Precision Heart Health Program
Detect Hidden Heart Disease. Protect Your Future.
Heart disease often develops silently for years before symptoms appear. A standard cholesterol panel may identify some risk, but it does not show whether plaque is already building inside the coronary arteries—or what type of plaque is present.
At Integrative Health Solutions, Dr. Bronner Handwerger uses advanced cardiovascular imaging, precision laboratory testing, and personalized treatment strategies to identify risk earlier and help patients take meaningful steps to protect their long-term heart health.
Our Precision Heart Health Program is designed to go beyond routine screening by evaluating your actual cardiovascular risk factors, identifying hidden disease when appropriate, and creating an individualized plan focused on prevention, plaque stabilization, and improved metabolic health.
Is This Program Right for You?
The Precision Heart Health Program may be appropriate if you:
- Have a family history of heart attack, stroke, or premature cardiovascular disease
- Have elevated LDL cholesterol, ApoB, or triglycerides
- Have elevated lipoprotein(a), also known as Lp(a)
- Have high blood pressure
- Have insulin resistance, prediabetes, or Type 2 diabetes
- Have an elevated coronary artery calcium score
- Have previously been told that your cardiovascular testing was “normal” but remain concerned
- Experience reduced exercise tolerance, chest discomfort, or shortness of breath
- Want to understand whether plaque is already present
- Want a more precise plan for preventing a first or recurrent cardiovascular event
This program is not a substitute for emergency evaluation. New or severe chest pain, shortness of breath, weakness, or other acute symptoms require immediate medical attention.
Why Traditional Risk Assessment May Not Tell the Whole Story
Traditional cardiovascular screening commonly includes total cholesterol, LDL cholesterol, blood pressure, blood sugar, family history, and lifestyle factors. These measurements are valuable, but they do not always reveal the full picture.
Some people develop significant coronary plaque despite having cholesterol values that appear relatively acceptable. Others may have an elevated cholesterol level but little detectable plaque. Risk can also be influenced by ApoB particle number, Lp(a), insulin resistance, inflammation, blood pressure, genetics, smoking history, visceral fat, and other factors.
ApoB measures the number of circulating atherogenic lipoprotein particles capable of contributing to plaque formation, while Lp(a) represents an important inherited cardiovascular risk factor. These markers can provide information that is not always apparent from a conventional lipid panel alone. (www.heart.org)
Our goal is to integrate these different pieces of information so your prevention strategy is based on your individual biology—not population averages alone.
Advanced Cardiovascular Testing
Your evaluation is personalized based on your medical history, symptoms, previous results, family history, and goals.
Testing may include:
Advanced Lipid and Metabolic Testing
- ApoB
- Lipoprotein(a)
- LDL particle-related markers when appropriate
- Total cholesterol, LDL, HDL, and triglycerides
- Fasting glucose and insulin
- Hemoglobin A1c
- Comprehensive metabolic panel
- High-sensitivity C-reactive protein
- Thyroid markers
- Omega-3 status
- Additional inflammatory, nutritional, or metabolic markers when clinically appropriate
Coronary Artery Calcium Scoring
A coronary artery calcium scan measures calcified plaque within the coronary arteries. It can be particularly useful for refining risk and helping guide preventive treatment decisions in appropriately selected patients. (American College of Cardiology)
A calcium score is valuable, but it does not directly quantify noncalcified plaque. For some patients, additional imaging may provide a more complete assessment.
Coronary CT Angiography With Cleerly Analysis
When clinically appropriate, coronary CT angiography can provide detailed images of the coronary arteries. Cleerly’s AI-assisted analysis is designed to quantify plaque burden and characterize calcified and noncalcified plaque rather than reporting only broad categories of arterial narrowing. (Cleerly)
This may help answer questions such as:
- Is coronary plaque present?
- How much plaque is present?
- Is the plaque calcified, noncalcified, or mixed?
- Which arteries are affected?
- Is there significant narrowing?
- Are there features that may influence the intensity of prevention?
Imaging is ordered selectively. It is not necessary or appropriate for every patient, and recommendations depend on clinical risk, symptoms, kidney function, prior testing, radiation exposure, contrast considerations, and shared decision-making.
What Makes Our Program Different?
Many prevention programs focus primarily on lowering LDL cholesterol and advising patients to improve their diet and exercise.
Those steps are important, but our approach is more comprehensive.
We evaluate:
- Whether atherosclerosis is already present
- The extent and characteristics of coronary plaque when imaging is appropriate
- ApoB particle burden
- Inherited risk from Lp(a)
- Blood pressure
- Glucose regulation and insulin resistance
- Inflammation
- Body composition and visceral fat
- Exercise capacity
- Sleep and stress
- Nutrition
- Hormonal and thyroid factors
- Medication and supplement use
- Family history and genetic risk
This allows us to create a cardiovascular strategy based on the patient in front of us rather than applying the same treatment target to everyone.
Your Personalized Heart-Health Plan
After reviewing your testing, Dr. Bronner develops an individualized plan based on your level of risk and the presence or absence of detectable disease.
Your plan may include:
Nutrition
Recommendations may incorporate Mediterranean-style eating patterns, increased soluble fiber, appropriate protein intake, improved fat quality, reduced intake of highly processed foods, and strategies tailored to insulin resistance, triglycerides, blood pressure, or body composition.
