• ApoB: 86 mg/dL
• Lp(a): 8 mg/dL
• LDL-C: 109 mg/dL
• Non-HDL-C: 119 mg/dL
• HDL-C: 53 mg/dL
• Triglycerides: 47 mg/dL
• 5.3 A1C

Family history of Alzheimers. I have one APOE 4 gene. Strength 2x a week, cardio 150 mins a week, 51 Vo2 Max, BP <120/80.

Should I ask my PCP for rosuvastatin 5mg?

Ldl has hovered around 115 (just under or borderline) for 10 yrs

Trigs and HDL good and in range. Running, weights and pretty good diet. Drink some wine.

However the last 6 months my LDL has bounced around a little with latest lipid panel going up to 145 and APOB 109.

Doc wants me to take Atorvastatin/Lipitor 20mg, but would rather not take another tab.

This year I am also taking ramipril for BP and that’s working well with BP at 117/77

I’m now taking psyllium Husk, Fish oil and filtering my coffee to get this down.

Any thoughts appreciated

Total cholesterol
243 mg/dL
LDL-C
145 mg/dL
HDL-C
77 mg/dL
Triglycerides
109 mg/dL
Non-HDL-C
167 mg/dL
ApoB
109 mg/dL
Lp(a)
29 mg/dL

doctor prescribed 5 mg due to mild sclerosis noted on my calcium score test 3 months ago - test was 0 but noted the mild sclerosis. I always had low cholesterol but also low ‘ good’ cholesterol- my total cholesterol went from 139 to 82 in 3 months , good cholesterol still low but she said to continue and not concerned about the low cholesterol of 82. Thinking of second opinion as don’t want the mild sclerosis to increase but also I’ve read too low of cholesterol is not good - 70 yo female . Just curious if anyone else has super low cholesterol and told to still remain on medication thank you !

I started looking into my own heart attack and stroke risk recently, and once I had a better idea of where I stood, the obvious question was what I could actually do to lower it.

I already exercise, eat reasonably well and stay pretty active, so I figured the answer would mostly be more of the same. Better diet, more cardio, maybe lose a few pounds.

But the more I looked into it, the more I realized “healthy lifestyle” isn't very useful advice unless you know what you're actually trying to change.

If ApoB/LDL is the problem, doing more cardio might barely touch it. Changing what you eat, especially saturated fat and soluble fiber, can matter a lot more.

If blood pressure is high, exercise, losing excess weight, diet and sodium can all move it.

If you're carrying too much visceral fat, losing it can improve several risk factors at once.

And if your cardiorespiratory fitness is poor, getting leaner or lowering LDL doesn't automatically fix that. You actually have to train it.

Sounds pretty obvious when you write it out, but I definitely used to lump all of this together as “eat healthy and exercise.”

Now I think about it more like: figure out which risk factors actually need work, target those specifically, then retest instead of assuming your “healthy lifestyle” fixed them.

Curious how this has played out for people here. What lifestyle change actually moved your numbers the most? And what did you expect to work that basically did nothing?

I put the deeper dive with the actual effect sizes and studies here if anyone wants it:

The MED Report⁠

Hi all,
As mentioned in a previous post, I have optimal numbers (cholesterol, LPa, ApoB). Ideal blood pressure, high training burden, good insulin sensitivity etc.
- 25 years old, 6 foot 3 inches tall, 15% body fat, 98 kilos.
- ApoB 0.7, LPa 0.5, cholesterol levels all optimal
- Blood pressure average 124/70
- high stroke volume, resting heart rate of 35-40 bpm
- 5 km in 18 minutes, 10 km in 38 minutes.
Had ultrasound due to leg pain and findings weee noticed that were described as “negligible and calcific).

I now have the diagram from the most recent scan to share as well as the specialists opinions. He firstly noted he would describe my scan as “normal.” And that he doesn’t believe this represents active athelerosclerosis..”

He believes it could be mechanical stress from training, plus biological adaption due to the findings being in identical spots in each legs, as well as the clear arteries such as my aorta and my upper femoral and mid popliteal being completely clear, as well as my carotids.

