Health Heart, Health Brain

The personalized path to protect your memory, prevent heart attacks and strokes, and avoid chronic illness. By Bradley bale, MD and Amy Doneen, DNP with Lisa Collier Cool.

Large studies have shown that one of the simplest, and cost effective, keys to a longer, healthier life is to combine regular dental checkups with excellent self-case.

10 common red flags for cardiovascular peril, all of which you can diagnose yourself, without any medical tests. Even if you don’t have any noticeable symptoms of heart disease, and don’t consider yourself a candidate for stroke, dementia, or other chronic illnesses, if you have any of these conditions, you need to take action to protect yourself.

• Erectile dysfunction - Difficulty in achieving or maintaining an erection firm enough for sex is one of the most common early warning signs of arterial disease in men, and double risk for a cardiovascular event in the next 3 to 5 years.
• Migraine headaches - particularly those preceded by sensory symptoms known as an aura (such as seeing flashing lights or zigzag lines, or a disturbed sense of smell, taste, or touch), are strongly linked to increased risk for stroke, particularly in women.
• Bleeding gums - if your gums bleed even a little when you brush, floss, or eat abrasive foods (such as apples), that’s a warning sign of periodontal disease.
• Psoriasis and other autoimmune disease - People with severe psoriasis may suffer their first CV event by forty. Characterized by itchy, scaly patches, most commonly on the knees, elbows, trunk, and scalp and in some cases, swolen joints. It’s been linked to increased risk for high cholesterol, high blood pressure, obesity, diabetes, and metabolic syndrome.
• Dining out frequently - Study found that people who dine out frequently consume about 475 more calories a day, explaining why this pattern is also linked to increased risk for obesity.
• Snoring or trouble sleeping - Loud snoring or frequently waking up in the night for no apparent reason are both common symptoms of OSA.
• Gout - People with gout are at nearly 50 percent higher risk for coronary artery disease than those without gout.
• Working long hours - also been linked to increased likelihood of weight gain, smoking, and excessive drinking.
• Asthma - Having persistent asthma symptoms can double your risk for a cardiovascular event. another study found that taking daily medication for chronic asthama boosts risk for such events by 60 percent over a ten year period.
• Divorce - one divorce raises women’s heart attack risk by 30 percent, and two divorces doubles their risk! the same study found that men mest be divorced at least twice to have any increased heart attack risk.

People with an optimism have 35 percent lower risk for heart attack, strokes, angina and death from CV.

Physical red flag to check :

• Male pattern baldness - this form of hair loss, which affects the front and top of the scalp, to a 40 percent rise in heart attack risk, as compared to men with the same age with full head of hair.
• Prematurely gray hair of wrinkles - going gray at a young age, or excessive wringling in sun-protected areas is also linked to elevated heart risk in women.
• A ring around the colored part of your eye - Primary found in people with an inherited form of extremely high cholesterol.
• Yellowish, waxy skin growths - known as xanthoma, these fatty growths can be a sign of high cholesterol. They can be as small as pinhead or as big as a grape and can occur in many areas, including the corners of your eyes, your hands, and the back of your legs.

Cinnamon can have beneficial effects on levels of several lipids, including LDL, ApoB, and triglycerides, and can also help reduce blood pressure and blood sugar.

Stop heart disease in its tracks with our top ten prevention tips for women

• Get Educated - The more women know about heart disease, the easier it is for them to partner with their healthcare providers and avoid their leading health threats.
• Move more - Exercise has such powerful mental and physical benefits that it’s been called the ultimate wonder drug.
• Follow a healthy lifestyle - an optimal lifestyle reduces heart attack and stroke risk by up to 90 percent
• No nicotine
• Check blood pressure - With each five mm Hg drop in blood pressure, a patient’s risk for heart attacks, strokes, and other major cardiovascular events in the next four years fell by 10 percent.
• Have your cholesterol checked at least once a year
• Get checked for prediabetes - It’s very common for people to be diagnosed with diabetes or insulin resistance (IR), a disorder also known as prediabetes, shortly after they suffer a heart attack. IR is the underlying cause of 70 percent of heart attacks and many strokes.
• Get dental care at least twice a year
• Sleep well - those who snoozed less than 5 hours a night were nearly twice as likely to suffer a stroke as people who slept 6 to 8 hours a night.

