Summary
The Drive podcast provides a comprehensive understanding of atherosclerotic cardiovascular disease (ASVCD), cholesterol, and apob in this special episode. ASVCD is the most common chronic disease that affects longevity and is ubiquitous. Over 50% of men and one-third of women will have their first cardiac event before the age of 65. Cholesterol is essential for the body, and it contributes heavily to the cell membrane of virtually every cell in the body. It is necessary to create bile acids, which are necessary to digest food. Most of the cholesterol in the bloodstream is made by the body and transported between cells through lipoproteins. Atherosclerosis is a disease that begins in the tissue and develops in the arteries. The 10-year risk approach to preventing atherosclerosis is flawed because it makes prevention of premature disease almost impossible. The causal benefit model measures non-hdl or apob and projects the risk over 20 or 30 years.
The speaker emphasizes the importance of measuring APO B in order to fully evaluate the risk of heart disease. APO B is a more accurate index of risk than LDL cholesterol and VLDL cholesterol because it measures the number of atherogenic particles in the blood, which is a better predictor of disease than just measuring cholesterol levels. The speaker also explains the concept of mendelian randomization, which allows for a more causal relationship between genes and disease outcomes. The conversation revolves around the relationship between apob concentration and atherosclerosis. The speaker explains that hypertension weakens the endothelium, and the presence of APO B-bearing particles in injured endothelium begins the destructive trajectory of taking cholesterol into the sub-endothelial space. Particle number is a major factor that might force atherosclerosis, but not always.
In this podcast episode, the speaker discusses the importance of lowering apob levels to reduce the risk of atherosclerotic cardiovascular disease (ASCVAD). They explain that the current guidelines recommend a 50% reduction in apob levels as the most effective way to reduce risk, but there is little information on the risk reduction of lowering levels below 60 milligrams per deciliter. The speaker suggests that lowering apob levels to under 50 milligrams per deciliter is the most effective way to reduce risk and that this should be done early on in life, possibly in the 20s. They also explain the different pools of cholesterol in the body and how reducing apob levels in the plasma does not necessarily mean a significant reduction in total body cholesterol. The speaker recommends measuring apob instead of LDL cholesterol as a better indicator of risk and suggests treating apob levels aggressively to prevent ASCVAD. Overall, the podcast aims to provide listeners with a better understanding of the topic and identify past episodes to listen to for more in-depth content.