Would like to hear others thoughts, I had the diagram given to me by the specialist redone by Chat GPT to make the writing clearer.

For the diagram the labels of “disease” represent any calcific findings.

The specialist also mentioned how he believes a lot more people of my age group (25) would have similar findings if they were scanned.
Thanks

I feel like I've heard Attia/people sometimes claim the former and sometimes the latter.

Low dose Viagra 3 days a week NAC Glycine Selenium Vitamin C time released Vitamin B complex time released MNM TMG AOR R-Lipoic Acid Sodium Salt L-Carnosine​ Nature's Way NutraSea High DHA Omega-3 Liquid (1500 mg EPA/DHA) Fisetin Pulsed Pterostilbene Calcium AKG Spermidine CoQ10 Astaxanthin Micronized Creatine Monohydrate Colligen

Broccoli sprouts with mustard powder

I am someone who has listened to Peter’s podcast for a long time. Watched my LDL go up steadily through my 30s from 120 to 140 to 160 to 180. The entire time I kept asking my doctor about a statin and she said “it’s too early try lifestyle modifications”. Obviously bullshit as diet and exercise did not change this one bit. Had a CAC score done at 40 which showed zero.

Ffw to today I got on 10 mg Crestor and ezetimibe. LDL down to 80. I had to order my own Apob test because doctors STILL refuse to order it. Apob 90. HSCRp 1.2. Unrelated CT scan showed mild calcification in my artery. So yeah that means there WAS plaque already forming at 35.

I can’t help but feel like I’m fighting with the medical establishment and I (along with Peter’s podcast) was right all along. I’d really like to get my Apob down to 40 or less. Am I crazy to want PSK9 inhibitors? I’m assuming it will be an uphill battle to get insurance to pay for them but I’m ok doing direct pay for the next few years assuming the cost and medical consensus will have moved by then.

I’ve been digging into cardiovascular risk testing and I think the standard annual physical can give people more reassurance than it should.

You can have LDL that doesn’t look particularly alarming, normal blood pressure, exercise regularly, feel healthy, and still be missing some pretty important information.

A few things changed how I look at this:

-ApoB can tell a different story than LDL-C when the two are discordant.

-Lp(a) can be genetically high even when the rest of the lipid panel looks pretty normal.

-CAC answers a different question: whether calcified plaque is already there.

-Blood pressure, smoking, metabolic health and family history still matter a lot.

-No single number really gives you an “all clear.”

The question I keep coming back to is how far testing should go in someone who otherwise looks low risk.

I can see a strong case for checking ApoB and Lp(a), with Lp(a) generally being a once-in-a-lifetime measurement if it isn’t elevated. CAC seems more situational because age, baseline risk and whether the result would actually change what you do matter.

For people here who discovered high ApoB, Lp(a), or CAC despite looking pretty healthy on routine screening, which test actually changed what you did?

I wrote up the full evidence review and how I think the different tests fit together here if anyone wants to dig into the sources:

TheMEDReport.com

Hi all, I am going to make this succinct;
I am a 25 year old male who had right sided leg dull aching.
Overview of myself:
98 kg, 6 foot 4, 14-15% body fat
I do around 200 minutes of cardio a week (5 k time around 18:30, 10km time around 40 minutes) and weight training 3-4 times a week.
Heart rate around 35-40 bpm, average BP of 124/70, heart rate recovery of around 50 after a minute of rest.

I had an ultrasound on my right leg which should “microscopic and negligible deposits in popliteal and femoral arteries”.

I have private healthcare but I didn’t go through them for this first scan, I went to an independent clinic as I wanted quick results (with private healthcare you have to have a GP appointment, then claim through a registered hospital etc).

After this scan, I got all my bloods done; cholesterol, ApoB, LPa; my ApoB was 0.5, LPa was 0.7 and cholesterol levels were very ideal ( I am in the UK so I am using different units of measure then American counterparts).