Life-saving lesson

• To find out which patients are in cardiovascular danger, you need to look at their arteries, not just their risk factors.
• To find arterial disease, you have to look in the right place.
• Vascular imaging helps save lives and money
• even small plaques can be potentially lethal, if untreated.
• Arterial imaging helps patients get the right diagnosis and potentially lifesaving treatment.
• It’s never too late, or too soon, to take charge of your arterial health.

Old Thinking

• High cholesterol is the leading cause of heart attacks
• If your artery walls are healthy, cholesterol can’t invade
• Chronic inflammation is equally harmful to everyone’s arteries
• Medication is the most effective way to quell arterial fire

Use these easy Natural ways to “fireproof” your arteries

• Practice mindfulness daily - boost heart health, also improves sleep and mood.
• Step up physical activity - keeps the heart healthy by lowering cholesterol, blood pressure, and body weight.
• Eat the rainbow - consuming a variety of colorful fruits and vegetables has amazing cardiovascular benefits, including lower risk for heart attacks, strokes, diabetes, high blood pressure and several forms of cancer.
• Ditch sweet drinks

Dangerous disorder you can diagnose yourself

• A large waist - For Africans and middle easterners, the abnormal numbers are 37 and 13.5 inches respectively for men and women. for most Asians and people from central south America, 35,5 (men) and 31.5 (women). To tell if you might be a risk, wrap a tape measure around the top of your pelvic bones and exhale before measuring. Don’t assume that your belly button marks your waistline, as its location can vary. What to do: Combine aerobic exercises, such as walking, jogging, cycling, or swimming, with muscle-strengthening activities, such as lifting weights or resistance training.
• High blood pressure -  the threshold for a hypertension diagnosis is 130/80 mm Hg while top pressure is 120-129 and below 80 is classified as “elevated”. If your pressure is 130/85 mm Hg or higher, you have a strike. This level of pressure damages arteries, heightening the risk for heart attacks, stokes, kidney failure, vascular dementia, etc. What to do: check regularly and talk to your provider, although medication is usually necessary to treat hypertension, there are also some natural way to lower blood pressure. These include mindful meditation to reduce stress, eating foods that are rich in magnesium, such as dark green leafy vegetables, unrefined grains, and legumes, and getting seven to eight hours of sleep a night.
• Low HDL cholesterol - HDL is good cholesterol. HDL level below 50 mg/dl for women and under 40 mg/dl for men, is another strike for metabolic syndrome. What to do: if use tobacco or nicotine in any form, kick this deadly habit. Eating oily fish (such as salmon, tuna, and sardines) or other foods that are high in omega-3 fatty acids helps boost levels of good cholesterol, while reducing inflammation. Olive oil is also a healthy fat that helps raise HDL and contains heart-healthy antioxidants called anthocyanins, which fight inflammation, and reduce disease-inducing free radicals, and have been shown to increase HDL by up to 19 percent.
• High triglycerides -  Like cholesterol, triglycerides are a type of fat (lipid) found in your blood. When you consume more calories than you burn, the extra calories are converted into triglycerides and stored in fat cells until they’re needed for energy. If your triglyceride level is 150mg/dl or above, you have acquired another strike. Having high triglycerides alone magnifies heart attack danger by nearly threefold, while people with the highest ratio of triglycerides to HDL had nearly sixteen times the risk of heart attack than those with the lowest. What to do: if you’re overweight, losing 5 to 10 percent of your body weight can lower your triglycerides by 20 percent. Limiting or avoiding sugar, and increasing the fiber in your diet, also are helpful. Multiple studies have linked low levels of vitamin D to increased risk for high triglycerides, other lipid abnormalities, and metabolic syndrome.
• High fasting blood sugar - Fasting means you have not consumed anything with calories for at least ten hours. A level of 100mg.DL or higher counts as a strike. Fasting blood sugar levels of 100mg/dl to 126 mg/dl indicate that you’re prediabetic, while a level above 125/dl is diagnostic of diabetes. What to do: To prevent or reverse prediabetes, the treatment that surpasses all others is aerobic exercise, such as running, brisk walking, biking, and swimming. Working out thirty minutes daily, five or more times a week has been proven to prevent prediabetes from progressing to full-blown diabetes 60 percent of the time.

