The new thinking in cardiovascular disease prevention: Do you need a course correction?

This week, Dr Kenna Stephenson, MD, FAAFP, DipABFM, (right) and advisor to curranz.com, reveals how new insights in medicine and her research in preventative ageing have led to the discovery of four previously unconsidered missing links in cardiovascular disease. 

Dr Kenna writes:

Many clinicians focus on cholesterol and blood pressure measures when counselling patients about cardiovascular disease prevention; however, this limited approach may fall short as recent research reveals that 70% of patients with a new diagnosis of cardiovascular disease did not have traditional risk factors. 

A new review, published in Clinical Interventions in Aging, highlights FOUR areas of health risks for cardiovascular disease, which are now considered the Missing Links:

1. Age related hormone changes

2. Nutraceuticals

3. The gut microbiome

4. Environmental toxins

My clinical research of The Hormone Restoration Model of Care was recognized in this review’s discussion of how hormonal changes of aging increase disease risk.

In our study conducted at The University of Texas Health Center, perimenopausal and postmenopausal women underwent testing of sex steroid and steroid hormones of estrogen, progesterone, testosterone, DHEA and cortisol.

Plant-derived hormone therapy, applied via a topical skin cream, was individually prescribed to sustain normal levels in overcoming the age-related declining levels.

This model of care significantly improved blood pressure, triglycerides (fats used for energy, that circulate in the blood), insulin/glucose metabolism, immune and inflammatory factors, and other biomarkers of cardiovascular disease.

Furthermore, despite high life stress, this approach improved mental health and pain measures in aging women, and there were no adverse effects over 3 years.

The second link is nutraceuticals which are defined as products derived from food sources with potential health benefits in addition to basic nutritional values.

The review revealed that nutraceuticals that enhance nitric oxide bioavailability, thereby promoting healthy blood flow, and reduce oxidative stress have shown promise in correcting age-related damage to the blood vessels and decreasing inflammation thereby offering cardioprotection. 

The third missing link is the gut microbiome. Shifts in the intestinal bacterial composition are brought on by normal aging and by diets high in fat and sugar.

Such imbalances may be identified through lab analysis and correcting this imbalance through diet and probiotic support may decrease cardiovascular disease risk.

Finally, our physical environments may contain toxic metals in the air or water and chronic exposure over years has been linked to cardiovascular disease risk. Detoxification may be achieved through foods high in zinc, calcium and iron; through chelation therapy or through sweating enhanced by sauna use. Personally, I have utilized saunas for over a decade as my preferred method.

Case Study: How in just 16 weeks, 64-year-old patient returned to optimal health

A 64-year-old female patient presented with complaints of fatigue, joint pain, mid-body weight gain, poor sleep, sugar and salt cravings. Her prescribed medications for the last decade included anti-depressants, statins, anti-anxiety medication, proton-pump inhibitor and pain medications. Her lab evaluation showed: normal estrogen, low progesterone, high testostosterone, low cortisol levels, elevated inflammatory factors, and excessive heavy metals.

We made the decision to slowly taper off the long-term prescribed medications, and begin progesterone hormone therapy, bi-weekly infrared saunas, dietary changes and nutraceuticals, along with exercise.  

At her 8-week visit, she had improvement in most symptoms, and at her 16-week visit, her waist circumference was in goal range, and her symptoms had resolved. Repeat lab assessments showed her hormones and levels of inflammation had returned to optimal, with a marked decrease in heavy metals.

 I advise patients to ask their doctors about these vital aspects of health and to discover their individual numbers at a qualified lab.

This valuable assessment may guide prevention through diet, lifestyle, topical skin hormone therapy, and nutraceutical supplements and may decrease age-related cardiovascular disease risk.

About the Author: Dr. Kenna Stephenson currently practices family medicine and forensic medicine and is Associate Professor of Family, Community & Preventive Medicine at The University of Arizona College of Medicine. She serves on the Arizona Academy of Family Physicians Board of Directors, and is a member of The Royal College of New Zealand General Practitioners.

References:

1. Dinetz E, Zeballos-Palacios C, Martinez CA. Addressing the missing links in cardiovascular aging. Clinical Interventions in Aging 2024;19:873-882.
2. Stephenson K, Neuenschwander P, Kurdowska A, Pinson B, Price C. The effects of transdermal progesterone on menopausal symptoms, and thrombotic, anticoagulatory, and inflammatory factors in postmenopausal women: a prospective, randomized, controlled trial. International Journal of Pharmaceutical Compounding,2008;12(4):295-304.

3. Stephenson K, Neuenschwander P, Kurdowska A The effects of compounded bio-identical transdermal hormone therapy on hemostatic, inflammatory, immune factors; cardiovascular biomarkers; quality of life measures; and health outcomes in perimenopausal and postmenopausal women. International Journal of Pharmaceutical Compounding,2013;17(1):74-85.
4. Roux J, Stephenson K, Kapur S, Zava D. Neuroendocrine, inflammatory, and immune biomarkers associated with body composition, depression, and cognitive impairment in elderly men and women. Cleveland Clinic Heart and Brain Summit. 2010. Las Vegas, Nevada.
5. Stephenson K, Kurdowska A, Neuenschwander P, Olusola P, Brown, S, Stephenson J, Healy P, Kinsey R,  Kapur S, Zava D. Physiologic transdermal sex steroid replacement therapy and effects on cardiovascular biomarkers, quality of life, and age-related decline in peri/postmenopausal women. American Heart Association Scientific Sessions Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013, New Orleans, LA.
6. Stephenson K, The Gospel of Women’s Health: Awakening Athena Again, Spotlight Publishing, Goodyear, Arizona, 2023. doctorkenna.com
7. Kounsarka LE, Kostensalo J, et al. Effects of regular sauna bathing in conjunction with exercise on cardiovascular function: a multi-arm, randomized controlled trial. Am J Physiol Regu Integr Comp Physiol. 2022 Sep 1:;323(3): R289-R299.
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10. Hurst RD, Lyall KA, et al. Daily consumption of an anthocyanin-rich extract made from New Zealand blackcurrants for 5 weeks supports exercise recovery through the management of oxidative stress and inflammation: a randomized placebo controlled pilot study. Frontiers in Nutrition 2020;7:16.