Prevalence of Silent Atherosclerosis across Adult Life. NEJM, August 2026.

REACT imaged 16,808 apparently ASCVD-free adults aged 18–70 with carotid/femoral 3D ultrasound and coronary CTA. Silent atherosclerosis was already present in 57.1% overall and was detectable even at age 18–29. Plaque burden then rose dramatically with age.

What does primary care look like when you combine traditional medicine, functional medicine, hormone optimization, cardiovascular prevention, and longevity medicine under one roof?

In this conversation, I sit down with Dr. Manuel Salvadori, Biologo Nutrizionista, for a fascinating Italian-American discussion about what we do at Iron Direct Primary Care in Melbourne, Florida—and why our model looks so different from conventional healthcare in both the United States and Italy.We start with the basics:

What is a Physician Associate (PA-C)?

What is Direct Primary Care? And how can a primary care practice spend 60–90 minutes with a new patient instead of trying to solve complex problems in a seven-minute visit?

From there, the conversation goes much deeper.

We discuss:• How Iron DPC combines primary care + functional medicine + anti-aging/longevity medicine

• Why prevention should be built into primary care rather than treated as a separate specialty

• Hormone replacement therapy and the differences between replacement, optimization, and abuse

• Estradiol, progesterone, testosterone, menopause, muscle loss and healthy aging

• Why simple interventions—diet, exercise, sleep, appropriate medications and hormone management—often matter more than exotic biohacks

• My evolving view of biohacking and why constant optimization can become counterproductive

• Peptides, NAD, mitochondrial medicine and when we actually use them• Cold plunge, sauna, red-light therapy, exercise and recovery at Iron DPC

• Why I increasingly favor a little “Euromaxxing”: coffee, conversation, slower living and enjoying life

• The economics of Direct Primary Care and why patients pay a predictable monthly membership rather than paying us every time they need care

• Major differences between the American and Italian healthcare systems

• And our somewhat ambitious proposal: could Italy eventually develop its own version of the Physician Associate model with Functional Medicine combined?

One of the central ideas behind Iron Direct Primary Care is simple:Primary care should not just manage disease after it appears. It should actively work to preserve health, function, muscle, metabolic health and cardiovascular health for decades.

That means treating the knee injury that walks in today—but also thinking about the patient's cholesterol, hormones, exercise, sleep, nutrition and long-term risk.

Medicine does not have to exist in silos. This was one of my favorite international conversations because Manuel approaches these subjects from an Italian nutrition and functional-medicine perspective, while I approach them from everyday clinical practice in the United States.🇺🇸

Conversation recorded in Italian🇮🇹 with English subtitles available

Learn more about Iron Direct Primary Care on Instagram and YouTube or at ironDPC.com

For healthcare professionals interested in my complete course on hormone and anti-aging medicine: HRTPCP.com

Stefan Hartmann, PA-C

CEO, Iron Direct Primary Care Melbourne, Florida

This discussion is for educational purposes only and is not individualized medical advice.

#DirectPrimaryCare #FunctionalMedicine #LongevityMedicine #HormoneReplacementTherapy #HRT #PrimaryCare #AntiAgingMedicine #MensHealth #WomensHealth #Biohacking #Peptides #PreventiveMedicine #IronDirectPrimaryCare

Gillian Godon Perue MD on Acute Ischemic Stroke Guidelines at the FAPA conference in Daytona Beach June 26, 2026.As always, if interested in our HRT course please pre register via the linkhttps://docs.google.com/forms/d/1GoX_B7V9PxZGAPch8_MeRED5WLIVKghqSMwFhqNJo1E/edit

In this talk at The Mermaid House in Indian Harbour Beach, Ashley Curtis, MSN, APRN, FNP-C of Iron Direct Primary Care (Iron DPC) shares insights on hormone replacement therapy (HRT) for women. Ashley is a Family Nurse Practitioner with over 20 years of nursing experience. She earned her Master of Science in Nursing from Western Governors University and brings a strong background in functional medicine and integrative nutrition to her practice. Passionate about relationship-based, preventive care, she prioritizes listening to patients and partnering with them to support long-term health, optimize quality of life, and address root causes rather than simply managing symptoms. Her clinical interests include hormone optimization, women’s health, performance medicine, metabolic health, and lifestyle-based care. Outside the clinic, Ashley is a dedicated weightlifter who lives an active lifestyle focused on performance, longevity, and sustainable health alongside her family. Learn more about Ashley and the Iron DPC team: https://www.irondpc.com/about-usVisit Iron DPC: https://www.irondpc.com #WomensHealth #HormoneOptimization #Menopause #IronDPC #FunctionalMedicine #BioidenticalHormones

Kratom and suboxone treatment by Neil Nipper MD at the FAPA conference in Daytona Beach June 26, 2026.As always, if interested in our HRT course please pre register via the linkhttps://docs.google.com/forms/d/1GoX_B7V9PxZGAPch8_MeRED5WLIVKghqSMwFhqNJo1E/edit

Hormone health is one of the most misunderstood areas of medicine. In this episode, I sit down with Dr. Salome Masghati, MD, FACOG, a board-certified OB/GYN, fellowship-trained minimally invasive gynecologic surgeon, and functional medicine practitioner, to discuss the science of optimizing women's health through evidence-based hormone therapy. Dr. Masghati combines traditional gynecology with preventive, longevity-focused care and has extensive experience helping women navigate perimenopause, menopause, fertility, and individualized hormone optimization.

