The Proof with Simon Hill Why Heart Disease Happens Even When You’re 'Doing Everything Right' | Dr Thomas Dayspring, Md and Dr Dan Soffer, Md
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Jul 21, 2025 
Dr. Thomas Dayspring, a lipidologist with a focus on cardiovascular disease prevention, and Dr. Dan Soffer, a specialist in cardiovascular health, dive deep into heart disease despite seemingly healthy lifestyles. They discuss the insights from a coronary CT angiogram and the importance of advanced lipid testing tools like ApoB and Lp(a). Misconceptions about 'normal' bloodwork are tackled, alongside the role of lifestyle changes versus medication. Their conversation emphasizes early intervention and proactive management for long-lasting heart health.
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Early Plaque Indicates Elevated Risk
- Any plaque above zero before age 44 means you are in the higher than 50th percentile for plaque volume.
- Imaging is useful because it integrates risk factors we cannot fully measure otherwise.
LDL Cholesterol's Role in Atherosclerosis
- LDL cholesterol is the vehicle delivering cholesterol to artery walls causing foam cells and atherosclerosis.
- LDL cholesterol alone cannot fully predict arterial wall health because many subtle factors influence plaque.
Use Imaging to Guide Treatment
- Imaging confirms presence and severity of atherosclerosis and helps guide intensity of treatment.
- Early biomarkers and lifestyle changes can prevent progression before significant plaque appears.