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Heart Health 101

Hello everyone and welcome to this program on the heart and heart disease 101. I am Dr. Trish Murray – physician, author, and Health Catalyst Speaker. To kick off our event today, it is important that we are all on the same page when it comes to understanding what heart disease truly is.

According to Medical News Today, Heart disease is a term used to describe several conditions, many of which are related to plaque buildup in the walls of the arteries.” I’m going to be explaining how and why plaques develop. What truly causes an acute heart attack or a stroke to happen is that a plaque in the wall of an artery becomes unstable and either what’s called the cap or, if you will, the scab that is securing the plaque breaks down allowing the insides to spill into the bloodstream and form a clot that eventually blocks blood flow to a part of your heart or brain. Now that we are all clear on this, you may be asking yourself how this relates to you and if plaques are the problem, what causes them? How do they become unstable? How do I know if I am at risk?

With the following information I’m going to shake up your world a little bit! You see, abnormal cholesterol levels are NOT the primary causes or indicators of heart disease. Consuming a high cholesterol diet or eating eggs does NOT significantly raise your cholesterol levels. All LDL or “bad cholesterol” is NOT harmful. All HDL or “good cholesterol” is NOT protective. Blood pressure taken at the doctor’s office may NOT be an accurate measure of your true blood pressure. Fasting glucose or sugar of 99 when the normal range in the traditional medical model is less than 100 is NOT safe or normal. Normal body weight does NOT ensure heart health. You see, most doctors talk about coronary heart disease prevention as if it were a matter of simply dodging five specific bullets”

  1. Elevated cholesterol such as the “bad guy” LDL
  2. High blood pressure
  3. Diabetes mellitus
  4. Obesity
  5. Smoking

Now, I’m not saying these aren’t important. As important as these five items are, in many regards this list is ten to fifteen years outdated. That’s what we’re going to be talking about tonight.

This is the cover of a book written by Mark Houston who is a physician as well as a has a master’s degree in nutrition. What Your Doctor May Not Tell You About Heart Disease. The information in this presentation is predominantly sourced from this particular book and journal articles written by Dr. Mark Houston. Again, he is a cardiologist and he has a master’s degree in nutrition. He has been the primary cardiology instructor for the Institute for Functional Medicine for many, many years.

I’m going to read to you in a moment in Dr. Mark Houston’s words a little passage from his book. This is, “I prefer to think of the evolution of heart disease as a trip through a giant maze. When you first enter the heart disease maze, you see hundreds of little pathways that wander all over the place leading nowhere in particular. The walls lining these pathways are low and there’s plenty of light, so you experience no feeling of urgency or danger. Instead, you feel as if you can safely wander from path to path forever. If you just stroll down a few of these paths for a while then hopped over the short walls and walked out of the heart disease maze all would be well; however, if you kept walking and followed too many paths or followed one or more for too long, you would suddenly realize that you were moving along a different kind of path – one with higher walls, less light, and a kind of spooky feeling. You would have moved from the innocuous variations pathway to the one of considerably more dangerous ‘fast track to heart disease’ pathways. You wouldn’t have noticed any signs indicating you were leaving in the little variations pathways and entering the ominous fast track to heart disease pathways, but there you’d be. For many people, the fast track pathways of greatest concern are the following seven. These seven are the inflammation pathway, the oxidative or toxic stress pathway, the vascular autoimmune pathway, the dyslipidemia pathway, the blood pressure pathway, the blood sugar pathway, and/or the obesity and increased body fat pathway.”

Again, from Dr. Houston’s words, “As a hypertension and vascular specialist practicing preventative cardiology, I’ve been frustrated by the fact that most people have no idea they’re in the heart disease maze until they are already on the faulty arteries pathway or have splattered into the brick wall at the end of the journey. If only they knew how easy it is to step out of the maze at the beginning of the journey or how to get off the fast track to heart disease and faulty arteries pathway or better yet, how to avoid them all together. But they don’t know because they’re not told these things by their physicians.”

