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Most people think heart disease is obvious and easy to detect, yet emerging research shows women develop cardiovascular risk in completely different ways that traditional tests fail to catch. Microvascular dysfunction, soft plaque, hormonal shifts, and subtle metabolic changes often begin decades before a standard workup shows anything abnormal. In this episode of Extend, we sit down with Dr. Suzanne Steinbaum, preventive cardiologist and leading expert on women’s heart health, to uncover why classic cholesterol panels miss early risk, how microvascular disease develops long before blockages appear, and why expanded markers like ApoB and HSCRP are essential in 2025. We unpack how CLEARLY scans identify dangerous soft plaque, how CPET testing detects endothelial dysfunction, and why perimenopause dramatically shifts cardiovascular risk. We also explore how zone two training restores arterial flexibility, how lifestyle precision can reverse early disease, and why personalized prevention is the missing link for women who feel “off” even when their tests look normal. ✅ We Also Discuss: ➡️ Why women experience heart disease through microvascular dysfunction instead of classic blockages ➡️ How outdated testing misses dangerous soft plaque in women ➡️ The role of ApoB, HSCRP, triglycerides, and A1C in identifying true risk ➡️ How CLEARLY scans reveal non calcified plaque that calcium scores miss ➡️ Why angiograms often appear normal despite real disease ➡️ How CPET detects endothelial dysfunction and defines true zone two ➡️ How zone two training reverses early cardiovascular decline ➡️ Why perimenopause, sleep, stress, and pregnancy history shape long term heart health ➡️ How genetics like ApoE influence diet, metabolism, and plaque formation Subscribe for science backed conversations that connect longevity, metabolic health, and modern prevention so you can take control of your biology and extend your healthspan. Learn more about Dr. Shah: Website: https://www.drshah.com/ Clinic: https://www.next-health.com/ Instagram:@darshanshahmd Learn more about Dr. Suzanne Steinbaum: Website : drsuzannesteinbaum.com Instagram: @drsteinbaum X: @Dr. Suzanne Steinbaum Linkedin: Dr. Suzanne Steinbaum