A Perspective on Integrative Cardiology

An interview with Dr. Stephen Sinatra

Heart disease is still the leading cause of death in the United States according to the Centers For Disease Control and Prevention (CDC). Although the United States has made tremendous strides in the quality of cardiac care, heart disease still remains a primary health concern for many US citizens. Natural Solutions spoke with Dr. Stephen Sinatra about his perspective on what we can do about heart disease. Dr. Sinatra studies heart disease from a non-traditional perspective; the focus of his practice is on prevention and proactive lifestyle changes for leading healthier life. He considers himself to be an “integrative cardiologist” because he prefers to treat heart disease by using the best of both conventional and alternative medicine. His distinguished career in interventional and preventive cardiology has earned him much respect from both his patients and his peers.

NS: You have been involved in cardiology since the mid-1970s. What do you see as the biggest change in heart health care during your career?

SS: Conventional cardiology, like much of conventional medicine, has become increasingly expensive through my almost 40 years in cardiology. To be sure, there have been wonderful advances that are saving lives. Crisis cardiology is a shining example of the life-saving ability of high-tech medicine. On the other side of the coin, I have witnessed time again how low-tech and low-cost approaches can also save lives, improve quality of life, and enhance cardiovascular healing.

What stands out in my mind are two particular strategies. One is the use of simple nutritional supplements such as coenzyme Q10, magnesium carnitine, d-ribose, fish oil, and vitamin C. These nutritional factors can significantly improve the health of critical blood vessels or boost heart-cell energy production. The other strategy is called Earthing, and involves connecting the body to the natural and subtle electric energy omnipresent on the surface of the Earth through the use indoors of specially-conductive bed sheets, mats, and bands. Earthing reduces inflammation, the underlying cause of multiple common disorders, including cardiovascular disease, and also promotes a calming mode in the nervous system. Sleeping “grounded,” that is connected to the Earth’s energy, has the potential to lower high blood pressure, minimize cardiac arrhythmias, and, as I have personally described in a scientific paper, generate a desirable blood thinning effect.

NS: You describe yourself as an “integrative cardiologist.” Can you describe what this term means?

SS: Integrative cardiology means doing the best thing for the patient by reducing suffering, improving quality of life, and extending life. To do this, you bring the best methodologies of both conventional and alternative medicine to the table. For example, if a patient has a heart attack, conventional stent placement and balloon angioplasty are unquestionably the way to proceed. After the acute situation has passed, then a truly supportive lifestyle that is preventive in nature must be employed. This would include what I regard as [the] six pillars of healing: an organic diet emphasizing fruits, vegetables, and healthy fats, and minimizing sweeteners; creative exercise with appropriate stretching and breathing exercises; a detoxification program; targeted nutritional supplements; mind/body techniques to alleviate psychological and emotional stress; and Earthing to reduce inflammation, lessen stress in the nervous system, normalize the stress hormone cortisol, and improve blood thinning.

NS: What do you feel are the most important things patients can do to avoid heart problems?

SS: Clearly, a supportive lifestyle that reduces stress and inflammation is the way to go. This includes the six pillars of healing I just mentioned. They apply totally to a prevention mindset as well.

NS: Cardiology seems to be two different practices—one of prevention (avoiding heart issues) and one of reaction (recovering from a heart attack). How do you see the two relating to each other?

SS: Without a doubt, prevention is easier than cure. But as I just mentioned, the same basic lifestyle practices apply to prevention and therapy. They would just need to be customized in a therapeutic situation to address a particular condition. Even if someone develops heart disease, the most important predictor of a subsequent cardiac event is an unhealthy lifestyle. Here’s an example in point: if you have an angioplasty or stent placed for an acute coronary artery blockage and then go back to a previous destructive lifestyle of poor diet and smoking, you will surely close the stent and probably other coronary arteries as well. Good lifestyle works for prevention and for supporting recovery from a cardiac event.

NS: Can patients effectively improve heart health without pharmaceutical drugs by modifying lifestyle, improving nutrition, and taking an active role in their health management?

SS: Absolutely. Most, if not all, pharmaceutical drugs have some degree of mitochondrial toxicity. That means they poison the environment within cell structures where cellular energy is generated. It makes sense to reduce pharmaceutical dependency as much as is medically warranted. For most of my patients who have had coronary events, hypertension and even arrhythmia, I was able to wean them off of medication as long as they continued to be asymptomatic. However, some patients are more compromised than others and in need of some degree of pharmaceutical support. This is where integrative cardiology has tremendous merit. An integrative cardiologist can complement conventional cardiology care with targeted nutritional supports and a healthy lifestyle and thus reduce the dependency on pharmaceutical drugs. The lifestyle and nutritional strategies can often boost the quality of life beyond what could be done with drugs alone. Moreover, the fewer drugs that come into play, the less potential there is for side effects to develop.

