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We can lower cholesterol by over 85%.
Here's how.
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Here's how.
📕 Make Sure To Bookmark ✅
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It is always best to take a step back & frame the problem you are trying to solve:
🔴 Cardiovascular disease is the leading cause of death worldwide.
🔴 High cholesterol accounts for over half of the risk of cardiovascular disease in both males and females.
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🔴 Cardiovascular disease is the leading cause of death worldwide.
🔴 High cholesterol accounts for over half of the risk of cardiovascular disease in both males and females.
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🔴High cholesterol CAUSES coronary artery disease
🔴Individuals with lifelong elevated cholesterol are at a significantly increased risk of cardiovascular disease
🔴Individuals with lifelong low cholesterol levels are at a significantly lower risk of cardiovascular disease.
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🔴Individuals with lifelong elevated cholesterol are at a significantly increased risk of cardiovascular disease
🔴Individuals with lifelong low cholesterol levels are at a significantly lower risk of cardiovascular disease.
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🔴 We have the tools to reduce cholesterol by 85%.
🔴 A lifelong reduction in cholesterol would virtually eliminate the risk of coronary artery disease.
🔴To reduce the impact of the leading cause of death, the goal is to have low cholesterol for as long as possible.
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🔴 A lifelong reduction in cholesterol would virtually eliminate the risk of coronary artery disease.
🔴To reduce the impact of the leading cause of death, the goal is to have low cholesterol for as long as possible.
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How do we do this?
In 2 ways:
1. Lifestyle
2. Drug therapy
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In 2 ways:
1. Lifestyle
2. Drug therapy
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High cholesterol is a function of two elements; lifestyle and genetics.
Estimates vary, but about 40 - 50% of high cholesterol is a function of genetic factors.
Improving nutrition can lower cholesterol levels by 20 - 30%
The question is will that be enough for most?
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Estimates vary, but about 40 - 50% of high cholesterol is a function of genetic factors.
Improving nutrition can lower cholesterol levels by 20 - 30%
The question is will that be enough for most?
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For some nutrition, changes will be sufficient.
But for many, drug therapy will be required to achieve a low enough cholesterol level to significantly reduce their lifetime cardiovascular risk.
Nutrition is important but often not adequate.
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But for many, drug therapy will be required to achieve a low enough cholesterol level to significantly reduce their lifetime cardiovascular risk.
Nutrition is important but often not adequate.
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For most individuals, statin therapy will be the drug of choice to lower cholesterol.
Estimates of side effects of statin therapy vary between 0.3 to 33%.
The most common side effects are muscle aches or soreness.
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Estimates of side effects of statin therapy vary between 0.3 to 33%.
The most common side effects are muscle aches or soreness.
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When evaluated, 90% of these side effects are unrelated to statin therapy.
This means that the overwhelming majority of patients with side effects while on statin therapy do not have a side effect from the drug
But symptoms from alternative causes.
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This means that the overwhelming majority of patients with side effects while on statin therapy do not have a side effect from the drug
But symptoms from alternative causes.
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A range of statins are available, usually lowering LDL cholesterol by 20 - 50%.
Statins reduce cholesterol by:
Reducing cholesterol synthesis in the liver and
Increasing the concentration of LDL receptors in the liver to promote clearance.
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Statins reduce cholesterol by:
Reducing cholesterol synthesis in the liver and
Increasing the concentration of LDL receptors in the liver to promote clearance.
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Ezetimibe
Ezetimibe reduces cholesterol by increasing absorption from the gastrointestinal system.
It so results in greater numbers of LDL receptors in the liver, resulting in greater clearance of LDL cholesterol from circulation.
LDL-C Reduction ~ 20%
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Ezetimibe reduces cholesterol by increasing absorption from the gastrointestinal system.
It so results in greater numbers of LDL receptors in the liver, resulting in greater clearance of LDL cholesterol from circulation.
LDL-C Reduction ~ 20%
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PCSK9 Inhibitors
Twice-monthly injectable treatments can lower cholesterol levels by about 60% when used in isolation and by 85% when used with existing treatments.
Access to these therapies is often highly restricted because of reimbursement issues
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Twice-monthly injectable treatments can lower cholesterol levels by about 60% when used in isolation and by 85% when used with existing treatments.
Access to these therapies is often highly restricted because of reimbursement issues
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Bempedoic Acid
Trials demonstrated bempedoic acid to be safe and can reduce cholesterol levels by about 18% in addition to that achieved by statin therapy.
This is likely to be a valuable tool for patients not yet at their LDL cholesterol target or intolerant to statins
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Trials demonstrated bempedoic acid to be safe and can reduce cholesterol levels by about 18% in addition to that achieved by statin therapy.
This is likely to be a valuable tool for patients not yet at their LDL cholesterol target or intolerant to statins
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Inclisiran
Acting via the PCSK9 pathway, Inclisiran is a small interfering RNA that is an injectable LDL cholesterol-lowering therapy given every six months.
Inclisiran can lower LDL cholesterol by approximately 50% in addition to existing therapies.
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Acting via the PCSK9 pathway, Inclisiran is a small interfering RNA that is an injectable LDL cholesterol-lowering therapy given every six months.
Inclisiran can lower LDL cholesterol by approximately 50% in addition to existing therapies.
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With the addition of Inclisiran, it is likely now possible to lower LDL cholesterol by even more than 85%.
Could it get any better than that?
Amazingly, yes.
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Could it get any better than that?
Amazingly, yes.
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Verve Therapeutics has recently did human trials assessing the safety and effectiveness of using gene editing to turn off the PCSK9 machinery in the liver so as to result in very low LDL cholesterol levels.
Once off treatment
LDL-C reductions ~ 60%
Very exciting
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Once off treatment
LDL-C reductions ~ 60%
Very exciting
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Cardiovascular disease is the leading cause of death worldwide.
High cholesterol drives approximately 50% of that risk at a population level.
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High cholesterol drives approximately 50% of that risk at a population level.
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We currently have the tools to dramatically reduce cholesterol levels over a lifetime, and future therapies look even more promising.
The question is how we will use them.
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The question is how we will use them.
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That's a wrap!
If you enjoyed this thread:
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If you enjoyed this thread:
👋 You might like to join 14K+ others on my free weekly newsletter on heart disease prevention and living longer.
If so, just click my Bio above and follow the link.
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