By Dr. Poulina Uddin

Heart disease is the leading cause of death among both men and women in the United States, taking the lives of 610,000 Americans every year.

While conventional medicine can offer heart patients the very latest technology in terms of medications, surgeries and interventional procedures to treat heart attacks and other acute heart conditions, preventing those problems is often less precise and sometimes more complex.

Certainly risk factors such as family history, blood pressure, cholesterol levels and genetics are important, but often there are other, less obvious aspects involved as well.

Here are five things to know about integrative heart care, which focuses on caring for all aspects of a person’s health:

Look beyond the physical symptoms.

If someone comes in with a heart attack, I ask what happened that day. Were they angry with someone? Was there a stressful event? All of the physical risk factors are important, but why did it happen on this particular day? And the majority of the time, there is some emotional or environmental trigger.

An integrative approach to heart care takes all of those factors — physical, emotional, psychological and social — into consideration when determining treatment and crafting an individualized care plan for each patient that reflects and acknowledges their unique lifestyle.

Make nutrition and exercise realistic and achievable.

Physicians often instruct heart patients to eat well, exercise and live a healthy lifestyle, but patients may not have the knowledge and tools they need to follow through on those instructions.

A patient who is depressed, for example, is unlikely to stick to an exercise program unless the depression is addressed. Nutrition and cooking classes, for example, can help patients learn to make heart-healthy meals. I recommend being very specific about dietary recommendations.

I actually ask the patients what they are eating, make a list, and then give very specific recommendations for substitutions, portions, and problem foods. For example, replace your white rice with brown rice or quinoa, or eat only half of what you have taken on your plate. This makes it much easier for people to get started in the process.

Learn effective ways to manage stress.

Stress and anger can be major risk factors in heart disease, and learning to deal with these negative feeling can lower risk and benefit overall wellness.

I am a big proponent of dealing with stress. I send plenty of patients to acupuncture or healing touch, a therapy that focuses on the energy field surrounding the body. And I teach breathing exercises in my office. I often recommend yoga, and I recently became a certified yoga instructor myself because I want to be able to set up classes for my patients who are apprehensive about doing it on their own. A lot of patients just need that support.

Complement conventional medicine rather than replace it.

The integrative approach complements rather than replaces conventional heart care. For a generally healthy patient who may be slightly overweight and have high cholesterol, lifestyle changes such as improving their nutrition, exercising and managing stress may be enough to lower their risk, and having a personalized plan to follow makes that more realistic.

If after six months there is no improvement, it may be time for medication — and that often raises questions about prescription versus supplements or “natural” products.

Use natural supplements wisely.

Natural supplements such as fish oil and turmeric have a proven anti-inflammatory effect on the body and can help reduce risk, but for someone who has already had a heart attack or a stent placed in an artery, standard medications such as aspirin and statins are part of the recommended treatment.

Some patients, however, may be reluctant to take prescription drugs, preferring instead to use herbs or supplements. While these alternatives may do the same thing as prescription medications, they tend to be far less regulated and tested for safety and effectiveness than prescription drugs.

Red yeast rice, for example, can be a substitute for statins, but the chemical effect on the body is essentially the same, and you’re still taking a pill that may or may not be as safety-tested as a prescription.

Successful integrative heart care starts with an open, honest dialogue with your physician, and creating a care plan that addresses your unique physical, emotional, social and spiritual health.

—Dr. Poulina Uddin, M.D. is a board certified integrative cardiologist at the Scripps Women’s Heart Center and is on the medical staff at Scripps Mercy Hospital, which has campuses in Hillcrest and Chula Vista.