NS: What changes have you seen in the practice of cardiovascular medicine during your career?

SS: Cardiology has made dramatic advances, particularly in the area of emergency and crisis intervention. Unfortunately, some “standard of care” protocols have been abused. I am disturbed, for instance, by the excess utilization of coronary artery bypass surgery or stent angioplasty interventions for the treatment of coronary artery disease alone in the absence of symptoms. I have been gratified, however, to see increased interest and greater implementation of alternative methodologies in the treatment of cardiovascular diseases. For example, the incorporation of coenzyme Q10 for both congestive heart failure as well as diastolic dysfunction has been enormous over the last couple of years. I’ve been using, and loudly advocating, coenzyme Q10 for nearly three decades. This single supplement can do so much good for ailing hearts. Omega-3 essential fatty acids found in fish oil supplements are also major heart-friendly factors and are now included as part of accepted standard of care in cardiological patients. Recently, newer cholesterol-testing methodologies have demonstrated that fractionization of cholesterol is the only way to address the cholesterol hypothesis in patients.

Many cardiologists are now questioning the impact cholesterol really has as a major cardiological risk factor and the newer tests can help sort out, beyond mere and often meaningless numbers, whether cholesterol particles are inflammatory and dangerous, or benign. Cholesterol is found at the scene of arterial inflammation and plaque, but it is certainly not the perpetrator of the disease process.

Fortunately, more and more cardiologists are not being drawn into the cholesterol-lowering drug stampede. Inflammation is now being finally acknowledged as the root cause of heart disease as well as other illnesses. This is where integrative cardiology continues to shine. A good integrative cardiologist has many more tools to work with, in beating back inflammation, than a standard conventional cardiologist who simply relies on pharmaceuticals.

NS: What changes in practice would you like to see made in the future?

SS: I would like to see less reliance on pharmaceutical drugs. Drugs obviously can play a critical role in many situations, but I believe they are grossly overused. Drugs all have side effects, large or small, and [the side effects are] probably more widespread and serious than is admitted on labels. The fourth leading cause of death in America is, in fact, properly prescribed pharmaceutical drugs. Many people take multiple drugs, creating confusing reactions that often result in doctors prescribing additional drugs to combat the pharmaceutically-generated symptoms. I’ve seen many new patients taking a dozen or so medications, an insane situation itself causing destruction of health. Clearly, safer and more effective interactions must be considered.

Coronary disease is a lifestyle illness that requires more than just a drug treatment. The most important thing physicians need to understand is that smart medicine is not treating numbers but actually people. Since every patient is different, there is no one therapy that fits all. I would like to see physicians “think for themselves” more and do their own diligence, especially when they consider therapies that could cause harm. Hopefully more and more physicians and particularly cardiologists will consider more natural approaches that include healthy nutrition, targeted nutritional supplements, mind/body interactions, and Earthing. The cardiologist of the future needs to focus his or her clinical sights on mitochondrial function and how to protect and enhance the production of cellular energy. Mitochondrial dysfunction is at the core of cardiovascular disease, accelerated aging, disability, and premature death. This is the focus of integrative cardiology, and hopefully conventional doctors will adopt this focus as well.

It is never too late to take control of your heart health. But heart disease is not something that you can cure on your own. If you feel that you are at risk of developing heart disease, take the necessary steps to confront it. Seek a health practitioner who understands your concerns and will work with you to provide a plan that includes diet, nutrition, exercise, and lifestyle changes. You will feel better, have more energy, and be in better control of your life.

Your greatest wealth is health. Make an investment to reap the benefits of a healthy heart and a long life by taking action today. Still very much rooted in science, integrative cardiology treats your acute symptoms with medicine and advises smart lifestyle choices that will ultimately heal much more than your heart.

6 pillars of healing:

Consuming an organic diet emphasizing fruits, vegetables, and healthy fats, and minimizing sweeteners

Creative exercise with appropriate stretching and breathing exercises

A detoxification program

Targeted nutritional supplements

Mind/body techniques to alleviate psychological and emotional stress

Earthing to reduce inflammation, lessen stress in the nervous system, normalize the stress hormone cortisol, and improve blood thinning


Stephen T. Sinatra, MD, FACC, FACN, CNS, CBT, is a board-certified cardiologist, certified nutrition specialist, certified bioenergetic psychotherapist, and anti-aging specialist. Dr. Sinatra has authored fourteen books, numerous peer-reviewed journal articles, medical textbook chapters, and currently writes a monthly national newsletter entitled, Heart, Health & Nutrition. He is the founder of the HeartMD Institute. Visit Sinatra’s website at DrSinatra.com.