I am not a statin skeptic--or rather, I don't want to be a statin skeptic. I've done the research and it makes sense to me, but I still feel some social and psychological pressures to reject statins.
When I see that it is widely accepted that ApoB is better to measure than LDL-C, but the industry continues to measure LDL-C, but not ApoB, I wonder why. It makes me skeptical.
When I see that the purpose of statins is to reduce plaque buildup in the arteries, and that we have the ability to measure these plaque buildups with scans, but the scans are rarely done, I wonder why. Like, we will see a high LDL-C number (which, again, we should be looking at ApoB instead), and so we get worried about arterial plaque, and we have the ability to directly measure arterial plaque, but we don't, and instead just prescribe a statin. We're worried about X, and have the ability to measure X, but we don't measure X, and instead just prescribe a pill based on proxy indicator Y. It makes me skeptical.
In the end statins reduce the chance of heart attack by like 30% I think. Not bad, but if you have a heart attack without statins, you probably (70%) would have had a heart attack with statins too. That's what a 30% risk reduction means, right?
As you can see, I'm worried about cholesterol and statins.
If you fix it without statins through better lifestyle and diet, that is the preferrable route.
As to why medicine is like this, it's because it's conservative, usually about 17 years behind university research[0], and doctors are shackled to guidelines in most health systems or risk losing their licenses. It isn't a coincidence that the article author had his out-of-pocket concierge doctor tell him the more up-to-date stuff.
Meta-analysis conclusion: This literature-based meta-analysis did not find evidence for the benefit of statin therapy on all-cause mortality in a high-risk primary prevention set-up.
I ALSO want to not be a statin-skeptic but, like you, these things look very weird to me. The most prescribed drugs in the country and we don't even try to check if they are addressing the actual problem?
The primary thing I did was ask a cardiovascular surgeon in my network to send the lab requisition form to a lab. This is the gate for much of this stuff, even if you pay out of pocket. If someone knows a simple “pay and play” testing service that would be fantastic.
Most doctors recommend against these and against the full body MRI one can get because they believe you’ll always find things you don’t expect and that will make you indulge in interventions that have weak support, resulting in deleterious iatrogenic effects.
I found that I had no such impulse with the data I had. But a friend of mine, supplied with evidence of a little arrhythmia went through a battery of tests and experimentation. He was in line for getting a cardiac ablation when he finally quit his job and stopped having the problem. So I get why they say that. There’s people like that.
Anyway, if you’re curious what you can get for $800 email me and I’ll post here. I’d do it proactively but I’m traveling so it will take a little work.
Key Takeaway: Get a CT or CTA scan, and if you can afford it go for the CTA with Cleerly.
There is a reason that we don't recommend getting imaging for everyone, and that reason is uncertainty about the benefit vs the risks (cost, incidentalomas, radiation, etc, all generally minor). Most guidance recommends calcium scoring for people with intermediate risk who prefer to avoid taking statins. This is not a normative statement that is meant to last the test of time: it may well be the case that these tests are valuable for a broader population, but the data haven't really caught up to this viewpoint yet.
The central point of his article is that he went to a doctor who followed the guidelines, tested him and found he wasn't at risk for heart disease.
But then he went to another, very expensive concierge doctor, who did special extra tests, and discovered that he was likely to develop heart disease and have a heart attack.
Therefore he is arguing that THE STANDARD GUIDELINES ARE WRONG AND EVEN IF YOU DO EVERYTHING RIGHT AND YOUR DOCTOR CONFIRMS IT YOU MAY BE LIKELY TO DIE OF HEART DISEASE ANYWAY, SO ONLY THE SPECIAL EXTRA TESTS CAN REVEAL THE TRUTH.
I want a second opinion from a doctor. Is this true? Is this for real? Because it smells funny.
The claim on an individual level is not objectionable to me. The question is that if we extrapolate it out to the population and actually take this action for everyone, do we make people better off? This is what clinical trials (or at least large observational studies) try to achieve. Right now, it is not clear.
His evidence is also kinda weak. And appeal to authority largely about someone who he's paying to tell him he has health problems. The incentives aren't aligned.
I also disagree that the 50the percentile is the breakpoint between healthy and unhealthy. There's a lot more to deciding those ranges beside "well half of the population has better numbers"
Going deep on biomarkers, blood tests, and debates about optimal levels is okay for some people who derive motivation from obsessing over topics, but I’m starting to notice a trend where people obsess about these things for a couple years before burning out and moving on to the next topic.
The best thing you can do for yourself is to establish healthy diet and lifestyle habits that are sustainable. A lot of people who jump from obsession to obsession do a great job at optimizing for something for a few years, but when their life changes they drop it completely and fall back to forgetting about it.
Fad diets are the original example of this: They work while the person is doing it, but they’re hard to maintain for years or decades. CrossFit and other exercise trends have the same problem where some people get extremely excited about fitness for a couple years before falling off completely because it’s unsustainable for them. Some people are able to continue these things for decades, but most people do it for a short while and then stop.
I’m now seeing the same pattern with biomarker obsessives: They go a few years obsessing over charts and trying things for a few months at time, but when the interest subsides or they get busy with life most of it disappears.
