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Alzheimer’s, cancer, erectile dysfunction, arthritis, and other inflammatory diseases. The reactionary, traditional approach to healthcare today avoids preventive measures and moves us near the archway of death, then uses highly invasive, highly expensive treatments to pull us back, making us feel “grateful” while heart centers and hospitals reap the fiscal profits.
    There are plenty of established, proactive medical protocols that are inexpensive and shown to prevent cardiovascular disease. And yet, are they promoted by cardiologists, the AMA, or health centers? Not sufficiently. As a result, many of us will undergo costly procedures, be prescribed expensive heart medication, and live less-than-desired quality lives. And quite possibly, many of us will go to emergency rooms with chest pain or die suddenly before we get to the hospital.
    My proactive approach makes much more sense, since it keeps you disease free for as long as possible. It begins with positive measures, running diagnostics that uncover disease biomarkers so you can take action. And that clearly puts you in a better position to make lifestyle changes, which promote better health and diminish disease risks. Every aspect—nutrition/supplements, exercise, endocrine balance, and mind-body—must work in concert.
    Since heart disease is the leading cause of death for men—and is intricately linked to erectile dysfunction—every strategy in this book is designed to help you prevent or reverse cardiovascular disorders and maintain a great sex life. I believe it’s my duty as a physician to present a heart-healthy approach that proactively protects your endothelium. The endothelium forms a dynamic interface between your blood and your body. Endothelial cells secrete substances—like the important messenger molecule, nitric oxide, needed for a number of critical physiological processes—to regulate vital chemical reactions, keep blood moving smoothly, control blood pressure, ensure vascular tone, control inflammatory processes, and prevent oxidation and coagulation.
    When not properly cared for, your endothelial cells become dysfunctional and fall prey to numerous disease processes, which cause atherosclerosis, hypertension, inflammatory syndromes, heart attacks, stroke, and dementia. A 2003 Mayo Clinic paper defined endothelial dysfunction as the “ultimate risk” among all the cardiovascular risk factors. If you have any of the conditions/histories listed below, you must start working very hard at improving the health of your endothelium:

    Family history of heart disease and/or confirmed heart disease, based on carotid ultrasound diagnostics, abnormal stress test, or an elevated calcium score
     

    History of elevated LDL levels or low HDL levels
     

    Elevated total cholesterol levels
     

    Have been diagnosed with Metabolic Syndrome (see
    page 32
    )
     

    Elevated triglyceride levels
     

    Elevated cardio CRP (C Reactive Protein) levels
     

    Vascular disease
     
    Take my experience, for example. Thanks to a truly forward-thinking physician, I began undergoing periodic, proactive evaluations and, later, a carotid ultrasound, years before I should have had a heart attack. The normal protocol would have been to wait until I barely survived an emergency room visit. Instead, because of an abnormal carotid ultrasound, I was encouraged to have a 64-slice CT scan and subsequent cardiac catheterization. I learned I had chronic, yet stable heart disease involving my coronary arteries, which probably began back in my 20s. According to my cardiologist, what saved me from advanced disease and an early death was the age management medicine program I had been following for the past seven years: low-glycemic nutrition, supplements, a vital exercise regimen, and correcting my hormone deficiencies.
    Further research made me realize that although the low-glycemic nutrition I had been following for years may have been good, it wasn’t enough to fight or reverse heart