Q: What inspired you to dedicate your career to preventing heart attacks, strokes, and chronic disease?
A: Prevention is the most exciting aspect of healthcare. It takes continual learning, research, teaching and building firm partnerships with patients. I can’t imagine doing anything else!
Q: When you and Dr. Bale began developing the BaleDoneen Method, what gap in traditional care were you trying to solve?
A: The healthcare system is (and has been) broken. It is a sick-care model that treats people AFTER they are sick. We have a proven model of prevention that works to prevent heart attacks, strokes, type 2 diabetes. Our model also protects against microvascular disease such as chronic kidney disease and dementia.
Q: How do you explain the term “arteriology” to a patient hearing it for the first time?
A: Arteriology is the science focused on the health and wellness of the arteries. The BaleDoneen Method has developed a cure for arterial disease, keeping arteries stable without inflammation. This allows blood flow to continue throughout the body. We identify and optimally manage the causes of oxidative stress that could compromise the health of the arterial wall.
Q: What do you wish every person understood about inflammation and its connection to heart disease?
A: Inflammation drives plaque development in the artery wall, while mitigating arterial inflammation keeps the arteries stable. Plaque forms in the wall of the artery when cholesterol is trapped in the wall due to oxidative stress (inflammation). There are several causes of oxidative stress that go beyond the traditional risk factors of lipids and blood pressure. Other causes of oxidative stress include lipo(a), insulin resistance, periodontal disease, sleep apnea, gut health, sedentary lifestyle, obesity, stress, anxiety, and nutrient deficiencies and more.
Q: Why is personalized prevention so important in cardiovascular care?
A: We are all genetically unique, in our genetic risk profile and our pharmacogenetic profile (how we metabolize medications). There is no panacea diet for everyone and we use genetics to understand and respect how each person responds to lifestyle recommendations. All patients are wonderfully unique and each patient deserves to be treated as an individual. This allows for optimal CV prevention!
Research, Innovation, and the Oral-Systemic Connection
Q: Your publication linking oral pathogens to arterial disease was called a landmark study. What was that discovery process like for you?
A: Our paper proved that high risk periodontal pathogens are causal of arterial disease development. The complexity of this document proposed several nuances such as shifting from oral pathogens to be associated with arterial disease to causal of arterial disease, proposing that the ‘criteria’ for periodontal disease include clinical laboratory testing with pathogen evaluation along with the physical assessment. Read more on the BaleDoneen Landmark Study here.
Q: Why do you think the oral-systemic connection has been overlooked in traditional cardiovascular care?
A: The data with oral systemic health and cardiovascular health has long been represented as an associated connection. ‘Association’ does not require a causal relationship. Causality requires action. Meaning, when we proved ‘causality’ of high risk periodontal pathogens having a cause and effect relationship with arterial disease, it demands that dentistry and medicine add periodontal disease as a ‘root cause’ of arterial disease.
Q: How do you see collaboration between medicine and dentistry improving cardiovascular outcomes?
A: Dentistry has an opportunity to mitigate one vital root cause of arterial disease by elucidating the high-risk pathogens that drive periodontal disease and arterial disease. As medicine and dentistry begin this collaborative relationship, one of the important root causes of arterial inflammation/oxidative stress can be mitigated.
Q: What is something surprising patients learn when they hear about the connection between oral health and arterial health?
A: Patients are inspired to know that this is something that they can actually do something to lower their cardiovascular risk. People who suffer a cardiovascular event want to find hope that another root cause of arterial inflammation/oxidative stress can be identified and mitigated. How wonderful it is to know that we can reduce our risk of heart disease by seeing our dentist and hygienist regularly and doing optimal home care at least twice per day!
Education, Leadership, and Clinical Impact
Q: You’ve taught thousands of providers around the world. What are some of the most common reactions you hear after they go through the BaleDoneen preceptorship?
A: BaleDoneen is inclusive of all providers who have an impact on the health and wellness of patients. We welcome all including dentists, hygienists, cardiologists, internal medicine, family practice, nurse practitioners, physician assistants, nutritionists, exercise physiologists and all individuals who care about heart health. Working together to mitigate the number one cause of death and disability creates an inclusive goal of patient centric care with one goal in mind – optimal health.
Q: What advice would you give to medical or dental professionals who want to bring this level of prevention into their practice?
A: Education is key. Come to the BaleDoneen Preceptorship program and learn the method. Allow yourself to be vulnerable and get a BaleDoneen assessment. Remember, arterial disease is our leading cause of death and disability. We are all vulnerable.
Q: Why do you believe cardiovascular prevention should be integrated across all areas of medicine and dentistry?