The most successful people over a lifetime are those who establish healthy habits that are easy to sustain: Eating well enough, reducing bad habits like frequent alcohol or fast food consumption, some light physical activity every day, and other common sense things.
The most important factor is making it something easy to comply with. The $300 biomarker panels are interesting, but most people don’t want to pay $300 every year or more to get snapshots that depend largely on what they did the past week. Some people even get into self-deceiving habits where they eat well for a week before their blood tests because the blood test itself has become the game.
Not all things labeled "processed foods" are bad, it seems. There are enough scientists that say the distinction is often hypocritical (example from an article: a factory-made carrot cake is labeled UPF, but a home-baked one isn't, even though they're practically the same thing). Sugar, fats, and lack of fiber make factory-food unhealthy, they say. Others add that we can't feed the growing metropolitan areas without it.
WRT the carrot cake, I will say that while there is only a minimal physical difference, there is a practical difference. Making a carrot cake at home is a commitment, and most people won't frequently go to the trouble except on special occasions... But one from the grocery store can be acquired casually and without effort, and it's easy to eat a lot more of something when it requires no effort.
>a factory-made carrot cake is labeled UPF, but a home-baked one isn't, even though they're practically the same thing).
Actually they are not. "Practically" is carrying a lot of weight there. The factory baked cake will have a lot more extraneous ingredients and usually has a larger quantity of sugar and fat. Similar to how restaurant food generally has a lot more salt and fat than home cooked food.
This is wrong. Our bodies evolved to eat a diverse omnivorous diet and complex carbs + the antioxidants present in vegetables and fruits are anti-oxidative.
Vegetables aren't "carb-heavy". And we don't need to recreate blindly the circumstances evolution had to adapt us to. E.g., our bodies evolved when the population was much smaller, but I don't think you want to argue for mass extinction.
There's something I deeply don't understand about this.
> I shared these results with a leading lipidologist who proclaimed: “Not sure if the lab or the primary care doc said an LDL-C of 116 mg/dL was fine but that concentration is the 50th percentile population cut point in the MESA study and should never ever be considered as normal.
> It’s also important to note that, according to a lipidologist friend, an ApoB of 96 is at a totally unacceptable 50th percentile population cutpoint from Framingham Offspring Study.
So... the exact median value is "totally unacceptable" and "should never ever be considered as normal"? I'm open to the possibility that the US population is so deeply unhealthy that this is true, but then that needs to be argued for or at least mentioned. Like, you can't say "you're exactly average in this respect" and expect your and that's terrible to be taken seriously without any followup.
Or if I'm misunderstanding what's meant by "50th percentile population cut point" then again, I think this jargon should be explained, as it's plainly not the usual meaning of "50th percentile".
I'm not sure that non-medically indicated CT scans are a great idea, as you're at least doubling your yearly dose of radiation in the year of the CT scan. Perhaps it's warranted, but the article doesn't seem to balance that at all against doing a CT scan "every 1-5 years".
Yes - in addition, medical professionals warn against “overdiagnosis” from unnecessary screenings.
This can happen when we choose to treat otherwise benign issues that would have had few negative consequences for our health or longevities. Those treatments can have negative effects that are worse than the ailment we’re trying to treat.
I know it’s a natural tech-guy impulse to quantify everything and get access to as much data as you can, but that myopic focus can actually lead us to optimize for the wrong thing.
I agree. I’m a physician and this is sticking out to me as bad advice. You’re dramatically increasing your risk for cancer by getting unneeded regular CT scans, in addition the not insignificant risk of detecting incident findings, which will put you at increased risk via biopsies, unneeded test etc.
Diet and exercise I agree with, everything else take with a grain of salt.
Great post but quite surprised there is no mention of cutting red meat. There is a lot of evidence that especially the American diet is dangerously high in red meat to the point of elevating Heart Disease risk.
IMO, I think that is more of a saturated fat issue, and only a subset of the population is like that. Others solve their health issues through eating a lot of red meat.
Also processed red meats or processed meats in general. Processed meats are the ones strongly linked with heart disease. At least for those who dont want to go vegetarian.
Processed meats are so bad, they should be eliminated entirely from everyone's diet. The World Health Organization has classified processed meat as a Group 1 carcinogen. No amount of it is considered safe.
Unprocessed read meat is still a problem and WHO advises less than 350g a week. Which is 12–18 ounces of cooked meat. 12g is about one adult serving of steak. So you really are looking at 1.5 servings per week of unprocessed red meat to be safe. At most! You probably should try for less or closer to 12g.
And really if you're at a healthy weight, then I'm not sure how helpful this is. Obesity is a bigger risk factor. This is a bit of the elephant in the room for heart health. Not only should we not be eating things associated with heart disease but also we need to keep ourselves at a healthy weight.
I was planning to start getting scans ordered for specific risks like aneurysm or heart attack but what holds me back is the idea the scans will harm me worse than those things.
It is very difficult to have any level of confidence with the medical industry so my current approach has been to eat as healthy as possible while staying as fit as I can without undue extreme stress.
