| Heart
Disease
Risk Reduction
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
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| 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.
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