An easy 4 step plan to optimize your oral systemic health

1. Partner with your dental provider and set goals to take your oral health to the next level of excellence.
2. Ask your dental provider to screen you for periodontal and endodontic disease and check you for high risk oral bacteria.
3. X-ray to check for signs of gum disease such as bone loss
4. A periodontal exam
5. An oral salivary test for high risk periodontal bacteria
6. Disinfect your entire mouth daily
7. Get a dental cleaning at least twice a year or as advised by your dental provider

• Never brushing at night elevated risk for death during the study period by 20 to 25 percent, compared to brushing every night.
• Never following upped mortality risk by 30 percent, versus daily flossing.
• Not seeing a dentist in the previous twelve months raised mortality risk by up to 50 percent, compared to getting dental care two or more times a year.

If you have 9P21 genotype :

• At forty, get an abdominal aortic aneurysm (aaa) scan.
• Avoid smoking
• make exercise a daily habit
• maintain health cholesterol levels

3 keys to optimal brain health throughout your life

1. Protect your brain from injury by optimizing your arterial wellness - Health blood vessels are essential to your brain’s wellbeing. Although your brain only accoutns for about 2 percent, it is powered by 25 percent of your blood flow, which supplies it with about 20 percent of the oxygen you breathe and 25 percent of the calories you consume.
2. Take action to avoid arterial and brain inflammation.
3. Boost your cognitive reserve

Top Ten Action steps to help you avoid memory loss

1. Lifestyle matters - Follow a mediterranean diet that is high in fruits, vegetables, fish, seeds, and nuts. Healthy oils are also important, the amount of fat in your diet should be guided by your Apo E genotype. Stay hydrated and drink adequate water. If you weight one hundred pounds, aim for fifty ounces per day. Keeping your waistline trim (less than 40 inches for men and less than thirty-five inches for women) also helps reduce dementia risk. to rev up your brain and muscles is to get at least 30 minutes of cardiovascular exercise daily, plus resistance training twice a week. Fun ways to keep fit include Zumba, taichi, yoga, brisk walking, biking, and dancing.
2. Make healthy brain activities a daily habit - We recommend 15 minutes of mindful meditation daily. Give your brain plenty of stimulation by listening to music, studying a new language, trying brain training games, volunteering and social engagement. Great ways to connect with others include book clubs, current event discussions, online groups, and even chatting with friends.
3. Get 7 to 8 hours of sound, refreshing sleep every night
4. get your vitamin D level checked - The optimal level of the sunshine vitamin is 40-60 ng/ml , if lower than that you need a supplement. You need to get your level checked before taking a supplement and during treatment. if your level is low, taking 2000 to 5000 iu of vitamin d3 daily is usually effective.
5. Optimize your oral health
6. Get your cholesterol checked - if your total cholesterol is above 200 mg/dl, the risk for AD rises by 23 percent, and if total cholesterol is above 250 mg/dl, risk is doubled. therefore, maintaining a cholesterol level below 200 mg/dl should be a top priority. Pay attention to your HDL level as well: this “good” cholesterol is brain food. In a recent study, people whose HDL level was below 40 mg/dl had a 53 percent higher risk for memory loss, compared to those with a level above 60 mg/dl.
7. Maintaining healthy blood pressure levels - your goal should be below 120/80mm hg, treatment for elevated blood pressure includes exercise, laughter, mindfulness, proper sleep, a low salt diet, staying hydrated, if necessary medication.
8. A healthy gut helps keep your brain healthy - Ways to enhance gut health include eating prebiotic and probiotic foods such as fermented foods like sauerkraut, kombucha, kefir and tempeh, and yogurt, asparagus, garlic, dandelion root, and apples. Epidemiological studies have shown that coffee intake can also be a healthy food for the gut because of its antioxidant, anti-inflammatory, and antiproliferative effects on the mucosa. Avoid saturated fat, artificial sweeteners, and all soft drinks.
9. Know your blood sugar numbers
10. Certain medications used to treat arterial disease may also protect against Alzheimer’s

