Misperceptions in Cardiology

As common as cardiovascular issues are, unfortunately, so are the misconceptions people have surrounding cardiovascular diseases & cardiology.

In this blog, Dr. Nisha Chellam, Founder and Internist at Holistic ICON conversation with Dr. Regina Druz, Board Certified Cardiologist and Functional Medicine Physician, FACC and FASNC, clears up all the misperceptions pertaining to cardiology, such as:

• Preventive Cardiology vs. Cardiac Surgery
• Cardiovascular Diseases
• Traditional Cardiology vs. Functional Medical Approach
• Risk Factor: Hypertension
• Risk Factor: High cholesterol
• A Heart-friendly Diet—Do’s & Don’ts

All the answers from a functional medicine perspective. So, lie back & keep reading.

Preventive Cardiology vs. Cardiac Surgery 

When talking about cardiovascular diseases, the first image that comes to one’s mind is of a person clutching their chest during a heart attack, followed by taking the person to a cardiac surgeon for a stenting procedure. 

While this is a common notion, it’s certainly not true. Procedural cardiology (such as surgery or stenting) is the end-stage management of cardiovascular diseases; just the tip of the iceberg. This notion has given the preventive aspect of cardiology a low priority. 

On the other hand, preventive cardiology is the study & analysis, followed by the treatment of chronic heart diseases; to effectively prevent or fix them. Most of the curing of heart diseases isn’t always as dramatic as putting in a stent or a defibrillator.

Dr. Druz explains this through an exceptional analogy of forest fires; where heart diseases are uncontrollable fire in someone’s vascular system.

“Through the normalization of these acute treatments like surgeries & stenting, what we’re doing here is putting out the fires, but not preventing the forest from getting dry.” 

— Dr. Regina Druz, Board Certified Cardiologist and Functional Medicine Physician

So, how do we prevent these diseases from a global standpoint?

1. We need to stop adding fuel: By paying attention to apparent risk factors such as hypertension, diabetes, high cholesterol, or obesity, and not normalizing them.

2. We need to take care of the forest so that it doesn’t become too dry and susceptible to catching fire by taking care of the foundations of health—eating the right food, managing stress, etc. 

Cardiovascular Diseases

All the heart conditions concerning damaged or diseased parts of the human heart are called cardiovascular diseases, as simple as that. However, people still fail to realize that there are multiple other forms of heart disease other than heart attacks, cardiac arrest, or coronary artery disease (CAD).

• Structural diseases
• Heart failure 
• Blood Clots
• Deterioration in the function of the heart muscle
• Diastolic dysfunction
• Arrhythmia
• Vascular diseases

This understanding will help clear the misconception that all of the cardiology is concerned with just bypass surgeries & stent placements.

Traditional Cardiology vs. Functional Medical Approach

When a person goes to a traditional doctor, they will put the person on medications related to what their situation is. Then, the doctor might send them back after stenting that one dangerous vessel & ask them to follow up for elective stenting.

Unlike the traditional approach to cardiovascular assessment, functional medical cardiologists go to the root cause of the problem. The functional medical perspective asks more “why” questions to reveal the history behind the risk factors, depending from patient to patient. They delve deep into the root cause of hypertension, or obesity, or stress, or high cholesterol, etc. Practitioners assess the impact of the environment, genetics, diet & even pollution on the person's condition.

Thus, functional medicine provides the foundation that traditional cardiology doesn’t.  

Risk Factor #1— Hypertension

Most people tend to exaggerate the numerical measurements when it comes to high blood pressure.

The functional medical cardiologists approach such situations by helping the patient realize that the blood pressure measurement is more than just a separate measurement at a specific time; there’s so much more to it. Such involvement in the whole journey helps them understand the gravity of their reactions to numbers and even calms them down.

Root Causes 

Before looking for the root causes, the doctor considers the context & the timeline of the condition and cross-checks any secondary causes. After this, the doctor confirms if the patient is hypertensive or not.

Whether the patient has labile blood pressure or established hypertension, there are two causes:

• Insulin resistance: Insulin resistance is one of the most overlooked causes of hypertension, ignoring which you may/may not increase your chances of gradually developing type 2 diabetes.

• Sympathetic Activation: While most people are not aware of their sympathetic reactions, being in this state of fight or flight causes consistent changes in the vascular tone, changing the vessels without the person even realizing it. Being in this zone of an increased heart rate contributes to hypertension.

Risk Factor #2—High cholesterol

Cholesterol alleviation is a stress reaction or an indicator of imbalance. In functional medicine, cardiologists strive to find the reason behind the high cholesterol levels instead of just prescribing cholesterol decreasing medications.

Misperceptions:

1. No need for statin drugs if there’s an optimal level of cholesterol. Wrong. The patient still needs to be put on statin drugs for LDL because of the residual risks of cardiovascular problems.

2. Having high levels of HDL or the “good” cholesterol protects you from cardiovascular diseases. Not always. At times people have HDL cholesterol levels that are just too good to be true. In such cases, patients should check:

• the amount of LDL & HDL particles
• the size of LDL & HDL particles

Having extremely high levels of HDL can be a sign of zygosity that can cause dementia.

Medication—Statin Drug

Statin, a cholesterol-lowering drug, increases the coronary arterial calcification causing the more unstable plaques to come to their final healing stage and get calcified, which is a good thing. The likelihood of memory-related issues only increases when the cholesterol level goes to less than 150.

The decision to take Statin drug depends on:

• Total cholesterol production
• Cardiac risk
• Cognitive risk
• Genetic risk (direct or polygenic)
• Lipoprotein (a) levels

A Heart-friendly Diet

Cardiologist-recommended diet for a healthy heart has clean eating, hydration, timely eating & elimination of sugars as the foundation.

Do’s

• Follow the Mediterranean-style diet
• Incorporate healthy fats
• Avoid processed foods
• Cut off all saturated & trans fats
• Follow time-restricted eating patterns

Don’ts

• Consumption of simple sugars
• Opt for a Ketogenic diet as a long-term solution
• Over-consumption of fish oils (Omega 3 & Omega 6)

Supplements

• Optifibre, by Xymogen
• Alpha Lipoic Acid (ALA) (for patients with insulin resistance)
• BergaCor Plus, by Xymogen
• Metamucil

This blog covered just the highlights from our latest podcast by Dr. Nisha Chellam, Board Certified Internist and Founder of Holistic ICON, and Dr. Regina Druz, Board Certified Cardiologist, Functional Medicine Physician, FACC, and FASNC. If you wish to listen to a more detailed version, you can listen to the entire podcast on our YouTube channel by clicking this link:

In case you have any questions related to cardiology or cardiovascular diseases, please drop us an email with your question and a brief about yourself at xxx or xxx, and we will get back to you shortly.

Hoping this blog was helpful!