Let’s look at an artery, particularly what’s called the endothelium which is where the trouble begins. Folks, arteries carry blood away from the heart. They are complex, multilayered living tubes. They have three layers to them. The most inner layer is called the tunica intima. The tunica intima is the inner most layer and is composed of a thin layer of endothelial cells that in the smallest arteries, called capillaries. This is actually the only layer that exists, and this is the layer that nutrients and gases pass (like oxygen) through to get into your tissues. The next layer of the artery is called the tunica media. This is a muscular middle layer made of smooth muscle that allows an artery to constrict or dilate to adjust the volume of blood needed by a particular area of your body or tissue. The final layer of an artery is called the tunica externa. This is the outer most layer of the artery and is made up of connective tissue that provides protection for the vessel or the artery or the hose or the tube.

Now, the intima or the endothelium lining the vessel of the artery is the point of contact between blood inside the vessel and the inner artery wall. Remember that the endothelium is extremely thin. It is just one cell layer deep. If you’ve listened to my other talks and you’ve learned about the intestines, then you know that the lining of our intestines is also only one cell layer thick. Similar to the lining of the intestines, our arteries our inner lining…remember the concept of leaky gut? Well, you can have leaky arteries as well. Now, the job of the endothelial lining and the cells that make up the endothelium of your arteries, folks, have a lot of jobs that they have to do:

  1. Act as a barrier
  2. Fight off disease by regulating immune responses to bacteria, viruses, or other types of infectious agents
  3. Regulate blood pressure
  4. Control the response to toxins (such as inflammation and oxidative stress)
  5. Control blood clotting
  6. Control the growth of new arteries (Neovascularization: if a certain area of your body needs more vessels you grow more of them. Remember, this is living tissue. We are alive and we can grow new arteries at different times.)

The endothelium, or the intima, makes executive decisions and is a living organ. [click_to_tweet tweet=”As one of the largest organs in the body, it consists of the surface area of 6 ½ tennis courts!” quote=”As one of the largest organs in the body, it consists of the surface area of 6 ½ tennis courts!”] It is not protected. In continues to be in direct contact with bacteria, toxins, hormones, and other substances that can either harm it or give it information or alter its behavior.

The belief that heart disease happens due to excess cholesterol just sticking to the inner lining of your arteries is an obsolete and completely outdated concept! Heart disease truly begins with an injury to your endothelium, that inner lining of an artery, that then leads to wound healing. Just in the same way that if you scratch your skin and you have wound healing, if you scratch the inner lining of your artery you also are going to have, what? Wound healing. It is the wound healing process initiated by your immune system that then leads to the development of an atherosclerotic plague. So, let’s take a look at this process.

What happens is, in your blood certain things can be dangerous to the vessel wall. A microscopic scratch or irritation to the endothelium can be caused by many different things. Some of the things that can cause this are:

  • sugar
  • cigarette smoke
  • chronic infections
  • heavy metals
  • oxidized (or toxic) LDL
  • elevated blood pressure
  • inflammation

You see, once a scratch or irritation occurs to an area of the endothelium white blood cells, platelets, and other immune cells rush to patch things up and initiate the wound healing response. Now, some of these cells burrow inside the artery wall and create a toxic brew that remains and gets walled off from the bloodstream, and a fibrous cap or scab forms over this toxic brew. This brew that is now enclosed within the artery wall – you got it – is the development of an atherosclerotic plaque.

But guess what? This walled off toxic brew is not harmless! You see, it continues to send out signals to increase inflammation, oxidative stress, and immune responses. Over time the toxic brew grows larger and more dangerous, especially if you’re on one of those seven fast tracks to heart disease paths and in the heart disease maze. See, as the plaque grows it then may bulge into the lumen (the inner aspect of the hose of the artery) and interfere with blood flow. But what you need to need to understand is that’s not what causes the heart attacks. Even a 50-90% blockage can be actually asymptomatic, meaning you don’t even know it’s there.

The real reason why a heart attack truly happens and when it happens is that the fibrous cap or scab comes off and the toxic brew of the plaque and the insides of the toxic brew is spewed into the bloodstream. Substances in the toxic brew initiate an instantaneous blood clot. This immediate clot formation can be big enough to fill the artery, block blood flow, and cause, therefore, a heart attack or a stroke.

