Cardiovascular Health

Despite advances in treatment and prevention, cardiovascular disease remains the leading cause of death worldwide. Here is some information on major risk factors which can cause cardiovascular disease and strategies to mitigate the risk.  

1. Hypertension

2. High cholesterol

3. Metabolic syndrome / toxemia

Hypertension - Don't just treat the numbers:

Most people know that hypertension or high blood pressure can lead to heart disease. What a lot of people do not know is that hypertension is often a sign of chronic and sustained underlying process which consists of inflammation, oxidative stress and vascular ageing. 


Normal adult blood pressure is 120/80. There is a wide range of normal numbers based upon individual age, gender and additional factors. 

What strategies can lower inflammation, oxidative stress and improve vascular aging?

Following non-pharmacological strategies can help

  1. A healthy diet low in salt, saturated fats, caffeine and alcohol

  2. Sleep - 6 to 8 hours of uninterrupted and good quality sleep and

  3. Stress management can help mitigate inflammation.

In addition, several pharmacological methods including blood pressure lowering medications can mitigate three components of hypertension. 

Blood Pressure lowering foods: 

About these foods

  1. They lower blood pressure from 15 - 20 mmHg when combined with healthy lifestyle and low sodium diet.

  2. Greens are always great

  3. Leave the sugar behind when eating that dark chocolate

  4. Make garlic your friend

  5. Berries are good with portion control

  6. One banana a day is just ok

  7. Red beets have additional benefits

  8. Walnuts work on brain as well

  9. Just eat a serving of pomegranate as whole fruit

  10. When eating some of these delicious fruits, keep total daily carbs in check. Do not overdo carbs. Instead mix and match these foods and keep it fun 

Non pharmacologic device to lower blood pressure:

Resperate is an FDA approved device and can lower blood pressure by 10 - 15 mm Hg. More information can be found at




Normal cholesterol should be below 200 mg/dl. However, there are many details to it. LDL should be low. HDL should be high and total cholesterol levels should be factored into the overall cardiovascular risk. In other words, if you have multiple risk factors for cardiovascular disease, it is recommended to maintain a even a lower cholesterol level.  That being said, cholesterol plays key functions in the body including synthesis and metabolism of several hormones and neurotransmitters. Therefore, it is important to keep the levels within an optimal range. 

Non - Pharmacological strategies to help regulate cholesterol 

1. Eat a healthy fiber and plant rich diet.

2. Obtain essential fatty acids from dietary sources such as nuts and seeds, olive oil, avacado oil, murine oil etc. 

3. Add omega-3 fish oil supplements with a balanced EPA and DHA ratio if it is hard to get essential fats from food. 

4. Supplements such as plant sterols and red yeast rice can lower choletserol to some degree.

5. Exercise regularly 

Important points to keep in mind when using pharmacologic methods to lower cholesterol 

1. Pharmacologic methods (medicines) only play a partial role. A healthy diet and lifestyle should still be incorporated. 

2. Certain medications such as statins, deplete body of essential nutrients such as Co-enzyme Q10, zinc, magnesium etc. Therefore, it may be necessary to monitor their levels. 

Do I really need to take cholesterol medicine?

Check your risk of developing heart disease using the formula on the following website. If your risk is over 10% in the absence of diabetes or over 7.5% with diabetes, a cholesterol lowering medication must be considered.

Metabolic Syndrome or Metabolic Toxemia: 

Metabolic syndrome or metabolic toxemia refers to metabolic derangement which occurs as a result of lifestyle factors, environmental exposure and genetic predisposition. When all these factors work against our metabolism, oxidative stress, inflammation and vascular aging start to occur. One example of such state is metabolic syndrome which is a combination of 1) abdominal obesity, 2) elevated blood pressure, 3) abnormal cholesterol and 4) insulin resistance. While all these 4 are independent risk factors for cardiovascular disease, together these augment the devastating effect of each other and therefore must be controlled to the best of our abilities. 

Labs and tests to do to monitor cardiovascular health:

Metabolic toxemia.jpg

Intervene here 

Not just here 


  1. Blood Pressure

  2. Body Mass Index

  3. Diet 

  4. Exercise and fitness routine

Blood Tests

  1. Lipid panel

  2. C Reactive Protein

  3. Homocysteine 

  4. Uric acid

  5. HgbA1C

  6. Metabolic panel

Functional Tests

  1. QSART

  2. ANS with ABI

  3. Sudomotor 

  4. Vascular age

Structural Tests

  1. Echocardigram

  2. Coronary artery calcium score

  3. Coronary angiogram

Key Points to Remember and Follow:

If you have any of the above conditions, such as hypertension, high cholesterol or metabolic syndrome, use the following approach to improve your health.

  1. Diet & Lifestyle,

    1. Recommended diet advice mentioned above. That is, a diet low in salt, processed foods, unhealthy fats and high in green leafy vegetables, fruits and lean sources of proteins.

    2. Exercise at least 150 minutes a week.

    3. Use stress reduction techniques such as yoga, meditation etc.

    4. Improve sleep quality and aim to achieve sufficient amount of sleep .

  2. Take medications if/as prescribed.

  3. Use non-pharmacologic approaches such as supplements if appropriate.

  4. Based upon how well your condition is controlled, schedule follow up visits approximately once every 3-6 months.

  5. Consider getting advance level tests such as Coronary Artery Calcium Score (CAC score), Carotid ultrasound, Echocardiogram, Stress tests, advanced lipid panel and tests mentioned under metabolic syndrome. These tests help determine how well your conditions are controlled and if further therapeutic interventions are warranted.