Protect Your Heart Before It Becomes an Emergency

Why a Former Cardiac Surgery PA Now Practices This Differently

Before functional medicine, Dr. Gengo spent years as a physician assistant in cardiac surgery, eventually becoming Chief PA at NewYork-Presbyterian/Weill Cornell. She was in the room for the worst moments of heart disease — patients who arrived only after years of undetected high blood pressure, unmanaged cholesterol, or blood sugar problems had already done damage that surgery could repair but not undo.

That experience changed the question she asks. Instead of "how do we fix this once it's an emergency," she asks "how do we catch this ten or twenty years before it becomes one." That's what brought her to functional medicine — and it's why she built her practice around testing and nutrition that most cardiology visits don't have time for. Dr. Lisa Gengo, ND, PA-C, FMCP-M sees patients in Stamford, Greenwich, Darien, New Canaan, Fairfield, and Ridgefield, CT — and throughout the Tri-State Area via telehealth.

What Is Metabolic Syndrome — and Why Should You Care?

If your doctor has ever mentioned borderline blood pressure, a slightly high cholesterol number, a little extra weight around your middle, or blood sugar that's "not quite diabetes yet," you may already have metabolic syndrome without knowing the term for it.

Metabolic syndrome isn't one disease — it's a cluster of related warning signs that tend to show up together: blood pressure creeping up, blood sugar running higher than it should, extra weight around the waist, and cholesterol or triglyceride numbers moving in the wrong direction. On their own, each one might get waved off as "something to watch." Together, they're one of the strongest predictors we have for future heart attack, stroke, and type 2 diabetes — and most people who have it feel completely fine.

That's the part that catches people off guard. Metabolic syndrome doesn't usually hurt. It doesn't come with a dramatic symptom that sends you to urgent care. It just quietly raises your risk, year after year, until something forces the issue. Dr. Gengo's approach is to find it while it's still quiet — through lab testing that looks at the whole pattern, not just one number at a time — so it can be reversed instead of managed.

Insulin Resistance: The Piece Most People Don't Know They're Dealing With

Here's a fact that surprises most patients: you can have insulin resistance for years — sometimes a decade or more — before a standard blood sugar test ever flags it.

Insulin is the hormone that moves sugar from your bloodstream into your cells for energy. When your cells stop responding to insulin the way they should, your body compensates by pumping out more and more of it to get the job done. For a long time, that extra insulin succeeds in keeping your blood sugar looking "normal" on paper — which is exactly why standard testing can miss it. Meanwhile, that excess insulin is quietly driving up blood pressure, encouraging weight gain (especially around the waist), and raising your risk for heart disease, long before a diabetes diagnosis ever enters the conversation.

Dr. Gengo tests for insulin resistance directly, rather than waiting for blood sugar to cross a diagnostic line. Catching it here — while it's still reversible through nutrition, movement, and targeted support — is one of the most effective things she does for a patient's long-term heart health.

The Nutrients Your Heart Runs On — and Why Deficiency Hides in Plain Sight

Your heart and blood vessels depend on specific nutrients to function well: magnesium to help regulate blood pressure and heart rhythm, omega-3 fatty acids to calm inflammation and support healthy cholesterol, CoQ10 to fuel the heart muscle itself, and B vitamins to help clear homocysteine, a marker linked to arterial damage when it runs high. Low levels of any of these can quietly work against you — and most people have never had them tested, because they're not part of a standard checkup.

This is where Dr. Gengo's approach differs most from a typical visit: rather than reaching straight for a prescription, she checks what your body may actually be low on and helps you build it back up — first and foremost through food.

Her philosophy, in her words: Nutrition isn't about eating less. It's about eating more of what actually nourishes you. Dr. Gengo doesn't hand patients a restriction list. She works from abundance — real, nutrient-dense food that heals the gut, feeds the heart, and supports the whole body at once, because those systems were never meant to be treated separately. Fixing the gut often improves how well your body absorbs the nutrients your heart needs. It's all connected, and that's exactly the kind of connection a rushed 15-minute appointment doesn't have time to make.