8 Best ways to boost your heart and brain health

• Battle belly fat and keep chronic disease at bay with interval training, aerobics, and strength training - The benefits of physical activity start immediately and rapidly multiply over time: even one exercise session improves cardiovascular health for several days. Regular exercise lowers your risk for 13 types of cancer by up to 42 percent, halves it for heart attacks, and reduces it for diabetes by 70 percent. Daily physical activity also enhances the brain’s cognitive reserve and helps keep your memory sharp. The best way to keep your heart healthy is to combine aerobic exercise, such as walking, jogging, cycling, or swimming, with muscle-strengthening activities, such as lifting weights or resistance training. Including weight lifting in your workout not only tones your muscles, but it can also help prevent age-related gain in waist size. Larger, stronger muscles help rev up your metabolism, so you torch more calories even when you’re at rest.
• Intermittent fasting dials down inflammation helps heal your gut, and burns fat - here’s 16/8 plan works: if you finish your evening meal at 8 pm, you’d wait until noon the next day to eat again, thus completing a 16-hour fast. During the fasting window, it’s important to stay hydrated by drinking plenty of water, which helps quell hunger pangs. It’s also fine to drink coffee or tea during the fasting window as long as these beverages are unsweetened and don’t contain anything with calories, such as milk or cream.
• Soothe your spirit and defuse stress with mindful meditation or prayer - Research suggests that stress reduction doesn’t just make people feel better psychologically, it may also enhance arterial wellness, potentially protecting against heart attacks and strokes. Mindful meditation involves focusing on the present moment in an open, nonjudgmental way while letting stressful thoughts about the past or future drift way while letting stressful thoughts about the past or future drift away. Try sitting quietly for 10 minutes and paying attention to your breathing or a mantra. A recent study found that daily prayer is highly effective at reducing stress and anxiety in patients with coronary artery disease and instilling a sense of hope. Benefits from mindful meditations :
• Keeping your brain sharp throughout your life - helps prevents age-related mental decline and may change the brain by expanding areas involved in focused attention
• Fighting inflammation and stress
• Reducing chest pain and stress in heart patients
• Lowering your blood pressure
• Combating or preventing depression

Eat more of these foods

• Nuts - People tho eat nuts regularly have a lower risk of developing heart disease or experiencing cardiovascular events such as heart attacks and strokes. Eating almonds or hazelnuts may raise HDL (good) while pistachios help lower triglycerides. Recommended to eat a palmful of nuts daily, preferably tree nuts with skins, such as almonds, walnuts, hazelnuts, and pistachios.
• Fish - helps prevent heart disease, strokes, heart failure, and sudden cardiac death. Reducing triglycerides, blood pressure, and chronic inflammation and improving insulin sensitivity. The best sources of omega-3s are oily fish such as salmon, herring, sardines, tuna, and lake trout. Recommended eating at least two 3 1/2 ounce servings of nonfried fish per week.
• Fresh vegetables - A diet high in these nutritional powerhouses could add years to your life. Advised eating 2 to 3 cups of veggies daily.
• Fresh fruit - those who ate daily had a 36 percent lower risk for heart attack and stroke than those who ate no fresh fruit.
• High-fiber foods - People who eat a diet high in fiber were 56 to 59 percent less likely to die from CVD, infectious disease, or respiratory disorders.
• Dark chocolate