Together we explore:

• Why women feel "different" in their 30s, 40s, and beyond
• Perimenopause vs. menopause—what's actually happening?
• The truth about estrogen, progesterone, and testosterone
• Common myths surrounding hormone replacement therapy (HRT)
• Estrogen's role in cardiovascular, brain, and bone health
• Sexual wellness and quality of life
• Individualized hormone therapy vs. one-size-fits-all protocols
• Functional medicine and evidence-based women's healthcare
• Longevity medicine and optimizing health for decades to come

Whether you're experiencing fatigue, brain fog, weight changes, low libido, sleep problems, mood changes, or simply want to better understand your hormones, this conversation is packed with practical information and current medical evidence.

Guest
Dr. Salome Masghati, MD, FACOG
Board-Certified OB/GYN • Fellowship-Trained Gynecologic Surgeon • Anti Aging Medicine
Learn more about Dr. Masghati:
Dr. Salome Masghati's website

Follow Dr. Masghati:
Instagram: @drsalomemasghatimd

Host
Stefan Hartmann, PA-C
CEO, Iron Direct Primary Care

Learn more about Iron Direct Primary Care:
Iron Direct Primary Care

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Disclaimer: This podcast is for educational purposes only and should not be considered personal medical advice. Please consult your healthcare professional before making changes to your treatment plan.

Can we eliminate the leading cause of death and disability? Medicine in 2026 is changing faster than ever before—and the evidence for aggressive lipid lowering has never been stronger.In this lecture for the Osteopathic Society of Integrative Medicine, I review the latest science behind lipid-lowering therapy, ApoB reduction, plaque regression, and cardiovascular prevention. We'll explore why the goal of modern preventive medicine isn't just helping people live longer—it's helping them stay healthier, stronger, and independent for more years.Topics include:Why ApoB is the true driver of atherosclerosisThe newest evidence on LDL and ApoB targets for plaque stabilization and regressionStatins, ezetimibe, PCSK9 inhibitors, bempedoic acid, inclisiran, and combination therapyWhy morbidity (heart attacks, strokes, disability, hospitalizations) matters just as much as mortalityThe evidence from tens of millions of patient-years demonstrating reductions in cardiovascular eventsPrimary prevention vs. secondary preventionHow lipid lowering fits into the broader field of human optimization and longevity medicinePractical strategies for implementing evidence-based prevention in everyday clinical practiceThis lecture challenges outdated approaches to cardiovascular prevention and demonstrates why aggressively treating atherosclerosis before symptoms develop may be one of the most powerful interventions available in modern medicine.Because the goal isn't simply adding years to life—it's adding life to years.If you enjoy evidence-based discussions on preventive cardiology, longevity medicine, hormone optimization, and primary care, be sure to Like, Subscribe, and Share.

Learn the principles of wound management in this lecture by Karla McNish at the FAPA conference in Daytona Beach June 27th 2026.As always if interesting in learning and applying HRT pre register for our course here https://docs.google.com/forms/d/1GoX_B7V9PxZGAPch8_MeRED5WLIVKghqSMwFhqNJo1E/edit

It's 9am Monday in clinic the chief complaint for your first patient is Fatigue, Anxiety, joint aches in morning and eczema. Time to unpack all of this and create a comprehensive functional approach to optimize this patient. Join Stefan Hartmann PA-C and CEO of Iron Direct Primary Care on this journey of learning Anti Aging Medicine in Primary Care.This was the first lecture at the Daytona Beach FAPA conference on June 26th 2026 by Stefan HartmannIf you'd like to learn HRT and apply it every day then pre register for our HRT course https://docs.google.com/forms/d/1GoX_B7V9PxZGAPch8_MeRED5WLIVKghqSMwFhqNJo1E/edit

In this powerful episode of the Iron Direct Primary Care Podcast, Ashley Curtis NP and Stefan Hartmann PA welcome Dori Grace, founder of Somatics & Soul, for an eye-opening conversation on somatic release breathwork, nervous system regulation, and coming home to your body.Dori shares her personal journey from years of living “in her head” with high-functioning anxiety and overthinking to the transformative moment breathwork and somatics brought her back into her body. She explains the hidden struggles so many successful people face — looking great on the outside while feeling dysregulated, exhausted, or emotionally stuck on the inside.

What You’ll Learn: Simple explanation of somatic breathwork and nervous system regulationHow the nervous system works (fight/flight/freeze vs. rest & digest) and why it matters for your healthThe role of polyvagal theory and vagus nerve tone in healing anxiety, inflammation, and burnoutEasy at-home breath and somatic practices you can start todayThe powerful synergy between cold exposure (fresh off a 34°F Morozko Ice Bath plunge) and breathworkHow somatic tools perfectly complement Direct Primary Care for metabolic health, autoimmune issues, sleep problems, chronic stress, and athletic recoveryBig Announcement: Iron DPC is thrilled to welcome Dori Grace onboard! She will now be offering somatic release breathwork sessions and nervous system regulation services directly at our office. This is a game-changer for our patients who want integrated root-cause care that includes both body and nervous system healing.Dori also shares real client transformations, what her group workshops and corporate sessions look like, how she helps people release old trauma patterns safely, and clears up common misconceptions about breathwork and somatics. Book sessions through the website or through the elation portal for Iron DPC members. https://www.irondpc.com/breathwork-nervous-system-regulation-doriClosing Advice: One powerful piece of wisdom for anyone feeling overwhelmed and disconnected from their body right now, plus rapid-fire questions on morning vs. evening breath techniques, ice bath + breathwork order, recommended resources, and more. If you’re ready to move beyond just managing stress and truly regulate your nervous system, this episode is for you.