Again, I’m going to share with you a bit of story from Dr. Houston’s book. This story is about a gentleman named Ron. “Ron, a 42-year-old man, was rushed to the emergency room when he complained of chest pain. He told the doctors that he had been having ‘moderate chest pain’ off and on for several months. Ron, who was severely overweight, also divulged that he smoked a pack of cigarettes every day and was under a lot of stress. He was given the standard tests which revealed that he had elevated levels of total cholesterol, LDL (the bad guy cholesterol), blood pressure, and fasting blood sugar. However, his cardiac angiogram showed that his coronary arteries were all ‘wide open’ with only minimal blockage. That’s not surprising. For toxic brews can be hidden in the arterial walls and not protrude much into the lumen of the artery. Ron’s doctors assured him that he was fine and just needed to stop smoking, lose weight, take medicines to control his cholesterol, and otherwise keep his big five risk factors under control. Ron turned out to be an excellent patient and took his medicines exactly as prescribed. He also lost twenty pounds and cut back from one pack to half a pack of cigarettes a day. At his regular checkups, his doctor was delighted, but then three years later, Ron had his first heart attack.”

He was sent to see Dr. Houston, and the tests that Dr. Houston performed showed significant damage to the endothelium which could have been detected earlier, had someone looked. If Ron had worked to reduce the factors that contributed to his endothelial dysfunction, he probably would never have had that heart attack. Again, this is a quote now from Dr. Houston from his book, “Let me be clear – I don’t mean to imply that it’s okay to have elevated cholesterol, blood pressure, or blood sugar or smoke or to be obese, but our decades long insistence that the big five are the be all and end all of heart disease is a tragic myth that has led millions to an early grave. Endothelial dysfunction is much more important than any of these factors.”

Now, there are tests other than just blood tests that can help to look at the thickness of your arterial walls and not just look at how the lumen looks, for example. There are two of them, tests that can attest the thickness of the artery walls. One is called Carotid Artery Duplex Scan and the other is called a Carotid Intimal Medial Thickness Scan. Both of these tests are done by ultrasound. They are not invasive tests. Another thing I would point out is there is a blood test that is out there but probably no one, unless you probably have seen me or some other functional medicine doctor out there, has done the blood test. It is a mark that if elevated is a sign that there is unstable plaque that is leaking from your artery walls. We’re going to talk more about this, but you’ll see it’s called LP PLA2 or for short PLAC test. I’m going to get more into detail about that in a little while. So far, folks, in summary of what we’ve covered so far:

  1. My first objective was to shake up your world a bit and to point out that some of the ideas of heart disease that we’ve been following and believing for the past fifty years are not all there is to it. They are outdated.
  2. I listed for you the seven fast track to heart disease pathways.
  3. I hope you’re understanding how atherosclerotic plaques truly develop and that they are the cause of any heart attack or stroke.

Now, what I want to go into in the second portion of this talk today is this thing called an advanced lipid panel. You see, the traditional lipid testing that most people are still having today…medicine on the street today is about 10-15 years outdated. The traditional lipid panel that is still happening today most of you have had. It is not an accurate assess of your risk of having a heart attack or a stroke, but there is a better test, and it’s been out there a long time. It’s called an advanced lipid test.

I want to go into the details of this, but before we even get into the specific details of this test, I’d like to share with you some of the evidence that’s out there and has been out there in journals for quite some time saying that looking for new answers is extremely important in heart disease.

First of all, “Cardiovascular medicine needs a complete functional and metabolic evaluation related to diagnosis, prevention, and integrative treatments. We have reached the limit in our ability to treat cardiovascular disease appropriately.” Yes, you guessed it. This quote is from Dr. Mark Houston in a journal called the Journal of Restorative Medicine, and the title for his article there was “The New Concepts in Cardiovascular Disease.” This article was published back in 2013.

