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8.1.19

Joel Kahn cardiologist

Young at heart is a state of mind, but it’s also an important measure for overall health. According to holistic cardiologist, Dr. Joel Kahn — a bestselling author at the top of his field — despite your actual age, having a young and healthy heart comes down to a few key metrics. Dr. Kahn takes a uniquely integrated approach to heart health using functional medicine principles (including a plant-based diet) and has been instrumental in the health of a few of our own team’s family members.

Unless an older member of the family has experienced heart issues, most of us neglect the idea of cardiovascular health — at least in our twenties and thirties, but Dr. Kahn’s insights could change your perspective and help you better understand the fundamentals of heart health…

‘Beauty is skin deep’ — an age-old saying that rings true in terms of the cardiovascular anti-aging medicine that I practice. Yet, can you be sure you are glowing on the inside like you radiate externally? Whether you are 40-years-old plus or have a concerning family history of heart disease, tragedy can strike even the most buff of health gurus.

So, let’s plan some straight talk to be certain you are young inside and out. Maybe you drink raw juice, practice hot yoga, use red light therapy on your skin, sleep well, meditate and eat giant salads. But can you measure your age on the inside to be sure it is all working?

How To Measure Your Heart’s Age

The concept that heart aging is preventable — including living a heart attack proof life — is not new. Over 60 years ago, famous Harvard Medical School professor Paul Dudley White, MD said, “A heart attack after age 80 is an act of God but a heart attack before age 80 is a preventable event.” Isn’t it time we make these words ring true? Over 1,000 people per day — in the US alone — experience a heart death judged preventable by the Center for Disease Control. So, how can you measure your heart age with the precision of a finely tuned racing engine?

CACS SCAN | First up, ask for a coronary artery calcium scan (CACS) after age 40. At age 50 a health care provider will tell you to schedule a colonoscopy and mammogram (if female). A CACS is a CT scan of the heart that takes only a few seconds, is painless, uses no dye or needles, has a very low radiation exposure (like a mammogram) and costs about $100 at most hospitals.

The ideal result in about 50% of those tested is a CACS score of zero. Any CACS higher than zero raises the risk for heart attack and proves aging of the heart and entire body. Recently, the American Heart Association included the option of getting a CACS before starting prescription cholesterol medications. Ask your healthcare provider for a CACS if you have no known heart disease and are over 40. If you have had a heart attack, stent or bypass surgery, you do not need this screening test.

CIMT Scan | Find a carotid intimal-medial thickness (CIMT) scan. A CACS identifies calcification of arteries, something called hard plaque. But there is also a pathology called soft plaque that may threaten health. A CIMT is a 20-minute ultrasound of the neck that uses advanced software measurements to examine carotid arteries for both soft and hard plaque. The CIMT also measures the thickness of arteries, another sign of aging. The biggest drawback of the CIMT is finding a quality center that offers it. Most of my patients have had both of these exams so they know — with precision — their true arterial age then can work hard at a lifestyle program to stay “young at heart”.

advanced labs | In my view, it is unacceptable to have the same lab studies you had for the last 30 years because there has been major advances in laboratory testing since. I suggest asking your healthcare provider for advanced blood tests or arrange your own testing online. Start researching these:

Advanced cholesterol profile: A standard cholesterol panel provides calculated LDL cholesterol levels, but the top-of-the-line measures LDL-cholesterol particle number and size. These measures are more predictive of future heart and stroke events. All cholesterol particles raise the risk of an aging heart but the small, dense particles are the most dangerous and worth measuring.

hs-CRP: The high sensitivity C-reactive protein is a blood test patented by Harvard Medical School to measure inflammation — or the “fire” — that results from an irritated immune system. The higher the hs-CRP the greater the risk for atherosclerosis, heart attack, stroke and even other conditions like cancer and dementia. The challenge is finding why the hs-CRP is elevated — this may be due to a processed diet heavy in meat, silent dental or GI infections, nutritional deficiencies or food allergies, skin diseases like psoriasis and/or too much fat around the waistline.

Lipoprotein (a): This is a genetic form of cholesterol that’s elevated in about 20% of those tested — and in 70 million Americans alone. It’s rarely drawn even though hundreds of research studies indicate that if it’s high, the risk of heart attack and stroke skyrocket. It runs high in many families that have been decimated by heart disease.

Homocysteine: This amino acid is produced by a process called methylation. It can injure arteries when elevated. It may be due to a defect in the MTHFR gene, a meat-heavy diet or B vitamin deficiencies.

Astro-CHARM Score | A major advance in 2018 was the publication of the Astro-CHARM score. This online risk calculator is a collaboration of NASA and the University of Texas Southwestern Medical Center and is the most advanced tool available. It permits entering your CACS and hs-CRP along with more traditional measures (age, smoking status, total cholesterol, HDL-cholesterol and blood pressure) to predict the 10-year risk of heart attack and stroke. The Astro-CHARM score can also be a tool to help patients make necessary lifestyle changes.

Many decades have passed since Dr. Paul White declared that heart attacks are preventable. The current focus on learning CPR or having defibrillators in gym classes misses the mark. Heart disease is measurable, preventable and reversible long before tragedy strikes. You are beautiful on the outside, so now take the steps to guarantee you are also beautiful on the inside. A popular internet meme declares that if heart disease were attacking your face rather than your arteries, you’d do something about it. Well, now you know how to fight back.

The Chalkboard Mag and its materials are not intended to treat, diagnose, cure or prevent any disease. 
All material on The Chalkboard Mag is provided for educational purposes only. Always seek the advice of your physician or another qualified healthcare provider for any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health-related programs. 

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