How My Patients Inspired Me to Become an Integrative Cardiologist

08/23/2022 | 6 min. read

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I know many of you are frustrated when you ask your cardiologist about nutritional supplements, only to be met with a blank stare—or be told they’re not necessary, or necessarily good for you. I used to be one of those cardiologists as well.

My patients would come into my office, present their list of nutraceuticals, and ask my opinion. My standard naïve response was that I only practiced “evidence-based medicine,” which meant taking out my prescription pad. Sound familiar? Honestly, I felt like a drug pusher sometimes.

I realized that while people may like their doctors, they also pay attention to social media and friends. Plus, they hold a skeptical view of big-pharma-sponsored clinical trials and see the influence that pharmaceutical reps have on the prescribing habits of their provider under the guise of offering “free” samples.

That’s When I Switched to Integrative Medicine

I wanted to provide real answers to my inquisitive patients about nutraceuticals. So, I let my patients empower me to learn more about nutritional supplements.

Since my sister-in-law, a GYN Oncologist, was pursuing a degree in integrative medicine to help her patients, she inspired me to pursue a Master of Science in Integrative Medicine from George Washington University. I was also inspired by witnessing the real world impact of lifestyle and nutraceuticals on heart health.

Now my integrative approach to cardiovascular disease management and prevention is based on sound evidence that looks to alternative treatments that address the root causes of disease including a healthy lifestyle, nutraceuticals, and conventional treatments when needed. For all these approaches, it’s crucial to start with the right diagnostic testing.

The Top Heart Health Tests I Recommend

With my patients, prevention is always the top priority. One of the first things I look at is a patient’s coronary artery calcium (CAC) score, which is the measure of how much calcium is in the patient’s coronary arteries. I have found CAC to be an excellent marker for subclinical disease—which, in plain English, means it can help to detect heart disease before it advances too far.

The ideal CAC score is zero. If the score is not zero, optimizing lipids, blood pressure, and blood sugar are critical. In addition to lifestyle changes, I recommend nutrients for improving endothelial function, inflammation, and mitochondrial function—meaning your body’s ability to convert food into adenosine triphosphate (ATP), your body’s energy source. Some of my go-to nutraceuticals include CoQ10, vitamin D, fish oil, D-ribose, a B complex, magnesium, berberine, beetroot juice, red yeast rice, and aged garlic extract.

I also like to use a tool with patients that measures endothelial function– the health of the blood vessels by– using flow-mediated dilatation and digital thermal testing. Your endothelium is the membrane that lines the inside of your blood vessels and synthesizes nitric oxide, which is the substance that allows your blood vessels to expand and contract as they should—delivering nutrients and oxygen to every cell in your body and carrying away waste.

For thermal digital monitoring, I apply temperature sensors after putting the blood pressure cuff on the patient’s brachial artery. I’m looking to see how quick the temperature is rebound, which is called vascular reactivity. The greater the vascular reactivity index, the better the endothelial function. Most of my cardiology patients have poor or below-average scores at baseline on endothelial function and after implementing my lifestyle and nutraceutical recommendations, as well as pharmaceutical interventions if needed, I have seen marked improvements in scores in just six months.

While there are many other tests I do with patients, these are some of the top ones that help me to assess a patient’s individual risk for having a cardiac event, such as a heart attack or stroke.

5 Lifestyle Changes I Strongly Recommend

A healthy lifestyle is critical for good heart health. Plus, you can’t separate your physical and emotional health; they work in tandem to keep you healthy. The top five lifestyle changes I recommend include:

  • Exercise: Moving more is incredibly important for improving blood flow and endothelial function. I personally love hiking and tennis, but you don’t need to do high-intensity exercise to improve your health, especially as you’re starting out. I recommend 30 minutes of moderate-intensity exercises, such as walking, five days per week and resistance exercise two days per week. Remember to consult with your doctor before beginning a new exercise program.
  • Eating a Low-Inflammatory Diet: A low-inflammatory diet is very important. Most Americans have a SAD diet, which stands for the standard American diet—one that’s high in trans fats and other processed foods that are filled with salt, fat, and sugar. This is one reason obesity is so prevalent in the US. I recommend eating a Mediterranean Diet, which is a low-inflammatory diet that’s rich in whole foods and vegetables, lean meats, oily fish (such as salmon and sardines), walnuts, olive oil, and more.
  • Stress Management: Mindfulness-based stress reduction (MBSR) is very important for your heart and has been shown to improve endothelial function, reduce blood pressure, and improve sympathetic tone. Meditation, yoga, and breathing exercises can help. I meditate and do yoga on a regular basis and have found that they have made a significant difference in my physical and mental health.
  • Healthy Sleep Hygiene: Getting seven to eight hours of sleep per night is extremely important. For better quality sleep, you want to avoid looking at screens, exercise, and big meals for at least two hours before going to sleep. I also recommend avoiding any caffeine after 12:00 PM and making sure your room is cool and dark. If you can’t fall asleep, get out of bed, sit in a chair, and do reading, which is a good activity to help you fall asleep.
  • Community: Staying connected to friends and family is incredibly important. You want to have people you can count on and who can count on you. When you feel loved, cared for, and connected, it increases your body’s production of oxytocin and serotonin, which are the feel-good hormones that are important for your heart and overall health.

The Bottom Line

My goal is to never see a patient from my office in the ER with an acute coronary event. Since 80% of heart issues are preventable, that’s something I’m able to achieve with most patients—especially when they are highly motivated to improve their own health, which I know is a priority for all of you.

To that end, I am completing a certificate in medical writing from the University of Chicago, so I may help empower others with the knowledge they need to stay healthy. In this age of social media and misinformation, heart health is way too important to risk with information that’s based on anything but sound research.

Dr. Viral Sheth currently practices at Cardiocare™ in Maryland.

Dr. Viral Ras Sheth, Guest Contributor

Meet Dr. Viral Ras Sheth, Guest Contributor

Viral Ras Sheth is a board-certified integrative cardiologist with more than 25 years of experience in conventional cardiovascular medicine. He has an MD from Albany Medical College, Master’s in Public Health from Columbia University, and Master’s of Science in Integrative Medicine from George Washington University. He currently practices at Cardiocare™ in Maryland.