Next piece of evidence, and folks, this quote is from a journal called Circulation, and guess what? That is the journal of the American Heart Association. The title of the journal article was called “From Vulnerable Plaque to Vulnerable Patient.” It was published as far back as 2003, and it had as many as fifty different authors that were listed. The article said, “Atherosclerotic cardiovascular disease results in >19 million deaths annually. Despite major advances in treatment of coronary heart disease patients, a large number of victims of the disease who are apparently healthy die suddenly without prior symptoms. Available screening and diagnostic methods are insufficient to identify the victims before the event occurs.”

And finally, another piece of evidence. This quote is from a Lipid Specialist at the Florida Lipid Institute. “The sensitivity of the traditional lipid panel using the current criteria for identifying people at risk is about 40% in the American population. In other words, 60% of Americans at risk for coronary events are not identified using the current criteria and the traditional lipid panel. As a physician this means you are flying half-blind. There are not many areas in medicine that you would consider 40% predictability state of the art.” Folks, 50% of people having a heart attack right this minute have had a normal lipid panel in the last six months.”] If you consider that the right assessment of your risk of heart disease, that’s ridiculous! We must do a better job!

Let’s look at why this test that we’ve been using since the 1970s, basically, is outdated and why it’s not the best test. First of all, in the traditional lipid panel the LDL cholesterol is not directly measured. Rather, it is estimated using a mathematical equation called the Friedewald equation. You’ll see that the equation is: [LDL] = [total cholesterol] – [HDL] – [triglycerides/5]. That’s how your LDL number is determined on the traditional lipid panel. Thus,[click_to_tweet tweet=”your LDL cholesterol level is estimated, not actually measured, and it does not correlate well in patients already diagnosed with conditions like diabetes, previous heart disease, or other vascular diseases.” quote=”your LDL cholesterol level is estimated, not actually measured, and it does not correlate well in patients already diagnosed with conditions like diabetes, previous heart disease, or other vascular diseases.”]

What you’re seeing now is the results of a sample advanced lipid panel. I’m going to take you through this. This advanced lipid panel we’re going to be using is by a lab called Quest Diagnostics. That’s a national lab here in the United States. It is the lab I use because they do any labs, but they also offer the advanced lipid panel.

As we look at this, you will see that the traditional lipid panel numbers are there, and they’re in the first subsection of the report. The lipid panel, for example, the total cholesterol in the sample you see on this slide the result for this person’s sample is 166 of the total cholesterol. Optimally, this is the same for even the traditional lipid panel, your total cholesterol should be less than 200. This person is, and they’re in the green which is optimal. Next, HDL cholesterol (the good guy) should be greater than 40. For the sample number you see on this test on the slide, the person’s result is 61. Therefore, it’s also optimal or in the green. Next, triglycerides. The person’s triglycerides are 81. That’s less than what’s recommended at 150. This person also for their triglycerides is in the green – it’s optimal. Next, the bad guy LDL cholesterol. This person in the sample result is 89. It’s recommended to be less than 100. Again, this sample is in the green and it’s optimal. This person looks like they are doing great! Next, the ratio of total cholesterol to HDL cholesterol for this person in this sample is 2.7, recommended to be less than 3.5. Again! In the green, optimal. Finally, in the lipid panel numbers, the traditional type numbers, the non-HDL cholesterol is 105, recommended to be less than 130 so again, this person all the way through all of these traditional lipid numbers has been in the green and looks great! This person’s primary care doctor would tell them they have no risk of heart disease, “Don’t worry about it, live a healthy life, but you have no risk of heart disease.”

Well, wait a minute. If you look down at the rest of the information and you look under the hood some more at this person’s numbers, before I even get any of the details, there are six different numbers that we haven’t talked about yet that are not in the green. They are in the yellow which means they are moderately elevated and three of them are in the red which means they are pathologically elevated. This person does have risk of heart disease that they’re not aware of if they’ve never had the advanced lipid panel done.

One of the top numbers, the next number I’ll go over is in this lipoprotein subfractions, the number called the LDL particle number. You’ll notice for this person their LDL particle number is high. It’s 1503, recommended to be less than 1260. Huh. Let’s look at what this means.

