The comprehensive or holistic approach to cardiovascular disease (CVD) prevention and management goes beyond the traditional path of lowering low-density lipoprotein cholesterol (LDL-C) to create personalized treatment strategies.
CVD remains the leading cause of mortality in the United States and globally, accounting for about one-fourth of all deaths. Despite decades of research and medical advancements, traditional approaches have largely centered around lowering LDL cholesterol as the primary treatment strategy. However, emerging evidence suggests that CVD is a multifactorial disease that requires a comprehensive and personalized approach to prevention and management.
A truly holistic and scientific approach to cardiovascular health recognizes that heart disease is not just about cholesterol—it is a four-legged stool supported by:
Lipid Levels – Total cholesterol and LDL are a fraction of lipid markers impacting cardiovascular health.Â
Inflammation – Chronic inflammation is a primary driver of plaque formation and cardiovascular damage.
Metabolic Health – Blood sugar dysregulation, insulin resistance, and metabolic syndrome increase cardiovascular risk.
Genetics & Absorption – Genetic predispositions and how an individual metabolizes and absorbs lipids can significantly impact risk.
At Natural Medicine of Stillwater, we assess a broader range of cardiovascular biomarkers allowing us to develop personalized treatment plans that go beyond generic cholesterol-lowering strategies and address the root causes of cardiovascular dysfunction.
Holistic Cardiovascular Assessment: The Key Biomarkers
To fully understand an individual’s cardiovascular risk, an advanced biomarker panel should assess lipid particle quality, inflammation, metabolic function, and genetic predispositions. Below is a list of essential cardiovascular biomarkers, their function, and why they matter.
Advanced Lipid Testing: Beyond Total Cholesterol and LDL

High-density lipoprotein (HDL) Subfractions (HDL2 & HDL3)
Not all HDL, "good cholesterol," is protective—subfractions differentiate functional vs. dysfunctional HDL.
HDL2 is more protective, while HDL3 has a weaker cardioprotective effect.
Apolipoprotein B (ApoB)
ApoB is a marker for all atherogenic (plaque-forming) particles, including LDL, very low-density lipoprotein (VLDL), and lipoprotein(a).
Higher ApoB levels correlate with greater cardiovascular risk, even if LDL appears normal.
Apolipoprotein A1 (ApoA1)
ApoA1 is the primary protein in HDL. It is essential for removing excess cholesterol from arteries.
Low ApoA1 suggests impaired HDL function and increased risk of plaque buildup.
Lipoprotein(a) [Lp(a)]
A genetic risk factor for CVD, Lp(a) contributes to atherosclerosis, clotting, and inflammation.
Standard lipid panels do not measure Lp(a), which can be crucial, especially for those with family history of heart disease.
Small Dense LDL (sdLDL)
Small, dense LDL particles are more atherogenic than larger, buoyant LDL particles.
High sdLDL levels increase the risk of plaque formation and oxidation.
Oxidized LDL (Ox-LDL)
Measures the oxidation of LDL particles, which is a major driver of inflammation and endothelial damage.
Oxidized LDL plays a key role in atherosclerosis progression.
Sterol Panel (Lipid Absorption & Production)
Lathosterol and Desmosterol – Markers for cholesterol production in the liver.
Beta-Sitosterol and Campesterol – Markers for cholesterol absorption from the intestines.
A personalized lipid management strategy can be developed based on whether an individual is a hyper-absorber or hyper-producer of cholesterol.
Inflammatory Markers: The Fire Behind CVD
High-Sensitivity C-Reactive Protein (hs-CRP)
A marker of chronic systemic inflammation, hs-CRP correlates with cardiovascular events.
Elevated levels suggest ongoing arterial inflammation that contributes to plaque instability.
Lipoprotein-Associated Phospholipase A2 (LpPLA2)
Measures vascular inflammation and plaque vulnerability.
High levels indicate greater risk of rupture and heart attacks.
Myeloperoxidase (MPO)
An enzyme linked to oxidative stress and endothelial dysfunction.
High MPO levels suggest active inflammation in the arteries.
Metabolic & Blood Sugar Control: Insulin Resistance and CVD Risk
Hemoglobin A1c (HbA1c)
Long-term marker of blood sugar control; higher levels correlate with insulin resistance and diabetes.
Elevated HbA1c contributes to vascular damage and CVD risk.
Fasting Insulin
Early marker of insulin resistance, which is a major driver of metabolic syndrome and heart disease.
Homocysteine
High homocysteine levels are associated with endothelial damage, clotting risk, and inflammation.
Elevated levels often indicate methylation imbalances related to B-vitamin deficiencies.
Coenzyme Q10 (CoQ10)
Essential for mitochondrial energy production and cardiac function.
Statin drugs deplete CoQ10, increasing the risk of muscle fatigue and heart dysfunction.
A Truly Personalized Approach to Cardiovascular Health
Instead of focusing solely on LDL reduction, a comprehensive cardiovascular assessment provides a more accurate picture of individual risk. A holistic, science-based approach should integrate:
Personalized nutrition based on cholesterol metabolism and genetic markers.
Targeted supplementation including CoQ10, omega-3s, and anti-inflammatory nutrients.
Lifestyle interventions such as stress management, exercise, and sleep optimization.
By identifying individualized risk factors, we can move beyond the one-size-fits-all LDL approach and develop preventive strategies that truly optimize heart health.
Conclusion
Cardiovascular disease is complex, and lipids are only one piece of the puzzle. A holistic, science-based approach that includes advanced lab testing allows for personalized treatment plans that go beyond statins and LDL reduction.
By considering lipid subtypes, inflammation, metabolic health, and genetics, Natural Medicine of Stillwater can help you take a truly holistic approach to cardiovascular disease prevention—one that is tailored to your unique biology.
💙 Your heart deserves more than just an LDL number—let’s take a deeper look at what truly matters. 💙
Contact the clinic to get your holistic assessment to cardiovascular health.
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