, as cardiometabolic disease is characterized by cardiovascular issues such as heart attack, stroke, angina, high blood pressure and disorders of the vascular system, and metabolic disorders that occur together including obesity, diabetes, insulin resistance, abdominal adiposity (belly fat), and impaired glucose tolerance.

Other names used for cardiometabolic diseases are cardiometabolic syndrome (CMS), metabolic syndrome, insulin resistance, syndrome X, or beer belly syndrome. Metabolic Syndrome is a collection of symptoms which include abdominal obesity (waistline 40 inches or more in men, 35 inches or more in women), high triglycerides, low “good” HDL cholesterol and high blood pressure and is a major contributor to increased risk for cardiometabolic syndrome. Cardiometabolic disease is most common in middle and older generations. 

Cardiometabolic Disease is High Risk for Heart Disease or Diabetes

According to Jos Ordovs, PhD, director of the Nutrition and Genomics Research Lab at Tufts’ HNRCA, “When two or more of these risk factors coexist, it doubles the risk of heart attack and stroke and increases the risk of diabetes by a factor of 5 (both over a period of 5 to 10 years). Some experts have proposed additional cardiometabolic risk factors, including high levels of C-reactive protein in the blood, a marker of chronic inflammation thought to contribute to cardiovascular disease.Risk factors allow doctors and researchers to identify individuals who may be at risk of more serious cardiometabolic diseases and take corrective action.”

Around 25% of the world’s adults are suffering from cardiometabolic syndrome and it is now a global health issue.

Cardiometabolic Disease Treatment to Lower Risk Factors

A functional medicine approach to cardiometabolic disease treatment is necessary to address the root causes and risk factors involved. Many factors that contribute to disease are preventable or modifiable- dietary choices, exercise, weight,  cholesterol control, etc. After a comprehensive physical and history profile, advanced lab testing will help identify underlying issues that contribute to metabolic or cardiometabolic health. After a thorough medical evaluation, the physician will make recommendations for the patient to encourage effective and long-term lifestyle changes.

Advanced Lab Testing

Based on each patient’s unique profile,  functional medicine lab testing will be done to determine the root causes and contributory factors to cardiovascular disease and insulin resistance. Preventive testing or imaging may include vascular ultrasound of multiple areas of the body and coronary calcium score for risk stratification. DNA testing may be done to see what diet will give you the best results for longevity and to stay healthy without needing prescription drugs.

Lab Testing for the biomarkers of insulin sensitivity and biochemical assessments for cardiovascular and metabolic disease may include:

  • A1C, Fasting blood glucose
  • ADMA/SDMA
  • Blood pressure
  • Body weight
  • Lipid panel
  • Comprehensive CBC
  • Cortisol
  • C-Reactive protein (CRP)
  • Diabetes antibody panel
  • Fasting C-Peptide
  • Fibrinogen
  • GI MAP stool test
  • Heart rate variability HRV
  • Homocysteine, HDLfx, TMAO,  HS-CRP,
  • HS-CRP
  • Leptin
  • Lipoprotein A
  • Lyme disease
  • Nutreval
  • Pharmacogenetic profile
  • Thyroid panel
  • Uric acid
  • Vitamin D3

Continuous Glucose Monitoring

Continuous Glucose Monitoring (CGM) along with daily review of BP/PR during the course of treatment helps to see what the numbers are reflecting with the current diet that is being followed. This will assist in making incremental changes to the diet, which can then be monitored with CGM.
 

Heavy Metal Testing

Heavy Metal Testing-30% of all cases with high blood pressure have heavy metal toxicity(HMT). We will test urine for heavy metals and address these with heavy metal detoxification such as oral binders, or chelation with other methods if levels are too high.
 

Sleep Apnea

Sleep apnea is a major cause of silent hypertension and heart disease. Men age 30 and above and women in their late 40s or older are all susceptible to sleep apnea. This issue causes much inflammation in the body, possibly leading to cardiovascular and metabolic complications.
 

Hormonal Imbalance

Hormonal imbalance, which includes thyroid, adrenal and sex hormones can lead to metabolic diseases and thus, rapid aging. We will do hormone testing and use BHRT (bio-identical hormone replacement) where applicable in a safe way to ensure health, sex drive and longevity are maintained even at an elderly age, based on test results and close supervision.
 
 

In conclusion, a cardiometabolic assessment and treatment can address the underlying risk factors for disease. This, in turn, lowers the risk for a cardiac event or a diagnosis of diabetes, and reduced comorbidity from poor vascular health. With a functional medicine physician guiding the process, patients can establish long-lasting habits to maintain improvements over time.