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 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.

Berkeley Heart Lab Advanced Lipid Testing

Berkeley Heart Lab pioneered advanced lipid testing and continues to be the Gold Standard. We utilize the Berkeley Heart Lab to evaluate the size of your lipid particles as well as other newly recognized cardiovascular risk factors such as Lp(a), C-reactive protein (CRP), homocysteine and Lp-PLA2 (phospholipase A2). Did you know that we can check your ApoE genotype (the specific kind of ApoE gene you inherited from your parents) which affects how your cholesterol levels are affected by lifestyle factors such as alcohol, fish oil, and fat content in your diet, etc? View a detailed discussion of the advanced lipid testing...

Glucose Tolerance Testing

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

Prevu Skin Sterol Testing

PREVU* Point of Care (POC) Skin Sterol Test is an innovative new tool to help assess level of risk of Coronary Artery Disease (CAD).

The PREVU* POC Test is a unique and non-invasive tool that enables healthcare professionals to quickly and accurately assess a person’s skin sterol level. Skin sterol (or skin tissue cholesterol) assessment has been shown to be an effective approach for identifying people at risk for Coronary Artery Disease (CAD). CAD is the leading cause of death in North America. 25% of those who die of CAD had no prior symptoms.

The PREVU* POC Test has several important benefits:

• no blood sample is required – therefore no needle prick
• it is painless
• there is no need to fast
• it takes approximately 5 minutes – results are immediate

By having a clearer view of your risk level, more proactive strategies may be undertaken to successfully prevent a first cardiovascular event.

PREVU* Point of Care (POC) Skin Sterol Test

Researchers have discovered that your skin contains skin tissue cholesterol or skin sterol that can be measured to accurately reflect the level of cholesterol deposited in the tissues of your body. Your skin actually contains 11% of your total body cholesterol2 and it is also one of the methods that your body uses to eliminate excess cholesterol. The amount of cholesterol “build-up” in your skin can be considered a mirror of the plaque build-up in your arteries (artherosclerosis) which indicates Coronary Artery Disease (CAD).

Skin sterol (skin tissue cholesterol) is not another way to measure blood (serum) cholesterol. In fact, skin sterol and serum cholesterol do not correlate with one another. The PREVU* POC Test is a simple, rapid and non-invasive assessment tool that can accurately measure the build-up of sterol in the skin. It is painless, does not require you to fast or have a blood sample taken. A key advantage of the PREVU* POC Test is that it provides additional information to the traditional risk assessment tools. The skin sterol score will provide your physician with a better estimation of your risk level for developing heart disease.

Here is how it works...

A Detector solution containing a cholesterol-binding reagent is applied to the cleansed surface of the outer palm of the hand. A foam well pad keeps the reagents in place.

The cholesterol-binding reagent attaches to cholesterol on the surface of the skin. The more cholesterol present on the skin, the more the cholesterol-binding agent will attach. The Indicator solution, which is initially colorless, turns blue-green in direct proportion to the amount of detector that is bound to the skin cholesterol. The more Detector bound to the skin, the darker the color will become.

A hand-held reader is used to determine the patient’s skin cholesterol value by measuring the hue of color development in the test well. The bluer the color, the higher the skin cholesterol value will be.

Source: Information extracted from www.prevu.com.

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.