Cardiovascular disease (CVD) is still the leading cause of death for both men and women, killing more than 600,000 people each year in the US and responsible for ~30% of deaths worldwide.1,2 Globally, stroke is the second leading cause of death.1 While half of all adult Americans have at least one of the commonly known risk factors—high blood pressure, high low-density lipoprotein cholesterol (LDL-C), and smoking, many more have other, equally important risk factors such as diabetes, obesity, sedentary lifestyle, poor diet, and excessive alcohol use.3 Recent research is consistently pointing to the central role of gut problems in CVD (see below). Clinical practice guidelines currently recommend pharmaceuticals for treating many chronic diseases: in fact, nearly 60% of American adults took prescription drugs during 2011–2012 (15% taking five or more).4 But with a life expectancy ranking 31st in the world, the ever-rising use of medications is clearly not making us any healthier.5
Standard of care for reducing risk of cardiometabolic disease focuses on monitoring traditional lipids and fasting blood sugar, despite strong evidence that these two tests alone are inadequate. Half of all patients hospitalized with coronary artery disease (CAD) have acceptable levels of LDL-C, and by the time blood glucose has reached levels diagnostic of prediabetes, up to 80% of pancreatic β-cell function has been lost.6,7 The residual or ‘‘hidden’’ risk unidentified by these traditional measures is a major contributor to CVD-related morbidity and mortality.8 Moreover, statins and other lipid-lowering drugs may help modify the progression of atherosclerosis in some individuals, but they do not reverse the course of disease.
What scientific research makes clear is that traits such as inflammation and insulin resistance are intimate precursors to cardiometabolic diseases and huge risk factors for ischemic heart disease.9-11 Inflammation can be triggered by gut problems (e.g., intestinal dysbiosis, infections, food sensitivities, “Westernized” diet), stress, excess weight, sleep deficits, hormonal imbalances, and other factors that induce production of pro-inflammatory cytokines.12 If detected early using simple blood tests, and addressed with diet and lifestyle changes, such high-risk prodromic states can be reversed and many chronic diseases prevented or erased.13-17
With the comprehensive biomarker tests offered by Salveo Diagnostics, the modern practitioner now has effective tools to help uncover and treat the root causes of cardiometabolic disease. Our accurate assessment of cardiovascular risk uses validated serum biomarkers of dyslipoproteinemia, insulin resistance, inflammation, oxidative and cardiac stress, and hemostasis and thrombosis to catch warning signs early.
The relevance of gut health to cardiometabolic health cannot be overstated. The gastrointestinal tract and its resident microbes are the seat of the body’s immune surveillance system, responding to millions of antigens passing through each day.18 The composition of the intestinal microbiota can positively or negatively affect cardiometabolic health by influencing serum lipid levels, BMI, and insulin sensitivity.19-21 In fact, shifts in the gut microbiota and its metabolites (e.g., short-chain fatty acids, toxins), influenced by genetic and dietary factors, directly affect an individual’s risk for immune dysregulation, cardiovascular inflammation, hypertension, fatty liver disease, and atherosclerosis, and influence severity of disease in patients with heart failure.18,22-27
Calorie-rich, nutrient-poor diet plays a significant role in the development of this cardiometabolic mess. Foods containing little fiber, nutrients, or antioxidants but substantial amounts of added sugar are inflammatory foods. Anything that can be broken down quickly into simple sugars will drive hyperglycemia, promoting insulin resistance.28 Refined carbohydrates also promote yeast growth and oxidative stress in the gut, while lack of fiber hampers growth of beneficial bacteria, leading to intestinal dysbiosis and hyperpermeability.29 Artificial additives designed to prolong shelf-life of processed foods, such as emulsifiers, have the potential to erode the protective mucus layer lining the gut and promote gut inflammation, obesity, and metabolic syndrome.30 On the other hand, diets with the highest-quality foods and antioxidant content convey a 20% lower risk for CVD.31 The Salveo systems-biology approach can help physicians identify and address the expanded set of risk factors that impact cardiometabolic health on a patient-by-patient basis. Treating the gut in a tailored fashion via dietary interventions, probiotics, prebiotics, and other lifestyle therapies may be extremely effective in reversing risk for many cardiometabolic diseases.