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.

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

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.