Last Updated: October 2025

Overview

Integrative cardiology combines the strengths of conventional, guideline-based cardiology with a root-cause, whole-person approach. While conventional care excels at diagnosing heart disease and providing life-saving medications and procedures, integrative cardiology goes further to identify upstream drivers—such as inflammation, metabolic dysfunction, sleep, stress, nutrition, environmental factors, and genetics—and builds a personalized plan to prevent events and improve quality of life. At Holistic Heart Centers in New York, NY and Roslyn, NY, and via telemedicine in select states (including FL, TX, and VA), this approach is delivered through precision evaluation and tailored care plans that complement, not replace, standard cardiology.

How The Philosophy Differs

Conventional cardiology is primarily disease-centered: it focuses on diagnosing a condition (e.g., coronary artery disease, atrial fibrillation, heart failure) and reducing risk through established therapies—statins, antihypertensives, antiarrhythmics, and revascularization when appropriate. Integrative cardiology is patient-centered: it seeks to understand why the condition developed in the first place and to intervene at multiple levels (biology, lifestyle, behavior, environment, and genetics) to modify that trajectory. This includes a strong emphasis on patient education and shared decision-making so you fully understand your options and tradeoffs.

What “Root-Cause” Means In Cardiology

A root-cause lens looks beyond “cholesterol is high” or “blood pressure is elevated.” We examine the patterns behind those findings: insulin resistance, chronic inflammation, micronutrient gaps, sleep apnea, gut–metabolic links, hormonal shifts (e.g., perimenopause), autonomic imbalance from chronic stress, cardiometabolic genetics, and social determinants. The goal is to uncover the specific drivers in your case and correct them, so risk markers improve because the biology has improved.

Testing: Similar Tools, More Context

Integrative cardiology uses standard tests—lipid panels, echocardiograms, stress testing, coronary CT, ambulatory monitors—but often adds advanced risk assessment when appropriate:

  • Atherosclerosis Burden: Coronary artery calcium (CAC) scoring to quantify plaque.
  • Lipid Nuance: apoB, Lp(a), small dense LDL, and triglyceride/HDL ratio to refine residual risk.
  • Inflammation & Metabolism: high-sensitivity CRP, fasting insulin, glucose tolerance patterns, and liver fat surrogates.
  • Sleep & Autonomic Tone: sleep apnea evaluation and heart-rate variability trends.
  • Lifestyle & Social Factors: nutrition, activity, work stress, caregiving demands, and access to healthy resources.

Genetic Insights (When They Change Care)

Genetics meaningfully influences cardiovascular risk and therapy response. We consider targeted testing when results will guide management, including:

  • Lipoprotein(a) [Lp(a)]: Lp(a) levels are largely genetically determined and associated with residual atherosclerotic risk even when LDL is controlled.
  • Familial Hypercholesterolemia (FH): When history or labs suggest FH, gene testing (e.g., LDLR, APOB, PCSK9) can confirm diagnosis and inform intensity of lipid-lowering therapy and cascade screening.
  • Polygenic Risk Scores (PRS): In select prevention scenarios, PRS for coronary disease can help stratify baseline risk, especially when traditional scores are borderline.
  • Pharmacogenomic Considerations: In limited cases, variants that affect drug metabolism or myopathy risk may be considered to personalize medication choice and dosing.

We do not “test for testing’s sake.” Genetic tools are used judiciously—when results are likely to alter treatment, surveillance, or family screening.

Imaging Beyond Standard: Vascular Age With CIMT

In addition to CAC, integrative cardiology may use carotid intima–media thickness (CIMT) via ultrasound to assess early arterial wall changes and estimate “vascular age.” CIMT can detect subclinical atherosclerosis before calcification is visible, track trends over time, and support shared decisions about prevention intensity. In certain cases, carotid plaque characterization adds context to risk discussions.