First of all, the advanced lipid panel is a measurement of the “true” particle number. It is not calculated like we talked about before in a traditional lipid panel. They actually take a sample of blood and they count the number of LDL particles. It is not an estimation; it is a true measurement of how many LDL particles there are. Now, how many LDL particles there are in a sample of blood is determined by the size of the particles.

I love to share this particular analogy with people to understand this concept. If you imagine a laundry basket. Envision a laundry basket in your bathroom or you room. If you were to take basketballs and fill your laundry basket with basketballs, you probably fit, what? Five maybe in that laundry basket. If you take out the basketballs now and instead you take softballs and you fill that laundry basket with softballs, you’re going to fill it with maybe as many as fifty. As many as ten times more softballs than basketballs. Now, take the softballs out of your laundry basket and fill it with Ping-Pong balls. Folks, you’re going to fill it with a hundred times as many Ping-Pong balls as you are with basketballs. [click_to_tweet tweet=”Lipids are fats, and lipid and fat should be big fat globular and float down the bloodstream and bounce around and not cause any danger. As lipid and fat gets more toxic and more inflamed, it gets denser and it gets smaller.” quote=”Lipids are fats, and lipid and fat should be big fat globular and float down the bloodstream and bounce around and not cause any danger. As lipid and fat gets more toxic and more inflamed, it gets denser and it gets smaller.”]You develop more toxic smaller particles. Therefore you develop more LDL particles when they become toxic and inflamed they get to be more the size of the softball or the Ping-Pong ball and they become more dangerous to banging into the wall of the artery and causing a scratch and irritation and a wound and start that brew that we talked about in the beginning of the talk.

Studies have shown there is excess risk with normal total LDL cholesterol but increased LDL particle number. Dr. Houston and other functional medicine cardiologists have pointed out that the LDL particle number is probably the most important number of all in determining a person’s risk of vascular disease and heart attack. LDL particles that are inflamed and toxic become denser and smaller and dangerous, and they can be the primary cause of atherosclerotic plaque development.

Looking again at this person’s particle sizes now, look at the lipoprotein subfractions which is the second category of the test results. You see that this person’s LDL particle number is elevated at 1503, and there should be less than 1260 LDL particles total. Now, the next thing is look at LDL small. That is telling us how many Ping-Pong balls this person has. You will notice that the number of Ping-Pong balls or LDL small particles a person should have optimally is <162. This person in this sample is in the red, astronomically high, pathologically high at 236! Next, look at LDL medium or how many softballs does this person have. Should have <201. This person has a total of 273. Again, in the red, pathologically high over 271 at 273. Folks, even though this person’s sample results where all in the normal range for their total cholesterol and their number of LDL, the size of these particles and the amount of particles in the sample are toxic, inflamed, dangerous, and causing possibly endothelial damage and scratches causing atherosclerotic plaque. This is what helps provide a clearer picture of risk and helps determine the best treatment approach. Guess what? Statins which are the primary medicines used today against high cholesterol are not very effective in reducing your LDL particle number and usually do not increase LDL particle size. They’re not going to have an effect on this problem in this sample we’re looking at here.

To go on with this concept, now this slide talks about in the advanced lipid panel you also will get a grade, if you will. The grade will be based, again, on the size of your particles. Bigger is better! You want an A because if you get a mark or pattern if you’re given the marker that your pattern is a pattern A pattern, that means as this slide shows your LDL particles are large. Also, this same concept applies, everybody, to HDL particles. The larger the particle, again, the better. If you are told that your pattern is B, that means that you have smaller particles that are denser, more atherogenic, more toxic, and more dangerous. You want an A, you don’t want a B, and you also don’t want to mix A-B pattern. The bottom line is optimally you want an A because bigger is better when we talk about lipids.

Now, a whole other marker to look at in the advanced lipid panel that is never included in the traditional lipid panel is called lipoprotein (a). This marker is a genetically determined marker. If it is elevated, it has been called and nicknamed the “widow maker.” If present, it is a sign that the person has an increased risk of heart disease and stroke. Folks, it’s not just a little risk. It doubles the person’s risk of the possibility of having a heart attack or stroke.

