The Proof with Simon Hill

Preventing and treating cardiovascular disease (Lipid Series - Part 3) | Dr Thomas Dayspring

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Mar 27, 2023
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INSIGHT

Lifestyle Helps But Drugs Needed

  • Lifestyle improvements reduce many chronic diseases, but cannot eliminate atherosclerotic heart disease entirely.
  • Pharmacological interventions are necessary to achieve physiologic ApoB levels seen in children.
INSIGHT

Statins' Key Mode of Action

  • Statins inhibit cholesterol synthesis mainly in the liver to upregulate LDL receptors.
  • Most LDL cholesterol/ApoB reduction occurs at the lowest statin dose; higher doses yield smaller incremental benefits.
ADVICE

Use Desmosterol to Monitor Brain Risk

  • Monitor serum desmosterol to gauge brain cholesterol synthesis when on statins.
  • Stop statin dose escalation if desmosterol approaches the 20th percentile to avoid cognitive risks, especially in dementia-prone individuals.
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