• Big Picture: The Cardiometabolic Web Learning objectives:
• Differentiate a systems-based cardiometabolic framework from traditional siloed approaches to cardiovascular and metabolic disease management.
• Describe how pattern recognition across metabolic, inflammatory, vascular, and adipose pathways enhances early cardiometabolic risk identification.
• Identify lifestyle- and nutrition-based intervention targets that influence cardiometabolic risk trajectories.
• Identify common cardiometabolic risk patterns—including insulin resistance, chronic inflammation, endothelial dysfunction, and adipose tissue dysregulation—even when standard laboratory values appear within reference ranges.

2. Diabetes + Insulin Resistance Core Learning objectives:

• Describe the continuum from insulin resistance and prediabetes to overt type 2 diabetes, emphasizing early metabolic dysfunction prior to diagnostic thresholds.
• Recognize hyperinsulinemia as a primary driver of cardiometabolic risk, even in the absence of elevated fasting glucose or A1C.
• Identify common clinical patterns of dysglycemia, including postprandial glucose abnormalities and discordance between fasting glucose and A1C values.
• Apply pattern-based interpretation of glucose and insulin markers to improve early risk detection and clinical decision-making.

3. Liver: NAFLD/MASLD/MASH as a Risk Engine Learning objectives:

• Recognize fatty liver disease as a central driver of cardiometabolic risk rather than an isolated hepatic condition.
• Interpret liver enzymes within the broader context of metabolic, lipid, and glucose abnormalities.
• Identify patients with discordant laboratory findings in whom cardiometabolic risk may be underestimated.
• Apply practical risk stratification strategies to determine when further evaluation or escalation of workup for fatty liver disease is warranted.

4. Heart Disease Applications Learning objectives.

• Apply a cardiometabolic framework to the clinical assessment of coronary artery disease (CAD) and atherosclerotic cardiovascular disease (ASCVD).
• Explain the metabolic contributions to heart failure with preserved ejection fraction (HFpEF) and identify patient characteristics in which this framework is most clinically relevant.
• Recognize cardiovascular symptoms and red flags that warrant urgent evaluation or escalation of care within a cardiometabolic risk context.
• Describe key components of cardiometabolic optimization for patients with established cardiovascular disease, including lifestyle, metabolic, and risk-modifying strategies.

5. Related Metabolic Dysfunction: Obesity, Metabolic aging, PCOS, Osteoporosis, Cancer, and More Learning objectives:

• Recognize polycystic ovary syndrome (PCOS) as a phenotype of insulin resistance and metabolic dysfunction and identify key assessment priorities.
• Explain the concept of cancer as a metabolically influenced disease using a high-level, system-based framework.
• Discuss bone as a metabolically active organ and explain how metabolic dysfunction contributes to osteopenia and osteoporosis.
• Apply pattern recognition across conditions to inform upstream cardiometabolic risk assessment and intervention priorities.

6. Pharmacology for Cardiometabolic Care Learning objectives:

• Compare the mechanisms, clinical indications, and selection logic for key cardiometabolic pharmacotherapies, including metformin, GLP-1 receptor agonists, dual incretin therapies, and SGLT2 inhibitors.
• Apply high-level decision rules to lipid-lowering therapies—statins, ezetimibe, niacin, PCSK9 inhibitors, and bempedoic acid—based on cardiometabolic risk profiles.
• Identify first-line antihypertensive medication classes and distinguish metabolically neutral or favorable options in patients with cardiometabolic dysfunction.
• Recognize common medication-related adverse effects that may impair metabolic progress, adherence, or quality of life.
• Implement evidence-informed strategies to mitigate medication-related side effects while maintaining therapeutic benefit.
• Integrate pharmacologic therapy with lifestyle and nutritional interventions using a complementary—not either/or—approach to cardiometabolic care.

