logo
episode-header-image
Oct 2022
1h 18m

#229 ‒ Understanding cardiovascular dise...

Peter Attia, MD
About this episode

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter's Weekly Newsletter

In this special episode of The Drive, we have pulled together a variety of clips from previous podcasts about cardiovascular disease to help listeners understand this topic more deeply, as well as to identify previous episodes which may be of interest. In this episode, Peter highlights the importance of understanding cardiovascular disease and why early intervention is critical. He also provides a primer on lipoproteins and explains the fallacy of the terms "good cholesterol" and "bad cholesterol." Allan Sniderman discusses the metrics measured in routine blood work – along with the limitations of those standard panels – before explaining why apoB is a superior metric for determining risk. Additionally, Tom Dayspring explains the causal role of apoB in atherosclerotic cardiovascular disease (ASCVD) and the therapeutic goals for apoB concentration, and Peter explains how early and aggressive lowering of apoB could change the landscape of cardiovascular disease prevention.

We discuss:

  • The importance of understanding atherosclerosis early in life [2:25]
  • Defining ASCVD, its causes, and the role of cholesterol [8:00];
  • Why early prevention of atherosclerosis is critical [13:45];
  • Preventing atherosclerosis—two fatal flaws with the "10-Year Risk" approach [16:00];
  • Intro to lipids and lipoproteins: why there is no "bad" or "good" cholesterol [23:00];
  • Limitations of standard blood panels [35:45];
  • How Mendelian randomization is bolstering the case for apoB as the superior metric for risk prediction [39:30];
  • Therapeutic goals for apoB concentration [58:15];
  • How early and aggressive lowering of apoB could change the course of ASCVD [1:10:45]; and
  • More.

Connect With Peter on TwitterInstagramFacebook and YouTube

Up next
Today
The impact of gratitude, serving others, embracing mortality, and living intentionally | Walter Green (#288 rebroadcast)
<p><a href= "https://peterattiamd.com/waltergreen/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251124-pod-waltergreen&utm_content=251124-pod-waltergreen-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href= "https://peterattiamd.com/subscribe/?utm_s ... Show More
1h 31m
Nov 17
#373 – Thyroid function and hypothyroidism: why current diagnosis and treatment fall short for many, and how new approaches are transforming care | Antonio Bianco, M.D., Ph.D.
<p><a href= "https://peterattiamd.com/antoniobianco/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=251117-pod-antoniobianco&utm_content=251117-pod-antoniobianco-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href= "https://peterattiamd.com/subscribe/ ... Show More
2h 20m
Nov 10
#372 - AMA #77: Dietary fiber and health outcomes: real benefits, overhyped claims, and practical applications
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter In this "Ask Me Anything" (AMA) episode, Peter breaks down the science of dietary fiber, moving beyond the blanket advice to "eat more fiber" to unc ... Show More
24m 14s
Recommended Episodes
Dec 2023
#085 Dr. Peter Attia on Mastering Longevity – Insights on Cancer Prevention, Heart Disease, and Aging
<p><a href= "https://bdnfprotocols.com?utm_campaign=vig_ex_podcast&utm_medium=podcast&utm_source=podcast_description"> Download the 9-Page "<strong>Cognitive Enhancement Blueprint</strong>"</a></p> <p dir="ltr"><a href= "https://www.foundmyfitness.com/aliquot?utm_campaign=peter_a ... Show More
3h 59m
Feb 2024
Demystifying Cholesterol and Cardiometabolic Health #376
<p dir="ltr">The conversation around cholesterol has been clouded with misconceptions for years…</p> <p dir="ltr">Recently, however, a clearer narrative has emerged, shedding light on the importance of understanding cholesterol beyond the simplistic labels of "good" and "bad."</p ... Show More
1h 15m
Jun 2024
#525: Cholesterol-Lowering Medication – Dr. Paddy Barrett
<p>Cholesterol-lowering medications, particularly statins, play a pivotal role in reducing low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) concentrations, which are causal markers in atherosclerosis development. The efficacy of these medications is well-do ... Show More
48m 29s
May 2022
Addressing The Root Cause Of Heart Disease
This episode is brought to you by BiOptimizers, Cozy Earth, and Rupa Health. Insulin resistance is a main driver of cardiovascular disease that we don’t hear enough about. Paying attention to our sugar and starch intake, eating plenty of healthy fats and vegetables, and getting e ... Show More
54m 3s
Dec 2022
158 - PADing Your Understanding of Peripheral Arterial Disease: A Brief Treatment Overview
In this episode, we will discuss all things peripheral arterial disease – definitions, staging, clinical presentation, risk factors, goals of therapy, and guideline-directed medication therapy recommendations including the newest evidence for the use of DOACs. Key Concepts Addres ... Show More
49m 23s
Oct 2023
341. Guidelines: 2021 ESC Cardiovascular Prevention – Question #35 with Dr. Melissa Tracy
The following question refers to Section 4.9 of the 2021 ESC CV Prevention Guidelines. The question is asked by Dr. Christian Faaborg-Andersen, answered first by UCSD fellow Dr. Patrick Azcarate, and then by expert faculty Dr. Melissa Tracy. Dr. Tracy is a preventive cardiologist ... Show More
7m 5s
Mar 2022
191. Guidelines: 2021 ESC Cardiovascular Prevention – Question #5 with Dr. Laurence Sperling
The following question refers to Section 4.10 of the 2021 ESC CV Prevention Guidelines. The question is asked by CardioNerds Academy Intern student Dr. Christian Faaborg-Andersen, answered first by UCSD fellow Dr. Patrick Azcarate, and then by expert faculty Dr. Laurence Sperling ... Show More
11m 22s
Jul 2022
224. Atrial Fibrillation: Assessment of Stroke & Bleeding Risk with Dr. Elaine Hylek
CardioNerds (Amit Goyal), Dr. Colin Blumenthal (CardioNerds Academy House Faculty Leader and FIT at the University of Pennsylvania), and Dr. Anjali Wagle (CardioNerds Ambassador and FIT at Johns Hopkins University), discuss the baseline assessment of stroke and bleeding risk in p ... Show More
1h 15m
Mar 2023
Improve Vitality, Emotional & Physical Health & Lifespan | Dr. Peter Attia
In this episode, my guest is Peter Attia, M.D. He completed his medical and advanced training at Stanford University School of Medicine, Johns Hopkins School of Medicine and the National Institutes of Health (NIH). Dr. Attia is host of the health and medicine podcast, The Drive,  ... Show More
3h 25m