Identifying Cardiovascular Risk Factors Beyond LDL Cholesterol

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The discordance between APOB and LDL cholesterol shows that APOB is a better indicator of cardiovascular risk. While low LDL cholesterol may seem good, if APOB is high, there is an unidentified risk. HDL cholesterol, once deemed 'good cholesterol,' does not directly contribute to atherosclerosis like LDL, but low HDL levels still pose a significant risk for heart disease. Attempts to raise HDL cholesterol through drugs have failed to show cardiovascular benefits, indicating that focusing solely on HDL levels may not be effective in reducing cardiovascular risk.

Episode #252. In Part One of the blood lipids series, you learned what lipids are and how they work. In Part Two, Dr Thomas Dayspring returns to talk about the individualised testing you can get to understand where your lipids are now. Discover the tests you need, the ones you don’t, and when to start testing to protect yourself against atherosclerotic cardiovascular disease.

We discuss:

Intro (00:00)
What is Lp(a), and why do you need it checked? (02:05)
Does diet influence Lp(a)? (20:36)
The oxidized phospholipid test (29:00)
Early intervention and atherosclerosis screening for children (31:24)
The tests are helpful in predicting cardiovascular disease risk (40:27)
Discordance between ApoB and LDL-cholesterol (52:35)
Normal range of ApoB levels for a healthy young person (1:03:14)
Does atherosclerotic plaque ever disappear? (1:16:52)
Triglyceride: HDL ratio vs ApoB test (1:22:15)
Screening women in their 30s (1:29:31)
Screening women in their 70s (1:37:23)
What causes elevated ApoB (1:39:25)
Do phytosterols help manage cholesterol? (1:58:55)
Secondary prevention (2:07:08)
The obviously misunderstood case of ApoB (2:20:45)
Outro (2:22:35)

Next week, we’ll discuss in detail the interventions you can make to optimise your lipids. Make sure to stay connected via my social links below so you don’t miss Part Three.

The best place to connect with Dr Thomas Dayspring is on Twitter, @DrLipid. Learn more about Dr Dayspring’s career and current work on LinkedIn.

Discover more insights and supporting studies in the full show notes.

To assist with the digestibility of this content my team and I, along with Dr Dayspring, have added a bunch of illustrations and graphs to the video format of these episodes. So if you are visually inclined you can watch these episodes on our YouTube channel. Even if you prefer listening to the first time through audio, I highly recommend coming back for a second pass with the video versions.

Get your copy of the Lipid Series Cheat Sheet at theproof.com/lipidseries. This comprehensive resource provides valuable insights on assessing your risk, preventing, and treating atherosclerotic cardiovascular disease (ASCVD), the leading cause of death worldwide. The PDF not only highlights key learnings from the 3-Part Lipid Series but also includes a 1-week meal plan designed to promote healthy cholesterol levels.

Enjoy, friends.

Simon

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Simon Hill, MSc, BSc (Hons)

Creator of theproof.com and host of The Proof with Simon Hill

Author of The Proof is in the Plants

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