The Thriving Heart: Integrative Approaches to Cardiology

Although only the size of a fist, our hearts pump blood to our organs and supply oxygen and nutrients to our cells, allowing every system to function optimally. Maintaining a healthy heart is one of the most important factors for overall wellness, and cardiovascular disease is highly preventable. Integrative cardiology, which focuses on treating the whole person rather than just the heart, reflects a shift toward more individualized, patient-centered care. Using personalized nutrition, expansive blood testing, advanced therapies and holistic practices, doctors and patients can blend the best of traditional and integrative strategies for a more balanced and effective approach to heart health.

The 100-Year Heart

Dr. Jack Wolfson is a board-certified cardiologist, bestselling author and founder of the site NaturalHeartDoctor.com. He pioneered the 100-year heart method, which focuses on what he calls “thrival” nutrition, lifestyle, biohacking and ultra-diagnostics to lead a life filled with vitality, clarity and longevity. “Our approach is root-cause medicine, which puts pharma last,” he explains. “By looking at daily habits and lifestyle choices, we are able to see why people develop cardiovascular disease, which is the number one killer worldwide.”

Wolfson notes that cardiovascular health begins by giving the heart the nutrition it needs to thrive. “Food is medicine, and a paleo-based diet like our ancestors followed has been shown to optimize heart function,” he says. “I recommend patients focus on eating wild seafood and pasture-raised meats such as bison, including organs like the heart and liver. This is supplemented by foraging for things like eggs, raw dairy, nuts, seeds, avocados, coconuts and other fruits and vegetables.”

How we live has a dramatic effect on heart health, and Wolfson asserts that there are a number of lifestyle factors we can control. “A thrival lifestyle centers around being outside in natural sunlight and participating in activities we enjoy. When combined with a positive mindset and high-quality sleep, these practices increase longevity and contribute to a deeper sense of meaning and fulfillment,” he says. “It’s also essential to avoid environmental toxins, such as air pollution, plastic and indoor pollutants like mold from water damage, to the best of your ability. Finally, managing stress and getting movement throughout your day are key to optimal cardiovascular function.”

A truly holistic approach to wellness combines many interrelated tools. “Find an activity you love to do outside, whether that’s hiking, biking, stand-up paddleboarding or yoga. Before you begin, turn your attention inward and think of three things you are grateful for,” Wolfson advises. “This gratitude practice helps you find your happy place, and it gives you a sense of purpose in a world where that’s becoming increasingly difficult. It engages the autonomic nervous system, which controls functions like heart rate and blood pressure.”

Wolfson believes that for a healthy mind, body and heart, a chiropractor should be the gatekeeper to overall wellness. “Chiropractic care uses the manipulations of bones in a purposeful way to make impactful changes to the neurologic system. It sends out beneficial, efferent signals to all of the cells, tissues and organs, including the heart. It also helps to get us out of the ‘fight-flight-or-freeze’ mode that so many people are operating in,” he remarks. “Chronic stress from work, family, news and finances keeps the sympathetic nervous system activated, but chiropractic treatments help stimulate the parasympathetic nervous system, which allows us to rest and digest.”

To kickstart heart health even further, Wolfson’s 100-year heart method uses thrival biohacking methods such as supplements and non-surgical recovery therapies. “Evidence-based, food-grade supplements from field-harvested animals and wild fish support heart function without chemicals or pharmaceuticals,” he points out. “People also may need additional minerals like magnesium, herbal remedies, probiotics or detox strategies if they’ve been living around pollutants. Non-invasive technologies like red light therapy, sauna use, massage, ozone therapy and other cutting-edge treatments help to hack our system and support a healthy heart.”

Treating the Whole Person

Dr. Mimi Guarneri is a California-based cardiologist; the medical director of Pacific Pearl La Jolla; an award-winning researcher, consultant and philanthropist; and president of the Academy of Integrative Health and Medicine. In her practice, she combines conventional, integrative and natural medicine to holistically treat the whole patient.