  • CAC quantifies calcified plaque burden (event prediction).
  • CIMT reflects arterial wall remodeling and early disease biology (trajectory and “age” signals).

Additional imaging (when indicated) may include stress imaging, coronary CT angiography for plaque and stenosis evaluation, or advanced echocardiography for structure and function. As always, we align imaging with a clear clinical question, minimize radiation exposure, and avoid unnecessary repeat testing.

Treatment: Medications Plus Personalization

Integrative cardiology is not “anti-medication.” Statins, PCSK9 inhibitors, antihypertensives, SGLT2 inhibitors, GLP-1 receptor agonists (when appropriate for metabolic risk), and anticoagulants save lives when used appropriately. The difference lies in:

  • Personalization: We use your risk profile (apoB, Lp[a], CAC, CIMT trends, blood pressure patterns, kidney function, arrhythmia burden, and genetic context) to choose the right therapy at the right dose, and we actively monitor for side effects and alternatives if needed.
  • Lifestyle As First-Line And Always-On: Structured nutrition (e.g., Mediterranean-style or cardiometabolic plans), resistance and aerobic training, sleep optimization, stress regulation, and tobacco cessation are built into your plan with granular steps.
  • Evidence-Informed Nutraceuticals: When appropriate, options such as omega-3s, soluble fiber/plant sterols, or specific micronutrients may complement medications—selected for quality and interactions, and monitored for effect.
  • Team-Based Care: Coaching, remote monitoring, and care coordination support you between visits, where most lifestyle change actually happens.

Procedures And Safety

When you need a procedure—catheterization, stenting, ablation, device therapy—integrative cardiology refers and co-manages with interventional, electrophysiology, and surgical colleagues. Safety is paramount. We follow national guidelines for urgent symptoms (chest pain, neurologic deficits, decompensated heart failure) and ensure that root-cause work never delays time-sensitive care.

Who Benefits Most

Patients with coronary artery disease, elevated CAC, dyslipidemia (including statin intolerance), hypertension, atrial fibrillation, and heart failure often benefit from this comprehensive approach. It is also well suited for prevention—especially if you have a strong family history, metabolic syndrome, autoimmune conditions, sleep apnea, or high chronic stress. Integrative cardiology can be especially helpful when you feel “over-medicated but under-well,” or when standard plans have plateaued.

What To Expect At Holistic Heart Centers

Your first visit includes a detailed history, medication and supplement review, targeted physical exam, and a review of prior testing. We may order selective advanced labs, genetic assessments, or vascular-aging imaging (CIMT) to clarify risk and personalize your plan. You’ll receive a stepwise roadmap: immediate safety steps, short-term wins (e.g., blood pressure to target, walking and resistance schedule, sleep plan), and longer-term goals (weight recomposition, insulin sensitivity, inflammation reduction). We make each step specific and achievable, and we track objective markers—apoB, Lp(a), CAC/CIMT trends—so you can see progress.

Our Clinical Stance

We emphasize a root-cause, precision-medicine approach that goes beyond prescriptions and procedures to restore cardiometabolic health. That means aligning therapies with your biology and preferences, using the least medication necessary to achieve risk reduction, and intensifying when data indicate. Personalization is non-negotiable; two patients with the same LDL, CAC, or CIMT may need different plans.

How We Coordinate Care

We communicate with your primary care physician and specialists, share pertinent results, and create consistent messaging. For those receiving virtual care in eligible states (including FL, TX, and VA), we integrate home blood pressure, weight, and rhythm monitoring when appropriate, and we schedule periodic in-person evaluations when needed.

Getting Started

If you’re ready for a personalized prevention or treatment plan, explore our HeartWell toolkits and care pathways here: https://holisticheartcenters.com/heartwell-toolkits/

To request an appointment or discovery call, use: https://go.holisticheartcenters.com/apply

Sources

Medically reviewed by Dr. Regina Druz, MD, MBA, FACC
This content is for educational purposes and does not substitute personalized medical advice.