Jacob Hwang, ND

Naturopathic doctor and integrative health specialist focused on cardiovascular, kidney, urology, MedEd at @SSIHI_OC & @UCIrvineHealth. Posts ≠ medical advice.

[Jacob Hwang, ND @drjacobhwang]

Stressors and Resilience: An Integrative Model for Understanding Chronic Kidney Disease https://t.co/hOebju01TW #CKD #KidneyDisease #Hypertension #Diabetes #Dysbiosis #Diet #ChronicKidneyDisease #Dialysis #GFR #Renal #KidneyFailure #IntegrativeMedicine #IntegrativeHealth

[Jacob Hwang, ND @drjacobhwang]

Most #macronutrient diets, #caloric restriction, and time-restricted feeding can lead to #weight loss. Physical activity at moderate intensity with strength training can reduce fat mass loss and improve muscle mass. Using medical therapies can augment or support lifestyle/diet.

[Jacob Hwang, ND @drjacobhwang]

#Obesity is being redefined as a disease of excess #adiposity instead of being a risk factor for other chronic disease. It should no longer be the stigmatized as a lack of willpower over #lifestyle and #diet. There are #genetic causes but also #metabolic dysfunction that occurs.

[Jacob Hwang, ND @drjacobhwang]

The distribution and type of #adipose tissue affects #hormones, #insulin sensitivity, #inflammation, #appetite, and body composition. These all have direct influences on multiple downstream effects that alter #cardiometabolic parameters, increasing risk of #obesity complications.

[Jacob Hwang, ND @drjacobhwang]

I enjoy identifying and treating early stage #CKD. I take an active preventative approach by removing disease promoting factors and supporting physiology. The focus is to delay disease progression while optimizing #kidney function and health parameters. #GFR #albuminuria #nephron

[Jacob Hwang, ND @drjacobhwang]

I do not treat cardiovascular disease without thinking about #kidneys. I do not think about treating kidney disease without thinking about cardiovascular health. #Obesity and metabolic health is not the lack of will power. It shouldn’t be separated and treatments can benefit all.

[Jacob Hwang, ND @drjacobhwang]

It is #NationalKidneyMonth - the kidneys are resilient organs that play very important roles for life maintenance and health optimization. It’s not just #kidney dz, but also #cardiovascular dz and #metabolic disorders. #CKM syndrome unifies these conditions into a spectrum.

[Jacob Hwang, ND @drjacobhwang]

Cardiovascular-kidney-metabolic (#CKM) syndrome changes how we can approach patients. It informs and guides treatment strategies to be more whole person and consider multiple treatment targets. #Integrative health and medicine already does this, as a foundational philosophy.

[Jacob Hwang, ND @drjacobhwang]

With Mendelian randomization, it was found that each 50 mg/dL increase in plasma #Lp(a) levels was associated with an increased risk of at least 25% for chronic #kidney disease. #CKD #ASCVD #CVD #CKMsyndrome #cardiorenal #atherosclerosis #kidneydisease #lipids #lipoproteina

[Jacob Hwang, ND @drjacobhwang]

New data from the Copenhagen General Population Study revealed a relationship between decreasing #eGFR and increasing #lipoprotein(a) levels. It hypothesized #kidney disease caused elevated #Lp(a) levels, but it may the opposite. Instead, elevated Lp(a) may be a #CKD risk factor.

[Jacob Hwang, ND @drjacobhwang]

For example, a patient with #kidney disease can develop #hypertension and #hyperlipidemia, leading to #cardiovascular disease. Another patient can have existing #CVD and later develop chronic #kidney disease. The mechanisms are the same, but the starting point is different. #CKM

[Jacob Hwang, ND @drjacobhwang]

The newly defined “cardiovascular-kidney-metabolic syndrome” accounts for about 50-60% of the patient population that I see as an integrative health specialist. It is no surprise why many therapies have both #cardioprotective and #nephroprotective effects. #CKM #CVD #CKD #MetS

[AHA Science @AHAScience]

Cardiovascular-Kidney-Metabolic Syndrome: a health disorder due to connections among obesity, diabetes, chronic kidney disease & CVD.

