By: Dr. Mary Pardee
Dr. Jim Min, a renowned expert in cardiovascular health and the Founder of Cleerly, joins Dr. Mary to discuss the facts about cholesterol, heart disease prevention, and why being proactive about your health is the key to living a longer, healthier life. Whether you're in your 20s or approaching your 50s, understanding how to manage cholesterol is critical to preventing cardiovascular issues before they start.
What is Cleerly?
The Cleerly analysis essentially provides a full assessment of the heart arteries and plaque burden. By leveraging advanced AI and cloud computing, it automates the analysis of these imaging scans, giving cardiologists precise insights on the types, volumes, and risks associated with the plaques, which in turn leads to better-informed treatment decisions.
Cleerly enhances coronary CT angiograms by offering highly detailed, quantified, and actionable insights into plaque characteristics and coronary artery disease—helping doctors move from a reactive to a proactive approach in heart care.
Why Cardiology?
Dr. Min emphasized the significance of atherosclerosis as a silent killer. Dr. Min advocates for a shift from a symptom-driven to a disease-focused approach, urging for early identification of heart disease before it manifests as a serious health crisis.
Heart disease remains the number one cause of death, a statistic Dr, Min attributes to our reliance on indirect markers of disease, like cholesterol levels, rather than directly measuring heart health. He pointed out that cardiovascular issues often lack warning signs, and many individuals can feel perfectly healthy while harboring significant risk.
Statistics are staggering:
Cardiovascular deaths surpass all cancer deaths combined, and in 2020, the number of cardiovascular fatalities was double that of COVID-19 deaths.
This highlights the urgent need for better prevention strategies and diagnostic tools.
Atherosclerosis: Understanding the Condition
Atherosclerosis is characterized by the buildup of plaque in arteries, which can take various forms—from calcified to soft plaques. Dr. Min explains that the earlier atherosclerosis is identified, the more manageable it becomes, reinforcing the importance of proactive screening.
He noted that the disease often begins early in life, with autopsy studies of young soldiers showing early signs of plaque buildup. As societies become more industrialized and adopt unhealthy dietary habits, the prevalence of atherosclerosis increases, making it a critical public health issue.
The Role of Technology in Detection
Dr. Min introduced two key imaging technologies: the Coronary Artery Calcium Score (CAC) and Coronary CT Angiography (CCTA). The CAC score identifies calcified plaques but is limited in its ability to visualize non-calcified plaques, which are often more dangerous. CCTA, on the other hand, provides a comprehensive view of both types of plaques and allows for better risk assessment.
He emphasized that
while a CAC score of zero can be reassuring, it does NOT guarantee the absence of plaque.
Instead, CCTA can reveal earlier signs of atherosclerosis, facilitating personalized heart care.
The Future of Cardiovascular Health
In discussing innovations in cardiovascular diagnostics, Dr. Min highlighted the work of his digital healthcare company, Cleerly. Their technology leverages machine learning to analyze imaging data, providing actionable insights into atherosclerosis, stenosis, and ischemia. This approach not only enhances efficiency but also improves the accuracy of cardiovascular assessments.
Prevention
In cardiovascular health, preventing high LDL cholesterol and high Apo B early on is crucial, the longer someone exposed to elevated levels of Apo B and LDL-c the greater the risk for atherosclerosis.
Risk Factors
The conversation highlights that risk factors like high LDL cholesterol/ Apo B, even in younger individuals with no visible disease, significantly increase the likelihood of disease development as they age. Addressing these risk factors through lifestyle modification and medical therapy can drastically alter their health trajectory.
Other risk factors for heart disease include:
high blood pressure
smoking
diabetes
obesity
sedentary lifestyle
genetics
elevated lp(a)
more
Imaging and Biomarkers
Imaging technologies (such as coronary artery calcium scores and CLEERLY analysis) and biomarkers (like LDL cholesterol, lp(a) and Apo B) complement each other. Imaging helps identify who needs treatment, while biomarkers guide how to treat and how aggressively.
Limitations of CCTA and Imaging Studies
There are limitations to current imaging technologies, which may not detect the earliest stages of atherosclerosis (like fatty streaks or foam cells), but they are highly effective for detecting more advanced stages of plaque. The importance of recognizing the role of early-stage disease (which may not show up on current scans).
Dr. Mary makes a point that given that the early stages of atherosclerosis (fatty streak formation) are not visible, even on a Cleerly scan, treating elevated levels of Apo B/ LDL-c is important to prevent lesions from forming in the first place.
LDL levels in Neonates
The conversation concludes with a discussion about natural cholesterol levels, noting that in other mammals (and in humans at birth), LDL levels are much lower. The dietary and genetic influences that raise human cholesterol levels over time are seen as abnormal, and the goal should be to keep LDL levels as low as possible to reduce the changes of atherosclerosis.
Cholesterol and Hormones
Myth:
Advocates for high LDL often use the argument:
"but you need cholesterol to make hormones"
Truth:
While cholesterol is a building block for hormones like cortisol, the body doesn’t require high levels of LDL cholesterol to perform these functions. Treating and lowering cholesterol has been proven to improve cognitive function and general health without compromising hormone production.
Long-Term Benefits of Lowering Cholesterol
Extensive research supports that reducing cholesterol—especially in at-risk populations—leads to better long-term health outcomes. The potential side effects of treatments are rare and minor compared to the vast benefits of managing cholesterol levels.
Proactive Prevention
The conversation circles back to the importance of adopting a preventive approach to heart disease. Dr. Min highlights that while it sounds simple, steps like eating well, staying active, reducing stress, maintaining good relationships, and sleeping well are the cornerstone of cardiovascular health. These commonsense practices form the basis of well-researched diets like the Mediterranean diet and the DASH diet, which are proven to reduce heart disease risk.
The Value of Early Detection
Both Dr. Min and Dr. Mary encourage listeners to be proactive about their health, advocating for early detection of risk factors like high LDL-c, Apo B, and lp(a). Intervening early prevents small issues from becoming larger, irreversible problems later in life.
Disclaimer:
The information in this blog is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this blog is for general information purposes only. Modrn med and Dr. Mary Pardee make no representation and assume no responsibility for the accuracy of information contained in or made available through this blog, and such information is subject to change without notice. This blog does not provide medical services, diagnosis or counsel. You are encouraged to confirm any information obtained from or through this email with other sources, and review all information regarding any medical condition or treatment with your physician. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this information.
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