The Drive with Peter Attia — Ron Kraus

On: A deep dive into heart disease.

Episode: 3

Date: July 2018

Key Subjects:

  • See Cholesterol write-up.
  • Importance of measuring LDL particle number vs LDL volume (which is what you get in a standard lipid test).
    • The LDL volume and LDL particle count may not always align.
  • Combination of (i) elevated levels of LDL plus (ii) inflammation and (iii) arterial damage increases risk of CVD.
  • Size of LDL particles – seems important, but not as important as number of particles.
  • Statins:
    • Lower LDL by preventing LDL synthesis in the liver, as well as by upregulating LDL clearance through LDL receptors.
    • Don’t work well on Lp(a); specifically, they doesn’t activate the LDL receptors that clear Lp(a).
    • Can have substantial side-effects.
  • PCSK9 inhibitors upregulate LDL receptors and work well to lower Lp(a).
  • Niacin lowers apoB/LDL, increases HDL and lowers Lp(a).
    • Trials, however, have not shown efficacy in reducing cardiovascular disease
    • Side-effect include raising insulin resistance.

Key Takeaways:

  • Meausre LDL-P count and Lp(a).
  • Supplement brand recommendation: Jarrow.

Worth Listening:

  • 7/10

Leave a Reply