The Proof with Simon Hill

Cholesterol, metabolic health and heart disease | Dr Alan Flanagan and Danny Lennon

26 snips
Oct 27, 2022
Guest
Alan Flanagan
Guest
Danny Lennon
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ADVICE

Treat LDL Early And Aim For Low Targets

  • Aim for LDL targets: ≤70 mg/dL for primary prevention and ~<30 mg/dL in high-risk secondary prevention when possible.
  • Earlier and lower LDL reduction yields better plaque regression and fewer events over time.
INSIGHT

Modifiers Amplify Risk But Don't Replace LDL Causality

  • Other markers (TG, HDL, CRP) are effect modifiers that amplify risk but don't replace LDL's causal role.
  • Lowering LDL reduces risk regardless of inflammation status, though combined reductions are optimal.
ADVICE

Prioritise LDL/ApoB Before Treating Residual Risks

  • Lower LDL first to reduce primary risk; then address residual risks like high triglycerides or inflammation.
  • Trials lowering TG without changing ApoB showed limited benefit, so target ApoB/LDL first.
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