Eat less of these foods

• Salt - recommends a limit of no more than 2300 mg per day of sodium and an ideal limit of no more than 1500mg  for most adults. Limiting or avoiding packaged, processed foods, which are typically high in salt, may lower your blood pressure or help you avoid hypertension
• Processed meats - has been tied to increased risk for cancers of the breast, pancreas and prostate.
• Sugar-sweetened beverages
• Red meat and plant meats - Eating 2 1/2 ounces or more of red meat per day raised colon cancer risk by 20 percent. while plant-based veggie burgers and other “meatless meats” might sound like a healthier alternative, in reality, these foods are ultra-processed and relatively high in
• Saturated fat
• If you smoke, keep trying to quit until you succeed
• Just quit
• replace a bad habit with a good one
• get smoking cessation counseling and talk to your health provider about nicotine replacement therapy
• Sexual activity is save and healthy, for most heart patients and an optimal lifestyle can heighted its pleasure.
• Staying physically fit has been shown to improve sexual performance, increase libido, and heighten sexual pleasure in both men and women. also linked a heart-healthy lifestyle to improved sexual function, increased sexual frequency, and having more fun in bed.
• Laughter and a spirit of optimism do your heart good.
• Eat the rainbox
• Red - tomatoes - reductions in blood pressure and inflammation, and also reduce stroke risk by 55 percent.
• Purple and blue - these colors result from pigments called anthocyanins that may enhance brain health. Blueberries are often called brain berries because studies link them to reduced risk for age-related memory loss.
• green - those who ate five servings of produce daily had a 12 percent lower risk of dying from CVD and 10 percent lower risk for cancer death than those who only ate two servings.
• yellow and orange - Citrus fruits, such as oranges, lemons, and grapefruit, also make important contributions to protecting against heart attacks and strokes. Citrus limonoids have been shown to help fight cancer of the mouth, skin, lungs, stomach, and colon in lab tests and may help lower cholesterol. A yellow fruit, the pineapple, contains bromelain, a mixture of enzymes that have been used for centuries to treat indigestion and fight inflammation.

4 cornerstones of treating arterial disease

• Optimal Lifestyle - Avoiding smoking, daily physical activity, getting adequate sleep, maintaining a healthy weight, and managing stress can reduce your risk for cardiovascular events by at least 80 percent.
• Vitamin D - The benefits of getting enough vitamin D are reduced inflammation, decreased risk for side effects in statin users, improved insulin sensitivity, and protection against developing type 2 diabetes, even if you are prediabetic.
• Vitamin C
• Omega-3 fatty acids - are found in oily fish ( rainbow trout, salmon, mackerel, tuna, sardine, and herring), caviar, and oysters. Supplementation with omega-3 is an effective lifestyle strategy for CVD prevention, and the protection likely increases with dosage.
• Coenzyme Q10 (CoQ10)
• Berberine - is a natural compound found in several plants, including goldenseal, tree turmeric, Oregon grape, and barberry. Used in traditional Chinese and ayurvedic medicine for centuries, this botanical supplement has an anti-inflammatory effect. also improve gut health, lower cholesterol, reduce fat in the liver, and aid weight loss. Also helpful for people with diabetes and prediabetes because it reduces glucose production in the liver and lowers blood sugar.
• Cinnamon - helps reduce blood sugar and lipid levels in people with type 2 diabetes. Improves glucose tolerance significantly in prediabetic patients, s compared to a -placebo.
• Low-dose aspirin - aspirin has proven anti-clotting effects, thus helping to prevent heart attacks and strokes, which occur when a clot blocks flow of blood to the heart of brain. Taking low-dose aspirin has been shown to reduce the risk of colon cancer and there is some evidence that it may also help protect against prostate, gastroesophageal, and breast cancer.
• Statin Therapy
• Renin-angiotensin-aldosterone system inhibitors

Four important things to know about high blood pressure

• Your morning blood pressure may be the best predictor of heart attack and stroke risk.
• The new AHA/ACC guidelines encourage home blood pressure monitoring as an important way for people with hypertension to track their health - A good way to tell if the device is correctly positioned is to hold the arm with cuff across your chest as you would if the national anthem were playing.
• Elevated systolic blood pressure is more dangerous than smoking or obesity.  - natural ways to maintain health blood pressure: mindful meditation to reduce stress, beet juice, foods that are rich in magnesium such as leafy vegetables, unrefined grains, and legumes, and getting seven to eight hours of sleep a night.
• Lowering systolic blood pressure from 140 to 120 saves lives
  