Exercise and Fitness
Your plan may include aerobic conditioning, resistance training, mobility work, and recommendations for improving cardiorespiratory fitness while accounting for your current health and exercise capacity.
Weight and Metabolic Optimization
When appropriate, treatment may address:
- Insulin resistance
- Prediabetes
- Visceral fat
- Fatty liver
- Poor body composition
- Sleep apnea risk
- Loss of lean muscle
Medical weight-management therapy may be considered when clinically indicated.
Blood-Pressure Management
Even modest elevations in blood pressure can increase long-term cardiovascular risk. Treatment may include lifestyle interventions, home monitoring, and medication when necessary.
Lipid-Lowering Therapy
Depending on your results and overall risk, treatment may include:
- Statins
- Ezetimibe
- PCSK9-directed therapy
- Other prescription lipid-lowering options
- Nutritional and lifestyle interventions
- Carefully selected supplements when appropriate
Medication recommendations are individualized and based on expected benefit, tolerance, imaging findings, laboratory results, and patient preference.
Inflammation and Lifestyle Risk Reduction
We also assess modifiable contributors such as:
- Smoking
- Poor sleep
- Sedentary behavior
- Chronic stress
- Excess alcohol
- Poor glucose regulation
- Nutrient deficiencies
- Inadequate recovery
Our Goals
The Precision Heart Health Program is not simply designed to produce a lower cholesterol number.
Our goals are to:
- Identify hidden cardiovascular disease earlier
- Clarify your true level of risk
- Reduce the number of atherogenic particles in circulation
- Address elevated blood pressure and metabolic dysfunction
- Stabilize vulnerable plaque
- Slow plaque progression
- Improve cardiovascular fitness
- Reduce the likelihood of heart attack and stroke
- Track your response over time
- Help you build a realistic long-term prevention strategy
No program can guarantee that a cardiovascular event will never occur. However, identifying risk early and treating the major drivers of atherosclerosis can provide a more informed and proactive path forward.
Ongoing Monitoring
Cardiovascular prevention is not a one-time test.
Follow-up may include:
- Repeat lipid and ApoB testing
- Blood-pressure monitoring
- Glucose and insulin assessment
- Medication adjustment
- Nutrition and exercise review
- Monitoring for side effects
- Review of body composition and metabolic progress
- Repeat imaging when clinically appropriate
The goal is to determine whether your treatment plan is producing the intended response and make changes when necessary.
Why Choose Dr. Bronner?
Dr. Bronner Handwerger combines advanced cardiovascular risk assessment with an integrative and precision-medicine approach.
Rather than looking at one laboratory value in isolation, he evaluates the interaction between plaque burden, lipoproteins, metabolism, inflammation, blood pressure, lifestyle, hormones, and family history.
Patients receive time, education, and a clear explanation of their results so they can understand:
- What their testing means
- Which risks matter most
- Which interventions are most likely to help
- What should be monitored
- How their plan may evolve over time
When specialist evaluation or additional cardiac testing is needed, care can be coordinated with preventive cardiologists, imaging centers, and other cardiovascular professionals.
Frequently Asked Questions
Is a calcium score the same as a coronary CT angiogram?
No. A calcium score measures calcified coronary plaque. A coronary CT angiogram uses contrast-enhanced imaging to visualize the coronary arteries and may identify both calcified and noncalcified plaque. The appropriate test depends on the clinical situation.
What is Cleerly?
Cleerly is an AI-assisted coronary CT analysis platform that evaluates CCTA images to quantify coronary plaque and characterize plaque composition. It is used as an additional analytical layer alongside the original imaging study and clinical interpretation. (Cleerly)
Why measure ApoB if I already know my LDL?
LDL cholesterol estimates how much cholesterol is being carried within LDL particles. ApoB reflects the number of atherogenic particles that can enter the artery wall. In some patients, these values are discordant, making ApoB useful for refining risk and treatment decisions. (Cleveland Clinic)
What is lipoprotein(a)?
Lp(a) is a genetically influenced lipoprotein associated with increased cardiovascular risk. Because lifestyle changes generally have limited influence on Lp(a), identifying it can help guide the intensity of overall risk reduction.
Can coronary plaque be reversed?
Plaque response varies. Intensive risk-factor treatment may stabilize plaque, reduce certain plaque components, and slow or potentially reduce overall plaque burden in some patients. The immediate priority is to reduce risk and make plaque less likely to cause a cardiovascular event.
Do you prescribe medication?
Yes, when appropriate. The program combines nutrition, exercise, metabolic care, supplements when indicated, and evidence-informed prescription therapy. The goal is not to avoid medication or automatically prescribe it, but to use the tools most appropriate for the individual patient.
Take Control of Your Heart Health
You do not need to wait for symptoms—or for a cardiovascular event—to begin taking heart health seriously.
If you have elevated cholesterol, ApoB, Lp(a), a high calcium score, metabolic risk, a strong family history, or simply want a more precise understanding of your cardiovascular health, schedule a consultation with Dr. Bronner.
Call our office or request an appointment online to begin your personalized cardiovascular evaluation.