A: We have a proven cure for arterial disease – The BaleDoneen Method. We are passionate that our method can be (and should be) incorporated into standard of care for both medicine and dentistry. Heart attacks and strokes CAN be prevented. Additionally, the BaleDoneen Method ensures that our lifespan matches our healthspan by protecting against the diseases of aging such as dementia, Alzheimer’s disease, diabetes, chronic kidney disease, fatty liver, vision loss, erectile dysfunction, and peripheral arterial disease. Eradicating these diseases allows for our healthspan to match our lifestyle.
Q: What do you enjoy most about teaching other providers to use the BaleDoneen Method?
A: Bringing hope to the millions of people who suffer heart attacks and strokes, diabetes and the chronic diseases that claim our independence.
Q: Considering that you have lectured around the world, how have conversations around prevention changed over the past decade?
A: When we first started, our message was meant with novelty and skepticism but now, we have the support of medicine and dentistry to propel our message. Our aim is that The BaleDoneen Method is available to all individuals to wish to live a life free of cardiovascular disease and the diseases that claim our independence.
Q: What keeps you motivated to continue researching, publishing, and leading in this field?
A: I have learned quickly that the more I learn, the more I have yet to learn. Over the past 25 years, we have remained on the cusp of the cutting edge of arterial disease prevention because we have a keen respect for research and a true respect for each individual patient.
Patient Care, Media, and Public Outreach
Q: What are some signs of arterial inflammation that people often overlook or misinterpret?
A: Oftentimes, arterial inflammation (oxidative stress) can be silent which is why heart disease can be silent until it isn’t. Sadly, heart attacks occur in people who do not know they have arterial disease and, sadly, the causes of arterial disease inflammation (oxidative stress) go beyond the commonly treated risk factors such as cholesterol, blood pressure and nicotine. The causes of arterial inflammation also include insulin resistance (pre-diabetes), periodontal disease, lifestyle challenges such as stress and anxiety, genetic factors such as lipoprotein(a), and many others.
Q: What is one vitamin or supplement that’s often misunderstood when it comes to heart health?
A: Vitamin D deficiency is extremely common in various ethnic and environmental circumstances. We treat vitamin D deficiency because when levels are low, arterial inflammation will ensue.
Q: For patients recovering from a heart-related event, what is one lifestyle change that makes a real difference?
A: In the recovery stages, it is incredibly important to participate in cardiac rehab to gain the reassurance that your body CAN handle exercise. Consistency is key – taking it slow and easy and consistently with cardio and weight resistant exercise.
Q: What do you say to patients who feel anxious or overwhelmed about their risk?
A: Knowledge is power and the key is KNOWING what causes heart disease and understanding that, with proper guidance, these risk factors CAN be identified and treated. Often people feel vulnerable because of a genetic path but, we and (and MUST) treat people properly to insure that our lifespan matches our healthspan.
Q: You worked with coaches and former players from the Seattle Seahawks to screen for cardiovascular disease. What role does public education play in your mission to prevent heart attacks and strokes? And what did you learn from that screening exercise?
A: We learned a lot. Specifically that the most fit and strong athletes are also vulnerable to heart disease. A reverse bias occurs in medicine today – people who are fit and healthy on the outside often are mistreated in the CV world as they are considered ‘healthy’. Heart disease has a genetic component and each individual needs to be assessed objectively and comprehensively for the presence of asymptomatic arterial disease, inflammation and all of the root causes.
Q: Why is it important for patients to hear directly from their providers about prevention – not just treatment?
A: Prevention is best appreciated at the youngest ages – it is a family disease. In an ideal world, cardiovascular prevention starts in pediatrics and family practice. Catching people (after a heart attack) is never as effective as identifying genetic risks early and implementing lifestyle throughout the family to change the outcome.
Q: What do you hope the next generation of patients understands differently than the last?
A: Simply that heart disease, strokes, diabetes, chronic kidney disease, fatty liver disease, blindness and peripheral artery disease are all preventable.
Universal Questions
Q: Can you share a story about a patient transformation that still sticks with you today?
A: There are so many special people.
Q: What do you wish more people understood about preventing heart attacks and strokes?
A: These illness are NOT inevitable, heart attacks, strokes, diabetes and memory loss CAN be prevented.
Q: What motivated you to focus your career on prevention rather than treatment?
A: I am an optimist, and the scientific literature is optimistic that we CAN make a difference. Sadly, standard of care medicine (insurance based medicine) has yet to embrace prevention, but we are getting closer.
Q: What’s one common misconception patients have about cardiovascular risk?
A: The root causes of arterial disease go well beyond the common risk factors of cholesterol, blood pressure, smoking, age and gender. We must identify and treat all of the root causes of arterial inflammation (oxidative stress) that drive arterial disease.
Q: What’s one simple change patients can make today to improve their heart health?
A: Drink more water, get eight hours of sleep each night, eat more vegetables and laugh more. Also – find a BaleDoneen provider to assess ALL of your risk.
Q: What do you love most about working with patients using the BaleDoneen Method?
A: Providing hope.