Test	Purpose	Optimal range
Highly sensitive Troponin T (HsTnT)	Detects if heart muscle cells are being stressed or dying	Less than or equal to 14 ng / L
Body mass index	Being overweight or obese increases risk for many chronic diseases, including cardiovascular disease, cancer, and joint disorders. Can cause arterial inflammation, also associated with dementia. However, it’s important to know that BMI is not an accurate way to check for obesity in highly muscular or athletic individuals	18-25
Basic lipid panel	Measures levels of cholesterol, a blood fat that is the main ingredient of new plaque, also associated with dementia risk if levels are high	Optimal levels of total cholesterol, triglycerides, HDL, and LDL as below
Total Cholesterol	Combined measurement of certain cholesterol components	Less than 200 mg/dL
Triglycerides	Measures levels of triglycerides, a type of fat, in your blood. Elevated levels can be a signal for insulin resistance and increased risk for heart attacks and strokes	Less than 100 mg/dL
High-density lipoprotein (HDL)	Measures levels of HDL (good) cholesterol; if levels are low, may signal insulin resistance	Men, less than 50 mg/dL; women, less than 60 mg/dL
Low-density lipoprotein (LDL)	Measures levels of HDL (bad) cholesterol	Less than 70 mg/dL
Apolipoprotein B-100 (ApoB)	Measures levels of ApoB, a major component of all four types of cholesterol that are most harmful to your arteries. This blood test is not included in the standard cholesterol test but can be performed at the same time. Big studies show that a strong predictor of heart attack and stroke risk is your ApoB level plus your triglyceride level	Less than 80 mg/dL
Lipoprotein (a) Lp(a)	Checks for inherited disorder marked by elevated levels of this dangerous cholesterol, which is not included in the standard cholesterol test. Elevated levels, if untreated, greatly increased heart attack and stroke risk, often at a relatively young age	Less than 75 nmol/L
Total Cholesterol/HDL ratio (TC/HDL)	Most predictive calculation for predicting risk of heart attack and stroke, calculated by dividing total cholesterol number by HDL (good) cholesterol number	Less than 3 mg/dL
Imaging	Check for arterial disease	No plaque (diseas)
Chart review of radiology reports, e.g., X-rays and mammograms	checks for calcified plaque calcium seen in any arteries proves presence of arterial disease	No calcium reported in any arteries
Carotid intimamedia thickness test (cimt)	Check for plaque in the neck arteries (carotid) and arterial age.	No plaque, chronological to arterial age disparity < 5 years
Femoral intimal media thickness test (fiMT)	check for plaque in the going arteries (femoral)	No plaque
Coronary artery calcium scan (CACS)	Check for calcium in the heart arteries (coronary)	No calcium = Score of 0
Abdominal Aortic Aneurysm scan	checks for a weak, ballooning area (aneurysm) in the main artery that carries blood away from the heart to the rest of the body (the aorta) and plaque (disease) in that artery	Less than 3 cm in diameter and no plaque noted
Inflammatory testing	Checks for elevated levels of inflammatory biomarkers linked to increased risk for developing arterial disease or having a heart attack or stroke, elevated levels also linked to increased dementia risk	No evidence of arterial inflammation
F2-Isoprotane / creatinine ratio	Checks for amount of oxidative stress int he body and provides insight into the effects of patient’s lifestyle	Less than 0.86 ng/mg
Microalbumin / creatine urine ratio (MACR)	Checks the wellness of the blood vessel lining, also called the endothelium (tennis court)	Men, less than 4 mg/L; women, less than 7.5 mg/L
Highly sensitive C-reactive protein	Checks for inflammation in the body, is not specific for the endothelium, but when optimal, suggests that the tennis court is not inflamed	Less than 0.5 mg/L
Fibrinogen	Checks for inflammation in the body, is not specific for the endothelium, but when optimal, suggests that the tennis court is not inflamed. [match more streamlined language from cell above]	Less than 350 mg/dL
Lippoprotein associated Phospholipase	Checks for inflammation inside the artery where the plaque resides.	Less than 123 nmol/min/mL
Myeloperoxidase (MPO)	Checks for very dangerous inflammation of the artery and imminent risk of a heart attack or stroke	Less than 420 pmol/L
Insulin resistance	Check for the root cause of type 2 diabetes; insulin resistance (IR), a prediabetic condition that causes arterial inflammation. IR raises risk for heart attack, stroke, dementia, and hypertension	Sensitive to insulin
Fasting Glucose	if elevated, signals insulin resistance. Test also checks for prediabetes and diabetes	Less than 100 mg/dL
