World Health Day was celebrated on April 7, 2013 to honor the founding of the World Health Organization (WHO) in 1948. Each year, a different theme is selected. The theme is based on a health concern affecting people worldwide. This year’s theme was high blood pressure, also known as hypertension.
The World Health Organization “is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends,” according to their website.
One in three adults worldwide suffer from high blood pressure. High blood pressure can increase the risk of heart attacks and strokes, and can lead to serious conditions such as blindness, irregular heartbeat, and heart failure.
The American Academy of Anti-Aging Medicine conducted the following Interview with Mark Houston, MD, MS regarding cardiovascular health
Matters of the Heart with Mark Houston, MD, MS
Dr. Mark Houston serves as the director of the Metabolic Cardiovascular Certification Modules (XVI(A), (B), (C) and (D)), presented by the Academy for Anti-Aging Medicine. Named one of the Most Influential Doctors in the USA by USA Today—and deemed a Top Physician in both Hypertension and Hyperlipidemia—Dr. Houston has spent five years developing what he says is “the only cardiovascular integrative certification course in the world that is certified and backed up by a university medical school [University of South Florida] with an actual certification program.” Here, he discusses the creation, scope and benefits of the course.
How do you incorporate cardiovascular health into your patient care? My practice is about 90% cardiovascular medicine. We have all the high-tech testing that we can to identify patients early, and it’s a very efficient system so people can get in and out, do all the tests, get the results and start a treatment program easily within two to three days.
How effective is it in preventing cardiovascular disease? It is very, very effective. In fact, we’ve looked at my data compared to other physicians in our group, and there’s 36 in our group, and our approach has decreased hospitalization rate, morbidity and mortality by a huge percent compared to others, and this has been seen by some of the insurance companies that monitor hospitalizations. Even though I have the largest clinical practice in my medical group by at least a factor of five, I have the fewest number of people who end up in the hospital with cardiovascular problems, and I think it’s because we have such an aggressive prevention program.
How do you describe the Metabolic Cardiovascular Certification Modules in your own words? This certification program is very different in that it takes a very basic understanding of vascular medicine from the beginning of vascular biology all the way through to the preventive treatment of cardiovascular disease.
It can literally be applied to any healthcare practitioner from any discipline. It is very scientific—everything’s backed up with references and peer-reviewed literature—but it’s presented in a way that, no matter what your background, you can take this course and understand it, learn it, and our key is to teach you how to apply the concepts to change the way cardiovascular medicine is being practiced in this country for a better way.
Why does there need to be change? If you look at the present death rate in cardiovascular disease in the United States, we’re not doing very well in the chronic part with the preventive treatment. We’re still doing the same types of approaches we’ve done for decades, with treating only five conventional risk factors, and we’re not doing a great job even with those. So we’ve ignored the other 395 coronary-disease risk factors that need to be measured and treated. We’re taking the wrong approach; we’re not looking at it from a functional medicine point of view. We’re looking at it from a very narrow, risk-factor point of view and don’t treat the basic finite causes of vascular problems. So 50% of people who are being treated in the traditional top-five risk factor approach still have heart attacks.
How could this type of training benefit the practices of non-cardiologists? What is really key in medicine in this country is the primary care physicians, the internists, the chiropractors, the osteopaths, the naturopaths. These are the ones seeing these patients early. They see more of them. They’re the ones who have to do the screening and then decide who needs what, and if they have an advanced problem, then they’d get up to a cardiologist. The cardiologist is typically the end of the consult chain, when you’ve already got a problem. It’s not to say that cardiologists don’t need to come to this, because they should as well, because they need to learn the same principles so when they get referrals, they know what’s going on. But as far as looking at the scope of the problem, you’re going to get more people involved in this type of functional medicine by using more of a primary-health approach than a specialist approach.
What do you hope to provide to participating doctors that they can’t get elsewhere? We teach a functional and metabolic integrative cardiology program. What that means is, very simply, if a patient comes in to see you, and you think in this new way, you’re going to try to identify the three finite causes of vascular disease, which are inflammation, oxidative stress and autoimmune disease of the arteries. Then you backtrack to find out what are the causes for those finite responses. And you ask the question: “Why do you have,” for example, “inflammation? What’s setting off vascular inflammation?” Then you order the appropriate test to find that, and then when you find those things, you remove the offending insult from the environment. And then you treat it with a very aggressive, integrative approach.
The other difference is early detection and aggressive therapy. We have, in our institute, tests that will allow us to determine if you have early vascular problems, called endothelial dysfunction, which can precede heart attacks by three or four decades. If we can pick up these cases early and treat them early, the patients never develop obstructive coronary heart disease, they never get heart failure, they never get some of the other cardiovascular complications. And the cost of that health care is miniscule compared to what you would be paying for someone who has already developed these problems.
Why haven’t these changes already been implemented in the field? Most MDs are not trained in functional medicine or metabolic medicine. They’re trained in a more pharmacologic approach. So, if a patient has a symptom or a risk factor, there’s an automatic reflex, which is to write a prescription for a drug to treat what they see in front of them without ever tracking back to what is the genesis behind this problem. They’re thinking in a sort of “recipe” approach, which is symptom-drug or disease-drug, and that approach has gotten us nowhere in cardiovascular disease in the last several decades. So unless we change what we’re doing, we’re going to continue to have deaths, poor care and astronomical healthcare costs that will literally bankrupt the country in cardiovascular disease by itself.
Where do you get the information provided in the modules? I’ve developed the modules—XVI(A) and (B), those 48 hours—I’ve put enormous amounts of medical literature and articles into this presentation. And what I teach is vascular biology, vascular aging, cardiovascular risk factors, blood pressure, dyslipidemia, a little bit of heavy metals and cardiovascular disease, and then we sum up with some really good pointers of how to incorporate this in your practice and make it a practical treatment program.
Then in Modules XVI(C) and (D), I have other experts in the field talking about the other cardiovascular-related problems. We picked some of the best of the best in their field to do these modules, which total 96 hours in length.
How do you stay up to date with the latest advances in the field? I read vociferously. I read lots of medical journals, and every week I pull key articles and put those into the presentation. So this presentation, XVI(A) and (B)—and I suspect other speakers will do this as well—is updated weekly with new information. So it literally will change dramatically from the time I first presented this to my next presentation.
“Ongoing education is absolutely key if you’re going to be a good physician and take care of your patients. If you don’t keep up, you just can’t do a good job. [In the Metabolic Cardiovascular Certification Modules,] we take 1,000 hours of crucial information and distill it down to 96 hours, so it’s about a 10-1 ratio on your learning curve, which is a very effective use of your time.” —Dr. Mark Houston
- The program will start with basic teaching of vascular biology concepts and how this relates to vascular disease.
- Vascular aging pathophysiology, diagnosis, prevention and treatment will be discussed.
- The role of nutrition, nutraceuticals, vitamins, minerals, antioxidants, weight management, body composition analysis, resistance and aerobic exercise, stress reduction, proper sleep hygiene and drugs in the integrative management of hypertension and CVD will be reviewed.
- Dyslipidemia will be defined based on new basic science and clinical research.
- Inflammation, oxidative stress, and the role for expanded lipid profiles using LDL and HDL particle size and number will be reviewed in the context of the pathophysiology of vascular damage.
- Proper analysis of CV risk factors, mediators and CV risk scoring will be taught using the COSEHC risk analysis methods.
- The role of heavy metals in CVD will be extensively reviewed based on a functional medicine model.
- All lectures will include actual case presentations to provide detailed insights into management of these complex disorders.