12th Annual Orange County Symposium for Cardiovascular Disease Prevention: Crossroads in Cardiovascular Disease Prevention

As an integrative cardiologist practicing functional medicine, I’m always excited about learning everything I can about prevention. At this virtual conference, I learned a few good pearls, but I was hoping for more!

The topics were clearly of interest: assessing cardiovascular risk, dealing with LDL-Cholesterol over 210 mg/dl, using fish oil in clinical practice, strategizing prevention in women, and dealing with the aging population. However, from the onset it was obvious that the pharmaceutical approach was the holy grail.

Now in my 35 years of active practice, I have treated countless ill patients with life-saving drugs. I’m very aggressive about using meds when the science points to their efficacy. My background is deeply entrenched in traditional cardiology. In fact, I still take regular emergency call at my local hospital to intervene in those who present with acute heart attacks.

However, this was billed as a preventative program. What I found disappointing was that there was little voiced about lifestyle. It was mentioned, but in word only. In all fairness, the overall emphasis was on secondary prevention (or treating those with known disease who are automatically stratified as being high risk). Such treatment clearly mandates a more aggressive approach. But many of the speakers advocated LDL-C levels of 30 or lower, or what I call “lower is better”. I personally do not support this concept.

There was a particularly good presentation on the use of nutraceuticals in cardiac patients. Mentioned was the use of berberine, bergamot, fish oil and turmeric. I also learned a new role of niacin for the treatment of nonalcoholic fatty liver disease (NAFLD), a disease entity of increasing incidence.

There was a single lecture on nutrition. The presenter essentially espoused the dogma of the American Heart Association (AHA); an extremely low saturated fat diet, less than 8% of all calories. Such thinking has been since debunked by many. (see “what’s new” from July 2020 at www.heartwise.com).

Any benefit of a low carb diet, ketogenic diet, or any form of fasting was quickly dismissed, despite documented benefits in the medical literature.

The use of hormone replacement therapy in menopausal/post-menopausal women was discouraged because of potential cardiac risks. This was most probably based on the results of the Women’s Health Initiative, released in 2002. What was never mentioned was the use of bioidentical hormone replacement, which has a myriad of benefits for both heart health and bone health.

It’s interesting but disappointing how a university sponsored educational event can be so one sided and seemingly dated. However, I endeavor to take it all in and utilize both my traditional training and what I’ve learned in integrative cardiology. It’s about knowing which hat to wear when.

PS Contrary to the symposium’s flier photo, there wasn’t any mention about running, walking or any form of exercise!

VERY IMPORTANT NOTE / DISCLAIMER: I am offering—always—only general information and my own opinion on this site. Always contact your physician or a health professional before starting any treatments, exercise programs or using supplements. ©Howard Elkin MD FACC, 2020