Let’s go back to our sample; I’m always coming back to the same sample we’ve been looking at. Again, this person has normal lipid panel in the traditional model. They had dense and small particles that were dangerous. If you go down and you look at the lipoprotein (a) that is recommended to be <75, this person’s number in our sample what we’re looking at is 77. It’s not astronomically high, but it is elevated which is concerning for this person having a double increased risk of vascular endothelial dysfunction. As you’ve noticed, if we’re looking under the hood at some of these numbers, this person is not to be told there is no risk in their life of having a heart attack. They absolutely do have risk, but there are things we could be doing to help them reduce this risk. This person would never had known this if they don’t do an advanced lipid panel.

Now, let’s take a look at HDL. Remember, HDL is supposed to be the good guy. It’s supposed to be protective. Let’s talk about HDL. See, HDL carries fat to the liver for excretion and is a potent antioxidant. The analogy I like to give is it’s like the garbage truck that takes bad cholesterol particles to the dump to get rid of them, but you want a big and effective garbage truck.

And there are different kinds of HDL. You see, in the primary care model today in the traditional lipid panel, HDL is just looked at as good no matter what. Well, advanced lipid studies and advanced lipid research has shown there are different kinds of HDL. HDL-2 is more active or protective than HDL-3.

Low HDL, yes, is a marker for metabolic syndrome. And, yes, low HDL overall is independent marker for increased risk of heart disease. We’ve always known that, but high HDL >40 and <70 is the optimal range and it shows a decreased risk for heart disease. But, HDL >70 can actually be a sign of dysfunctional HDL. So, if you have had an HDL level >70 and been told that this is protective against cardiovascular events, and it balances out your bad LDL…this may not be accurate anymore and not be the case. You see, the larger the HDL the better. The bigger the garbage truck the better. The smaller HDL can be possibly more toxic and more inflamed and dysfunctional.

Here are two studies that prove these points. First, the classic inverse correlation of HDL and coronary heart disease is not sustained when evaluating subjects with HDL <70. That study was called the “IDEAL” study. Next, dysfunctional HDL inhibits insulin output and may increase a person’s risk of diabetes. Dysfunctional HDL is possible and that was called the “FINNS” study.

Let’s take a look at the sample we’ve been using throughout this presentation. Same results and the same sample. Well, if you look at the top the HDL cholesterol total was 61, and that’s greater than 40, optimal, and in green. If we drop down to the size of the HDL, this person’s HDL size is large. It’s recommended to be >9386 in the test, and it is. It’s 9454, so you notice it is presented in the green, and their HDL particles are big, optimal size large, and so this person in this sample we’ve been using as an example doesn’t have to worry about their HDL particles being dysfunctional. They are big garbage trucks, there are plenty of them, and they are taking the cholesterol to the liver for getting rid of them. That’s good! This person does not have an HDL dysfunction problem. They’ve got some other problems we’ve been talking about, but they do not have and HDL problem.

Let’s move on to another marker in the advanced lipid panel to provide accurate assessment of your risk for heart disease. Let’s look at a marker called hsCRP. This stands for high sensitivity C reactive protein, and this is a general marker of inflammation and it should be <1.0. If it’s higher than 1.0 then anyone with a hsCRP >1.0 has generalized inflammation in their body and in their vessels and is causing irritation and endothelial function. On the slide you’ll see the cardinal signs of inflammation, which are swelling, redness, pain, loss of function, and things are hot.

So, let’s go back to our sample results. The result in our sample for hsCRP of the person we’re looking at here is 4.5! It should be, as we said, optimally less than 1.0. Folks, this is a significant elevation, it’s red, and it’s pathologically elevated. This person is on the fast track to heart disease related to inflammation and endothelial dysfunction due to their level of underlying inflammation in their system. Again, we’re looking under the hood and we’re finding numerous issues for this person that with a traditional lipid panel would have been told they have absolutely no risk of heart disease.