One-hour 75 gm oral glucose tolerance test (OGTT)	If elevated, signals insulin resistance and prediabetes	Less than 125 mg/dL
Two-hour 75 gm oral glucose tolerance test	Considered the gold standard for checking for diabetes, prediabetes, and insulin resistance	Less than 120 mg/dL
Hemoglobin A1C test	Measures 3 month average glucose level and may identify prediabetes or diabetes. (Less accurate than OGTT test above.)	Less than 5.7%
Triglyceride/HDL ratio	if elevated, strong signal for insulin resistance and prediabetes	Less than 3.5 (white); less than 3.0 (Hispanic) less than 2.0 (black)
Oral health evaluation	Evaluates overall oral health; checks for tooth and gum infections linked to arterial inflammation and increased dementia and prediabetes risk	No periodontal or endodontic disease
Periodontal chart pocket depth (PD) Bleeding of gums (BOP) clinical attachment level of teeth (CAL)	3 elements of periodontal exam used to identify patients with signs of periodontal disease, including loose teeth, pockets of infection and gum bleeding.	PD less than 4 mm BOP 0 CAL less than 1 mm
Oral pathogen testing		absence of high risk oral pathogens
Imaging with x-ray or computed tomography with 3d cone bean	Identifies infected teeth, abscess formation at base of teeth, and may detect calcified plaque in the carotid artery	No endodontic (tooth) infection. No calcification in the carotid artery
Genetic panel	Personalized healthcare and lifestyle	optimal genotypes for the 5 genes below
9P21	identifies carriers of “the heart attack gene” and guides lifestyle, medication and supplement advice to protect heart health	Noncarrier of 9P21
Apo E	Identifies Apo E genotype and people at increased genetic risk for cardiovascular disease and dementia, as well as the best lifestyle strategies to avoid these threats	Apo E 3/3 genotype
Haptoglobin	Identifies haptoglobin genotype, offering critical knowledge for type 2 diabetics to guide lifestyle advice, establish goals for glucose control and potential need for vitamin e, also provides guidance on value of glueten-free diet for nondiabetic patients.	Haptoglobin 101 genotype
KIF6	Checks for presence or absence of KIF6 genetic variant. Evaluates lifetime risk of developing cardiovascular disease and provides insight into statin response.	Noncarrier of the arginine variant
4Q25	Identifies inherited risk for atrial fibrillation	Noncarrier of the 4q25 gene
Sleep study to check for obstructive sleep apnea (OSA) and other sleep disturbances	Checks for episodes of interrupted breathing (apnea) during sleep. OSA can be a root cause of high blood pressure, and can cause arterial inflammation; also associated with insulin resistance and risk for dementia	Apnea hypopnea index (AHI) fewer than five events per hour. Sleep six to eight hours nightly on average without interruptions
Mental Health screening	Screens for psychological factors, including for depression, anxiety, substance abuse disorders, posttraumatic stress disorder (PTSD) and high stress levels, associated with increased risk for arterial disease, chronic inflammation and dementia. Stress is defined as “being in an environment where you feel a lack of control.” Your provider should also assess your use of tools for stress management techniques, such as mindfulness meditation.	Good mental health and effective stress management. If screening demonstrates concern, a referral to a mental health specialist for formal evaluation and counseling for is essential
Waist Circumference	Checks for abdominal obesity. A large waistline can be common warning sign of insulin resistance, prediabetes, and metabolic syndrome. Too much belly fat is also linked to increased risk for arterial disease, dementia, cancer, and other chronic diseases	Men, less than 40 inches; women less than 35 inches
Vitamin d blood test	when low, it can cause arterial inflammation; also associated with insulin resistance and increased risk for heart disease, dementia, certain cancers and other chronic conditions.	Less than 30 ng/mL
Blood pressure	Messure levels of systolic and diastolic blood pressure. If elevated, can cause arterial inflammation; also associated with dementia, heart attack and many chronic diseases. High blood pressure is the number one risk factor for stroke	Less than 120/80 mm Hg in healthy individuals
Pharmacogenetic panel	Identifies with medications and supplements are genetically best for patients and offers insight into most effective dosages.	Genotypes and allele for metabolism
N-terminal pro brain naturetic peptide (NT-proBNP)	“Happy heart” test to evaluate health of the heart; if abnormal, may signal inadequate blood flow to heart, faulty heart valves, arrhythmia, or heart failure	Less than 125 pg/mL