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