Let’s go on and get back to the marker I brought up early on. The LP PLA2 or what’s called the lipoprotein-associated phospholipase A2. What is that? Folks, it’s an enzyme specific marker for atherosclerosis-related vascular inflammation. You see, [click_to_tweet tweet=”individuals with elevated plaque or LP PLA2 activity are twice as likely to experience a myocardial infarction and coronary heart disease-related death within the next five years.” quote=”individuals with elevated plaque or LP PLA2 activity are twice as likely to experience a myocardial infarction and coronary heart disease-related death within the next five years.”] This is a marker for unstable plaque that is leaking from the artery wall. If this is elevated, folks, a person is at an increased risk of having that fibrous cap or that scab that’s supposed to be keeping the plaque stable – it’s leaking. That’s dangerous, and it’s a high risk for an event to come within the next five years. It can be measured in your blood.

Looking back at our blood sample, here. The sample result of the advanced lipid panel. If we go down to the LP PLA2, which is the last marker on the slide and on the sample, you’ll notice for this person it is recommended overall to be <123. This person is 120. It is less than the marker, it is optimal, and it is in the green. This person, thank goodness, even though they have other markers that are concerning (elevated inflammation, toxic-size particles, increased genetic risk for heart disease), they do not show that they are leaking plaque into their bloodstream. This person, once we get them on a path to get them off the fast track to heart disease and increase the size of their particles, lower their inflammation, and decrease their genetic risk, they are probably not going to have an event.

In summary, the advanced lipid panel is the most up to date lab test to assess cardiovascular disease risk. Elevated LDL particle number means you have too many small particles and those particles are toxic and inflamed. Bigger LDL and HDL particles are better! Lipoprotein (a) is a genetic marker for increased risk of heart disease. Plaque, or this enzyme LP PLA2, is a sign of vascular inflammation and unstable plaques.

Now that we’ve covered what causes heart disease, the plaques and what causes them, and we’ve looked at the advanced lipid panel, let’s look at some myths that are out there about heart disease in general. Let’s debunk some of these myths. You see, most of us have heard some information surrounding heart disease, and of course, there are always naysayers or just questions that surface when considering our health and the accompanying recommendations.

I wanted to look at a few commonly believed myths and discuss why they are not credible. This is one we hear often: “Heart disease is something only older people should worry about.” Folks, this can’t be more false. According to the Mayo Clinic, all of us should take heart disease seriously. Heart disease or vascular disease and the development of plagues in the walls of your vessels begins decades before any heart attack or stroke occurs. There are also risks even for younger people based on family history and lifestyle, particularly that concept of the lipoprotein (a).

Another myth: “If I’m a long-time smoker, I can’t reverse the damage I’ve caused to my heart or reduce my risk of heart disease.” Again, this is false. Harvard Medical School states that quitting smoking has immediate benefits, no matter how old you are or how long you have been smoking, and those benefits start the moment you quit. After just one year of not smoking, your risk of heart attack reduces by 50%. After 10 years, the risk drops to that of a person who has actually never smoked. As mentioned above, contact a medical professional for the tools you’ll need to help you quit. You can quit today!

And this concept goes for all paths to heart disease. You can take control of your health and reverse vascular disease, but you must take action, you must make changes, and you must be motivated to improve your health.”] Just taking a pill, such as a statin…as I’ve mentioned, statins are not going to change the particle size, they are not going to reduce the LDL particle number, and they are not going to lessen the genetic risk of lipoprotein (a). Just taking a pill is not going to reverse the bad behaviors that may have been going on for decades.

The next myth is: “I am only at risk for heart disease if it runs in my family.” Again, folks, this is false. Genetics do play a role in developing heart disease, which is claimed by the Cleveland Clinic, but [click_to_tweet tweet=”90% of heart disease cases are the result of lifestyle. Of course, this includes smoking, poor diet, lack of exercise, toxic exposure, stress, inflammation, and so on.” quote=”90% of heart disease cases are the result of lifestyle. Of course, this includes smoking, poor diet, lack of exercise, toxic exposure, stress, inflammation, and so on.”] It is often these lifestyle choices that can raise your level of inflammation and cause your cholesterol or lipids to become dense, toxic, and dangerous. As Dr. Mark Hyman states, “Lifestyle changes can even reduce the risks for heart disease when it comes to hereditary risk.”