8. Dyslipidemia + ASCVD Risk Beyond LDL Learning objectives:

• Compare LDL-cholesterol, non-HDL cholesterol, and apolipoprotein B (ApoB) as markers of atherogenic lipoprotein burden and ASCVD risk.
• Explain the role of triglyceride-rich lipoproteins and remnant cholesterol in residual cardiovascular risk.
• Identify lipid patterns associated with insulin resistance, including increased particle burden despite “normal” LDL-C levels.
• Summarize key principles of atherosclerosis pathophysiology relevant to clinical risk assessment and management.
• Differentiate patients who may benefit from aggressive lipid-lowering strategies from those appropriate for a more conservative, risk-based approach.

9. Hypertension + Vascular Health Learning objectives.

• Explain the metabolic mechanisms contributing to hypertension, including the roles of insulin resistance, sympathetic nervous system activation, the renin–angiotensin–aldosterone system (RAAS), and altered sodium handling.
• Describe how endothelial dysfunction and arterial stiffness contribute to blood pressure elevation and vascular risk.
• Identify secondary or contributing factors to hypertension that warrant further evaluation in patients with cardiometabolic dysfunction.
• Interpret blood pressure measurements using home readings and ambulatory patterns to distinguish white coat hypertension, masked hypertension, and sustained hypertension.
• Apply a cardiometabolic framework to blood pressure assessment to inform appropriate monitoring and management strategies.

10. Gut–Heart–Metabolism Connection Learning objectives:

• Describe how key gut-derived metabolites—including bile acids, short-chain fatty acids (SCFAs), and trimethylamine N-oxide (TMAO)—influence cardiometabolic physiology.
• Explain the role of intestinal permeability and gut-driven inflammation as amplifiers of cardiometabolic risk.
• Identify nutrition and dietary strategies that favorably modify gut-derived cardiometabolic signaling pathways.
• Differentiate clinical scenarios in which gut-focused interventions meaningfully support cardiometabolic outcomes from those in which they are unlikely to add value.
• Integrate gut-related mechanisms into a balanced, evidence-informed cardiometabolic care strategy.

11. Functional Drivers: Mitochondria, Hormones, Environment Learning objectives:

• Explain the clinical relevance of mitochondrial function and metabolic flexibility in cardiometabolic health and disease.
• Describe key intersections between hormone signaling—including thyroid function, stress physiology (cortisol), and sex hormones—and cardiometabolic risk.
• Discuss how sleep quality and circadian rhythm disruption influence metabolic regulation, insulin sensitivity, and cardiovascular risk.
• Identify environmental exposures, including endocrine-disrupting chemicals, that may contribute to cardiometabolic dysfunction.
• Integrate functional drivers such as mitochondrial health, hormonal balance, circadian alignment, and environmental inputs into a comprehensive cardiometabolic assessment framework.

12. Nutrition + Lifestyle Rx That Moves Outcomes Learning objectives:

• Identify dietary patterns with the strongest evidence for improving cardiometabolic outcomes.
• Apply practical nutrition strategies—including protein and fiber timing, glycemic control, and meal sequencing—to support metabolic health.
• Differentiate physical activity modalities (resistance training, walking, zone 2 aerobic activity) based on their relative impact on cardiometabolic risk.
• Prescribe sleep and stress interventions as clinical tools to support metabolic and cardiovascular health.
• Utilize minimal effective dose frameworks to design realistic, sustainable nutrition and lifestyle interventions.
• Evaluate the appropriate role of wearable technology in monitoring and supporting cardiometabolic behavior change.

13. Nutraceuticals: Top Evidence-Based Nutraceuticals for CM Health Learning objectives:

• Identify common cardiometabolic medications associated with drug-induced nutrient depletion (DIND) and determine when targeted nutrient repletion is clinically appropriate.
• Explain the adjunctive role of nutraceuticals in supporting cardiometabolic pathways alongside lifestyle and pharmacologic therapy, rather than as standalone treatment.
• Apply a pattern-driven approach to nutraceutical selection by matching interventions to dominant cardiometabolic patterns such as insulin resistance, dyslipidemia, hypertension, and fatty liver disease.
• Describe the primary mechanisms of action for selected evidence-based nutraceuticals that influence insulin signaling, lipid metabolism, vascular function, and hepatic health. Integrate nutraceutical strategies into comprehensive cardiometabolic care plans using an evidence-informed, risk-appropriate framework.