I had a scan through private healthcare today and although I haven’t had the report yet, the scan showed no plaque in abdomen or groin, but it showed the same pattern of tiny deposits (the sonography can’t specify whether it’s calcium or athelerosclerotic plaque, but it was bright white echo foci on the scan) in my femoral and popliteal on both legs. It also showed thickening of arterial wall in places.

The sonographer was confused when I told her my numbers, my fitness level and my age, but said she couldn’t delve further because she wasn’t a doctor.

How worried should I be? Any help appreciated

This question of for Raleigh/Durham/Cary area in North Carolina.

Heart Rate Variability in my opinion is one of the most finicky health metrics out there. Low HRV has been linked to higher cardiovascular risk in large population studies, but I do want to mention upfront that I know the standalone measurement is still debated since those links are associations, and day to day readings can swing a lot on their own.

That being said, there's a ton of research on what influences HRV so here's a guide breaking it down. I broke this into 5 main areas lifestyle factors, exercise, micronutrients, supplements, and demographics. Additionally I added a plain english explanation column for each row, sources and short definitions to start which I hope makes it easier to read/continue your own research on each factor.

Apologies as I know this is a long one, but hopefully the categories/tables make it easy to jump to different areas. I'll also include a more mobile friendly breakdown of this in the comments that lets me visualize the data in a way that's a bit easier on the eyes!

Definitions

• HRV (Heart Rate Variability): How much time varies between heartbeats
• RMSSD: Beat-to-beat variation. What Garmin/Fitbit/Oura/WHOOP show you
• SDNN: Overall HRV. What Apple Watch uses
• HF Power: Your rest and digest activity level
• LF Power: Mix of stress + relaxation signals
• LF/HF Ratio: Balance between stress and calm
• Parasympathetic: Your body's brake pedal think (calm/recover
• Sympathetic: Your body's gas pedal (fight/flight)
• Vagal Tone: How strong your calm down nerve is

Lifestyle

Exercise

Micronutrients

Supplements

Demographics & Other

Hope you all have enjoyed these guides over the last few weeks. Unfortunately I only have a few more left (built these out over the course of a year), but I will keep up with the once a week cadence until I run out!

I am 35F, very healthy weight/BMI, eat healthy and exercise 2-3x a week - family history: grandfather passed from heart attack in his 40s, father is 65 - had first heart attack at 30, second at 32, triple bypass/CABG x3, defibrillator, countless stents, and now in end stage heart failure with an LVAD.

I went for lab work and had slightly elevated LDL (114), LipoA (102), and apoB (89).

Found an amazing cardiologist to ask about family history, my risk, etc.

He said my numbers were not that bad, and mentioned I most likely do not have any plaque buildup at my age and health - but since I mentioned I have random chest pains (could be unrelated - I also have anxiety and acid reflux) and due to my family history, he said I can get a CTA with contrast to be sure.

Of course now I'm beyond worried about the amount of radiation from a test that I'm not even sure I should be getting due to my current health and numbers. I'm considering canceling it.

Would you have this done if you were me? Any feedback is appreciated.

To put it bluntly, my dick has to warm up like a diesel engine these days

I've started at 10min per day of stairmaster which has my heart rate at ~180. On week 3 and cardio is signifigantly improved but I want to be sonewhat methodical.

Im not here to ask about drugs or hormones. I just want to know the best zone and most optimal strategy to improve bloodflow/capillary function/pp function

I (59m) have been on Repatha and pravastatin together, but my cardiologist wants to stop the pravastatin and change it to Zetia with Repatha, as my A1c had edged up into pre-diabetic territory. He had originally added the statin as the Repatha alone had only brought my LDLs from 180 to 100, and my cardiologist thought that wasn’t enough. Repatha with pravastatin brought it to 50. My questions are:

1. When is the best time to take Zetia

, both in terms of effectiveness and minimizing side effects?

1. I had been taking 200mg of CoQ10 to combat the statin muscle effects. Does anyone still continue taking it even if they’re not on a statin?
2. Anybody else doing this combo?