📖 @CircAHA

✍️ @ChiadiNdumele & @RangaswJ

More on defining, screening, and treating this syndrome: https://t.co/Tm2DlaXMaE

[Jacob Hwang, ND @drjacobhwang]

More studies are needed to further understand the bidirectional relationship of #cardiovascular disease and #kidney disease. Both act as risk factors that amplifies each other; however, the clinical heterogeneity is likely dependent on different disease phenotypes. #CKM #CVD

[Jacob Hwang, ND @drjacobhwang]

@davidasinclair I wonder if berberine is also modulating the GI microbiota, influencing TMA production.

[Jacob Hwang, ND @drjacobhwang]

Long #COVID affects multiple organ systems and we may see different phenotypic patterns. Lessons from other #postviral syndromes demonstrate similar symptoms. These complications can really impact quality of life. #PASC #COVID19 #SARSCoV2 #dysautonomia #MCAS #LongCovid

[Nature Reviews Microbiology @NatureRevMicro]

Long COVID: major findings, mechanisms and recommendations

https://t.co/kO9mNFLm4Y

@EricTopol @ahandvanish @LisaAMcCorkell @julialmv explore key findings, potential mechanisms, overlap with other conditions, potential treatments, and perspectives on long COVID research and care

[Jacob Hwang, ND @drjacobhwang]

The #MESA study reveals Lp(a) as a #cardiovascular risk factor for primary prevention. The #cholesterol story reaches beyond #LDL and the traditional #lipid panel. This supports why #CV events still occur in “normal”LDL ranges. #lipoproteina #apoB #CHD #atherosclerosis #CVD

[Atherosclerosis @ATHjournal]

• #LDL-C & #Lpa are both #apoB-containing #lipoproteins
• LDL-C & Lp(a) are both associated w/ #CHD
• Lp(a) is an important risk #marker in primary prevention, even when LDL-C is optimal
👉The latest findings from #MESA are in press in #ATH
@society_eas
https://t.co/6WO0VxOedN

[Jacob Hwang, ND @drjacobhwang]

My colleagues and I routinely test for Lipoprotein(a) in our patients with #cardiovascular disease or at increased risk for #atherosclerosis. Testing for Lp(a) adds further value to the traditional #lipid panel. #cholesterol #lipoprotein #LDL #HDL #CAD https://t.co/3fclkzrm2s

[Jacob Hwang, ND @drjacobhwang]

Interesting population approach for #CVD prevention - I wonder why regulatory agencies were resistant to #sodium reduction policies. Using #potassium salt substitutes may carry a risk of #hyperkalemia in certain diseases. Perhaps, dietary potassium intake may be safer. #CKD #HTN

[Hypertension @HyperAHA]

Editorial: Potassium-Enriched Salt Substitution as a Population Strategy to Prevent Cardiovascular Disease

https://t.co/uOqWJZzd6O

[Jacob Hwang, ND @drjacobhwang]

I had an amazing opportunity to share my knowledge and expertise in #CKD with @ndprimarycare! Check out the other online CE courses as well. #medicaleducation #integrativemedicine #integrativehealth #chronickidneydisease #kidney #nephrology #prevention #primarycare

[Naturopathic Academy of Primary Care Physicians @ndprimarycare]

An astounding 9 out of 10 patients are unaware that they suffer from chronic kidney disease! Luckily, we have @drjacobhwang's 1 CE online course for NDs where you'll learn how to diagnose and treat this underdiagnosed health issue. Learn more: https://t.co/XQPM23bC5D #medtwitter

[Jacob Hwang, ND @drjacobhwang]

Overall, #coffee does not seem to be associated with greater #cardiovascular risk. There may be acute changes in #bloodpressure, but not necessarily observed in habitual drinkers. Coffee contains other compounds that have favorable #CV benefits. #CVD #hearthealth #lipids

[CVR Tomasz Guzik @CVR_TomaszGuzik]

EXPERT OPINION: Whether you enjoy your #coffee ice cold or steaming hot, what effect does it have on #cardiovascular #health?

Discover more on the impact of coffee consumption on the #heart and #CVD risk
https://t.co/O6tJDWIpoU

#caffeine #hypertension #CardiovascularResearch