Show Notes
In this episode, I try to cut through the noise of the cholesterol debate and walk through 150 years of vascular science. From ancient mummies to modern genetics, we examine how lipidology reached its consensus, the response-to-retention hypothesis, why ApoB particle count matters more than LDL cholesterol mass, and what landmark clinical trials reveal about cardiovascular risk.
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CHAPTERS: 00:31 - The Ideological War in Lipidology 01:30 - Is Heart Disease a Modern Industrial Illness? 03:39 - The History of Atherosclerosis 04:31 - Early Rabbit Experiments & The Discovery of Foam Cells 06:13 - Post-War Heart Epidemic & The Framingham Study 07:53 - Disproving the Threshold Theory: MRFIT & Observational Data 09:18 - The Response-to-Retention Hypothesis Explained 12:30 - Mendelian Randomization: Nature's Lifelong Clinical Trial 16:04 - ApoB vs. LDL-C: Counting Particles vs. Cargo 17:18 - Statin & Non-Statin Randomized Controlled Trials 20:30 - The Scientific Consensus on ApoB and Cardiovascular Risk
SELECTED REFERENCES: Thompson et al. (2013): https://doi.org/10.1016/S0140-6736(13)60598-X Kannel et al. (1961): https://doi.org/10.7326/0003-4819-55-1-33 Stamler et al. (1986): https://doi.org/10.1001/jama.1986.03380200061022 Williams & Tabas (1995): https://doi.org/10.1161/01.ATV.15.5.551 Cohen et al. (2006): https://doi.org/10.1056/NEJMoa054013 Voight et al. (2012): https://doi.org/10.1016/S0140-6736(12)60312-2 Richardson et al. (2020): https://doi.org/10.1371/journal.pmed.1003062 Scandinavian Simvastatin Survival Study Group (1994): https://doi.org/10.1016/S0140-6736(94)90566-5 Cannon et al. (2015): https://doi.org/10.1056/NEJMoa1410489 Sabatine et al. (2017): https://doi.org/10.1056/NEJMoa1615664
Schwartz et al. (2018): https://www.nejm.org/doi/full/10.1056/NEJMoa1801174 Nissen et al. (2023): https://doi.org/10.1056/NEJMoa2215024
*Disclaimer* This podcast is for entertainment, education, and informational purposes only. The topics discussed should not solely be used to diagnose, treat , or prevent any condition. The information presented here was created with an evidence based approach, but you please keep in mind that science is always changing and at the time of listening to this there may some new data that makes this information incomplete or inaccurate. Always seek the advice of your personal physician or qualified health care provider for questions regarding any medical condition.
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