The Metabolic Classroom with Dr. Ben Bikman

Drugs for Cardiovascular Health with Dr. Ben Bikman

Feb 29, 2024

Dive into the world of cardiometabolic drugs that target heart disease, a leading cause of death. Discover the complexities of blood pressure regulation, comparing it to a balloon that can burst under pressure. Learn about the various classes of antihypertensive medications and their potential effects on insulin resistance. The podcast also challenges the common perceptions of cholesterol, proposing that it might not be the villain it's made out to be, and suggests a surprising link between higher cholesterol levels and longevity.

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INSIGHT

Cardiovascular Drug Categories

Two main cardiovascular drug categories exist: blood pressure and cholesterol medications.
High blood pressure, linked to heart attacks, damages blood vessels like overinflating a balloon.

INSIGHT

Drug Impacts and Study Limitations

Dr. Bikman emphasizes the impact of cardiovascular drugs on insulin resistance and mitochondrial function.
He highlights the limitations of studies on these drugs due to the inability to control all human variables.

INSIGHT

Beta Blockers and Their Effects

Beta blockers, targeting the sympathetic nervous system, can cause fatigue, sleep disturbances, and cold extremities.
They may worsen insulin resistance, especially in individuals with type 2 diabetes.

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In this week's episode of the Metabolic Classroom, Dr. Ben Bikman welcomes viewers to a discussion on commonly used cardiometabolic and weight loss drugs. The focus of this particular lecture is on drugs targeting heart disease, a leading cause of mortality globally. Dr. Bikman acknowledges the controversy surrounding cardiovascular drugs due to the severity of heart disease and the passionate advocacy for drug therapies.

The lecture begins with an overview of two main categories of cardiovascular drugs: those addressing blood pressure and those targeting cholesterol levels. Dr. Bikman explains the significance of blood pressure in cardiovascular health, emphasizing its correlation with heart attacks and hypertension. He delves into the physiological effects of high blood pressure, likening it to over-inflating a balloon and causing stress and damage to the inner lining of blood vessels.

Moving on to drugs that control blood pressure, Dr. Bikman highlights the potential impact on insulin resistance and mitochondrial function, crucial factors in heart disease risk. He discusses common classes of antihypertensive drugs such as beta blockers, ACE inhibitors, calcium channel blockers, and diuretics, detailing their mechanisms and side effects.

Transitioning to cholesterol-lowering drugs, Dr. Bikman discusses the controversy surrounding the assumption that cholesterol is solely responsible for heart disease. He challenges the oversimplified view of LDL cholesterol's role in plaque formation and suggests alternative paradigms, including the immune response to infections in blood vessels.

Dr. Bikman then discusses two classes of anti-cholesterol medications: PCSK9 inhibitors and statins. He explains how PCSK9 inhibitors increase LDL receptor expression to enhance LDL clearance and discusses potential side effects such as worsened insulin resistance and mitochondrial dysfunction. Finally, he explores the mechanism of statins in reducing cholesterol production and addresses controversies surrounding their use, including potential risks of developing type 2 diabetes and Alzheimer's disease.

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Learn more at: Insulin IQ

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