Heart Disease and Stroke


Cardiovascular disease is the number one cause of death in the US with myocardial infarction (MI), coronary heart disease (CHD) and congestive heart failure (CHF) leading the list.  We have reached a LIMIT in our ability to further decrease CHD by treating only the TOP FIVE CHD risk factors of hypertension, dyslipidemia, diabetes mellitus, obesity and smoking. Even within these top CHD risk factors, there exist important details that are not being addressed in CV medicine.  These include such issues as advanced lipid testing with lipid particle size and particle number and 24 hour ambulatory blood pressure monitoring with dipping responses, blood pressure lability and surges, nocturnal vs. daytime pressures and more.  Also, proper identification of dysglycemia with fasting glucose, 2 hour GTT, insulin levels, Hb AiC and other markers are important.  Visceral fat % and total body fat % are also important in the assessment of CHD risk, as the visceral fat produces over 35 biomarkers and mediators that induce CVD. About 50% of patients will still have a MI despite optimal treatment of these top five CHD risk factors.

The prevention and treatment of cardiovascular disease (CVD) is on the precipice of revolutionary concepts.   There are now over 400 known CHD risk factors and mediators than must be measured and treated.   We must realize that the blood vessel has a FINITE response to an INFINITE number of insults.   The THREE finite responses include inflammation, oxidative stress and vascular immunologic reactions.  The blood vessel responds acutely and correctly to protect itself from these myriad of insults.  However, with chronic insults to the endothelial lining, these responses become dysregulated and induce endothelial dysfunction and CVD.  It is key to ask “why” the patient has endothelial dysfunction or CVD and then backtrack to the genesis of the disease to find what the insults to the endothelium are.

Endothelial dysfunction is the earliest manifestation of CVD and can precede clinical CV events by decades.  Early detection of endothelial dysfunction and proper treatment of the inciting insults will prevent CVD and CHD.  It is clinically important to measure endothelial dysfunction with non invasive testing, identify the presence of inflammation, oxidative stress, vascular immune dysfunction and the CHD risk factors and mediators.  Proper integrative prevention and treatment strategies should be started early and aggressively using scientifically proven nutraceutical supplements, antioxidants, anti-inflammatory agents, anti-immunologic approaches, exercise, weight and body fat management, pharmacologic drugs and other life style modifications.

Call us at Complete Care of Colorado to schedule an appointment for simple, quick diagnostic testing to see where you stand with your cardiovascular risk factors.

Jeffrey Gappa, D.C, DABCI, AP-C