Vascular Health: Thinking Out of the Box

We have reached a limit in our ability to reduce the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) utilizing the traditional evaluation, prevention, and treatment strategies for the top 5 cardiovascular risk factors – hypertension, diabetes mellitus, dyslipidemia, obesity and smoking.. Statistics show that approximately 50% of patients continue to have CHD or myocardial infarction (MI) despite “normal” levels of these five risk factors as traditionally defined. A better understanding is required of the details behind these top five risk factors such as evaluation of 24 hour ambulatory blood pressure monitoring, advanced lipid profiles, dysglycemia parameters, visceral obesity, effects of adipokines and of the three finite vascular endothelial responses (inflammation, oxidative stress and immune vascular dysfunction) to the infinite insults. Understanding translational cardiovascular medicine to correlate the CHD risk factors to the presence or absence of vascular injury and disease with non ‐invasive vascular testing will allow for early identification, prevention and treatment of CHD and CVD. Cardiovascular medicine is in dire need of resuscitation. The heart and the vascular system are literarily on fire and our present techniques are not effective in reducing this inflammation. CVD remains the number one cause of morbidity and mortality in the United States . Statistics show that we spend over $80 billion a year treating CVD alone . More shocking is the fact that a staggering 2200 US citizens die from stroke or MI each and every day. We continue to have cholesterol‐centric approach to the management of CHD while not addressing the basic etiologies of CHD such as inflammation, oxidative stress and immune vascular dysfunction.. Furthermore, there are at least 395 other risk factors that physicians’ either do not know about or they are not using appropriate techniques to identify and treat them. Thus, it is imperative that we now begin to look at other methods to prevent and treat CVD.