I have seen people improve their lipoprotein (a) and get it into the normal range. I personally have had an elevated lipoprotein (a) in the past, and my lipoprotein (a) is no longer elevated. It is now in the green, in the normal level, based on lifestyle things and supplements that I have taken. It is absolutely possible to decrease your genetic risk.

Now, we’ve covered a lot here today. You may be feeling a bit overwhelmed, but you’ve got this! You came for a reason: to make more informed, healthier decisions when it comes to the health of your heart. You are on your way to making a difference in your life, and our hope is that the information we provided today are just what you need to get started!

One important thing to acknowledge is while getting accurate information is always the first step toward better health, in and of itself, it is not capable of improving your health. Instead, action is needed for you to live a healthy and happy life. If you want to accurately assess your present risk of heart disease and endothelial dysfunction by doing an advanced lipid panel and you would like your numbers evaluated, I am offering an opportunity to you as a result of your listening to this program. What I’m going to offer is the ability for those listening who are interested in doing the advanced lipid panel and a 30-minute one-on-one interpretation session with me. I will tell you that most primary care doctors on the street do not know about the advanced lipid panel and they do not know how to interpret it. I will tell you that, yes, if people live in my local area and you are already a patient of record or if you choose to become a patient of record, my office and I act as a hybrid. Meaning the things that are allowed to be covered by insurance, you can use your insurance. Things that insurance won’t cover has to be paid out of pocket. That’s not up to me, it’s up to the insurance model.

If someone listening lives in the local area and you’ve never had an advanced lipid panel and you would like one done, you could become a patient of record and we may be able to use your insurance. We have to figure that out with each and every individual. But, if you live outside of my local area such as in another state, or if you don’t have medical insurance or you choose not to use your medical insurance, this offer I am giving you is the following: you will receive an ability to get the Cardio IQ Advanced Lipid Panel test done through Quest Diagnostics. The cost of that test is included in this price. And you will get a 30-minute interpretation session of your results with me. The cost for this offer is $500.00. The value of this offer is way more than $1200 actually. Basically, the cost of this test if you sent it to your insurance company is probably $1200 and then the interpretation by me, my cost on top of it. I’m offering the cost of the test and the interpretation 30-minute session with me for only $500.00.

Plus, let’s say your results show that you are on the fast track to heart disease and you need help to get off of it because it is absolutely reversible, then we have coaching packages to work with myself or a combination of myself and our Health Coach Trish Chaput. It’s pretty easy around here to find one of us or know our names. Just say, “Trish,” and we’re both going to say, “What?” because we’re both named Trish! If your results show that you need to get off the fast track to heart disease, there will be a $100 discount on any of our further coaching packages with myself and/or Health Coach Trish. If you’re interested in any of this, and particularly the offer of the Cardio IQ Advanced Lipid Panel and the 30-minute interpretation for $500.00 just email and let us know you’re interested, and we’ll get you hooked up. Again, if you are interested in this offer email .

At the end of most of the webinars I give once a month, I usually post in our Discover Health Facebook Group (a closed group on Facebook). If you go to Discover Health Functional Medicine Center Facebook Page and simply request to be a member and join our closed group, you will get a listing of resources that were used to put this presentation together. We always post those the day after the webinar in our Discover Health Facebook Group. Don’t miss joining and getting access to this amazing information!

Thank you so much for attending our event! It means a lot to be able to share this information with people like you who are ready to make healthy changes in their lives. Now it is time to find out your risk and gain the tools to reduce it. Again, if you are interested in the testing offer and interpretation that I offered to get the advanced lipid panel and the 30-minute interpretation visit with me for only $500.00 or if you think you might be eligible to use your insurance, then email . Please reach out if you have any questions or concerns. We are always here to help! Take care, everybody!


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