Preventative Cardiology with Dr. Matthew Budoff: Rational Wellness Podcast 434

Oct 30, 2025

Dr. Matthew Budoff, a renowned preventative cardiologist, dives into cutting-edge advancements in cardiovascular health. He discusses the importance of lipids in disease prevention and introduces bempedoic acid as a powerful statin alternative. Insights on the benefits of purified EPA fish oil and the effects of testosterone on cardiovascular risks are explored. Plus, he highlights the promising outcomes of aged garlic extract for coronary health and the impact of red yeast rice and citrus bergamot on cholesterol management.

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INSIGHT

LDL Is The Biggest Modifiable Risk

LDL cholesterol represents the largest modifiable opportunity to reduce cardiovascular risk according to large population data.
Addressing lipids alongside smoking and blood pressure can reduce risk by roughly 90% when combined with other fixes.

ADVICE

Use Bempedoic Acid When Statins Aren't Tolerated

Consider bempedoic acid (Nexletol) for patients intolerant of statins or who want fewer muscle/brain side effects.
Combine bempedoic acid with ezetimibe to amplify LDL lowering toward statin-like reductions.

ADVICE

Prefer Purified EPA Over Mixed Fish Oils

Use purified EPA (not mixed EPA+DHA) at trial doses (~4 g/day prescription) to reduce cardiovascular events on top of statins.
Prefer prescription-grade, highly purified EPA formulations rather than over-the-counter mixed fish oils for outcome benefits.

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View the Show Notes For This Episode

Dr. Matthew Budoff discusses Preventative Cardiology with moderator Dr. Ben Weitz at the Functional Medicine Discussion Group meeting on September 25, 2025. This was the second annual Dr. Howard Elkin memorial Preventative Cardiology lecture.

[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]

Podcast Highlights

Functional Medicine, Preventative Cardiology, and the Latest in Supplement Research with Dr. Matthew Budoff In this episode of the Rational Wellness Podcast, Dr. Ben Weitz discusses the latest advancements in functional medicine and preventative cardiology. He hosts Dr. Matthew Budoff, a preventative cardiologist and published researcher, to delve into heart scans, the significance of lipids, and alternative therapies for managing cardiovascular health. Dr. Budoff covers a range of topics including the benefits of Bempadoic acid, the impact of testosterone on heart disease, the efficacy of fish oils, and the potential of aged garlic extract for slowing coronary calcium progression. They discuss studies on red rice yeast, citrus bergamot, and the mechanisms of various supplements in managing cholesterol and reducing cardiovascular risks. The episode also touches on the implications of iron and nitric oxide levels on heart health. 00:00 Introduction to the Rational Wellness Podcast 00:26 Functional Medicine Discussion Group Overview 01:40 Remembering Dr. Howard Elkin 02:10 Introduction to Dr. Matthew Budoff 02:30 Understanding Cardiovascular Scans 03:04 The Importance of Lipids in Cardiovascular Health 05:46 Alternative Lipid-Lowering Therapies 12:13 The Role of EPA in Cardiovascular Health 21:13 Testosterone and Cardiovascular Risks 25:59 Garlic Supplements for Heart Health 33:51 Garlic's Impact on Calcium Regression 34:08 Dosage and Tolerance of Garlic Supplements 35:10 Clinical Trials and Blood Pressure Benefits 36:30 Historical and Modern Uses of Garlic 37:06 Comparing Garlic Forms and Consistency 41:15 Red Yeast Rice and Its Benefits 47:08 The Role of Niacin and Other Supplements 49:12 Chelation Therapy and Other Treatments 49:40 The Importance of Prevention in Cardiology 50:19 Endothelial Health and Natural Compounds 53:00 CT Angiograms and Plaque Analysis 01:00:11 Iron Levels and Heart Disease 01:02:22 Conclusion and Podcast Information

Dr. Matthew Budoff is a professor of medicine at the David Geffen School of Medicine at UCLA, Program Director and Director of Cardiac-CT, Division of Cardiology, Harbor-UCLA Medical Center and he is an investigator with The Lundquist Institute https://lundquist.org/matthew-budoff-md. Dr. Budoff's research is devoted to advancing procedures that can help doctors identify patients early that are at high-risk for cardiac events and progression of atherosclerosis. This early detection can lead to patients being placed on the correct therapeutic path to prevent a heart attack. Additionally, Dr. Budoff's research focuses on determining the effect of different therapies on atherosclerosis and determine if heart disease can be reversed. His office is in Torrance, California and his office number is 310-222-2773.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.