Guarneri says that while cardiovascular disease is still largely misunderstood, it is also highly preventable. “People think it’s a disease of cholesterol, but it’s actually due to inflammation, oxidative stress and immune response,” she explains. “Inflammation can come from obesity, stress, sleep apnea, poor food choices and food sensitivities, and that is what causes damage to the lining of the blood vessels. In the conventional medicine realm, that means telling patients to stop smoking, lose weight and get blood pressure and cholesterol under control. From a holistic perspective, we look at all the lifestyle factors that contribute to heart health.”

When treating a patient with heart disease, Guarneri uses the metaphor of a tree with sick branches. “Instead of just cutting them off, you have to look at the soil to see what can be causing the illness. The soil of our lives includes micro- and macro-nutrition, a healthy microbiome, avoiding toxins, high-quality sleep, physical activity and mental, emotional and spiritual wellness. All these factors contribute to healthy heart function,” she says.

Guarneri uses advanced testing to assess a patient’s baseline heart health. “We begin with a blood and urine micronutrient analysis, which measures the level of antioxidants and nutrients in the body. Then we conduct a microbiome analysis, which is a three-day stool test that shows how someone is digesting their food. We can see every type of microbe, any parasites and if there is dysbiosis [imbalance] or bacteria overgrowth. Finally, we conduct an in-home study on sleep, which is an integral part of cardiovascular health. Someone with sleep apnea can snore and stop breathing, putting them at increased risk for heart disease, heart failure and high blood pressure,” she says.

Advanced cardiovascular testing shows additional valuable data. “An EndoPAT tells us if the lining of the blood vessels is making nitric oxide, the most important ingredient for heart health. This is a 40-minute, in-office procedure that does not require radiation. Since cardiovascular disease is an inflammatory disease, we do advanced lipid testing to measure inflammatory markers. A high-sensitivity C-reactive protein test measures the level of C-reactive protein in your blood to assess your risk of heart disease and stroke. A 24-hour blood pressure cuff tells us what’s happening throughout the day, and a continuous glucose monitor shows how blood sugar reacts to foods. It’s also valuable feedback to the patient, who can see how their body responds to what they’re ingesting,” says Guarneri.

With all this data, the team creates a road map to health. “We make recommendations based on each patient’s individual needs, including supplements, food choices and lifestyle modifications,” she says. “I may suggest nutraceuticals to complete something that’s missing, such as vitamin D, or I may use them to treat a problem. We’ll prescribe omega-3 [fatty acids] if your triglycerides are high, but we’re also going to give you a low glycemic index diet.”

Guarneri works with patients to manage stress through mindfulness, meditation, exercise and other lifestyle choices. “If you are in constant ‘fight-or-flight’ mode, you are producing adrenaline, noradrenaline and cortisol, which cause blood pressure to go up, the coronary arteries to constrict, cholesterol to increase and oxidative stress to develop,” she explains.

Guarini points to a study involving Black Americans with hypertension that showed a 48 percent reduction in cardiovascular events through the use of transcendental meditation. “Mindfulness has also been shown to improve telomeres, telomerase and other genes of aging. Making conscious decisions in our behavior in response to stress is key to overall wellness and cardiovascular function. If your habit is to go home and have a drink after a hard day, we encourage patients to put on their tennis shoes and take a walk instead,” she says.

The Future of Cardiology

New advancements in cardiology are made all the time. In the coming year, cardiologists and researchers are expected to dig deeper into lipid disorders, obesity management and RNA-based therapies for conditions like cardiac amyloidosis, heart failure, dilated cardiomyopathy and hypertrophic cardiomyopathy. We can also expect to see an increase of awareness and interest in the role lipidology [the study of lipids or fatty acids] has on cardiovascular disease. “Preventive cardiologists and clinical lipidologists like myself have been checking Lp(a) levels for well over two decades now, but there has been little we could do medically to reduce high levels,” says Yasmine S. Ali, MD, MSCI, FACC, FACP, adding that a number of nucleic acid therapeutic trials suggest this may change soon.

Experts stress that despite technological treatment advancements, preventative care is still the most effective way to ensure cardiovascular health. “Everyday lifestyle choices have the biggest impact on overall wellness and living a life of vitality, clarity and longevity,” says Wolfson.

Carrie Jackson is a Chicago-based freelance writer and frequent contributor to Natural Awakenings. Connect at CarrieJacksonWrites.com.