A relevant anecdote. I’m very athletic and skinny, eat well, have a resting heart rate in the 40s, but was recently prescribed a statin at 30, due to my very high LDL cholesterol and lipoprotein A.
My family has a history of cardiovascular disease despite us doing what we can w.r.t eating and exercise. I’d encourage you to get some tests at least.
My mother similarly was put on statins and is getting a cardiovascular work up (calcium scan) because she now has early atherosclerosis. She eats super healthy and is a former olympic sprinter..
Bonus anecdote: In my free time I do shifts as an EMT with my fire dept (911), that is a big wake up call to wanting to be as healthy as can be. The number of patients I see who are 50+, nearly all are on 5-10+ meds, few are just one 0, 1, or 2. At that age I see type 2 diabetes, hypertension, high cholesterol, and more.
- Radiation. This is why people shouldn't get these scans several times a year, but 1-2 are very unlikely to move the needle. The average radiation from a full chest CT is just under the average dose for ~2 years of normal background radiation. (I don't know if a CTA uses less than average.)
- Acting on something you would otherwise have ignored, where ignoring it might have been the right answer. The main problem here is that it's hard to get a medical opinion saying "you should ignore this" because of perverse incentives: there's an aversion to recommending doing nothing because that could lead to a lawsuit, whereas "overtreatment" will not get a doctor sued. However, you can make a deliberate decision to do this anyway even after getting the scan; seek second and third opinions, consider alternatives, weigh risk versus reward, make a considered decision.
> Sticking to a Mediterranean diet that is light on carbohydrates and saturated fats is almost always the safest bet. Almost every health diet is some permutation of this.
A permutation that's currently making the rounds in the press (even though the original research is from 20 years ago) is the "portfolio diet":
The "be an advocate" thing is both true but also incredibly selfish and egotistical.
If everyone did that, the whole system would grind to a halt. Doctors aren't in a rush because they enjoy so, they are because they're already overworked. 1 out of every 25 patients (their family) demanding extra attention is possible although still a burden. 21 out of every 25 is not possible.
Fabulous information, but lacking information isn’t the issue. The behavioral changes are obvious and well evangelized : lose weight, regular activity (walking), and if necessary, take meds. (Yes I know your marathon runner cousin who died suddenly of a heart attack, but these are still your best odds)
Telling people what to do rarely fixes anything. People need dozens of impressions for those changes to sink in. Friends, family, social outings, commercials, movies, songs all promoting overindulgence won’t be overcome with a helpful pamphlet or nagging.
This site isn't necessarily meant to have a big sociological impact; it provides enough information that someone with sufficient motivation, but a lack of resources and expertise can take concrete steps to reduce their risk. That seems useful to me.
“Stress” is so abused and nebulous that it’s impossible to define. Nearly every condition is worsened by “stress” but there’s no way to measure it. And there’s no conclusive way to manage stress either. Medication, psychotropics, self medication, mediation. Nearly all of those are more broadly abused and yet stress “worsens”.
One person may run an intense soup kitchen 15 hours a day and feel little stress, and another can sit at a computer for 9 hours sending pointless emails and feel tremendous stress.
Fortunately, as you mention in your last sentence, stress is introspectable.
How exactly stress corresponds to biomarkers doesn’t matter if your desire is to lower it.
The issue is that many of us don’t pay attention to how we keep our body & mind throughout the day, or do so on a very superficial level. So strain on the body can accumulate for a long time.
“Stress management” is a lifetime skill. It doesn’t come in bulletpoints, it’s as broad as “living happily”.
Edit: That said, this can make the advice “be less stressed” a bit vacuous.
But people do get scared when random health issues flare up and become more conscious of how they deal with stress in life.
So it’s not bad to keep reminding people either :)
> The behavioral changes are obvious and well evangelized : lose weight, regular activity (walking), and if necessary, take meds.
More specifically, it’s “change your diet and eat/drink less”, which is the hardest part. Diet’s impact eclipses regular activity, and it’s consequences build up and compound over decades.
I might just be tired, but this seems highly repetitive. The author mentions friends in the field and concierge doctors multiple times in as much as I read.
Feels like the whole thing could be shortened to just say "here's the tests you run, the drugs you might take, the lifestyle changes you should consider".
It’s also demonizing doctors and the healthcare system a bit too much for my liking.
I’m located in Europe, so I may have a slightly different view, but my doctors clearly care and discuss with me about prevention, risks, tradeoffs, …
They praise the methods of the „good“ doctors and stamps the others as driven by financial gain. Who says the expensive ones are any better in this regard? Who says they are more or less exaggerating the importance of test results to make you come back?
Somewhat related, one of my thoughts was “what if these concierge doctors just keep running tests until they find something, anything, to justify their fees”?
If you dig into research and follow the low-risk experiments that people do online to reduce their Lp(a), you can find techniques and evidence to do so. It doesn't have to be an impossible-to-fix issue.
In general, when science is done, recruitment requirements force the experimenters to bucket the participants. One thing that often happens is an open bucket, say 35+.
The resulting science is then reported as “When you cross 35, your chances of being pregnant immediately drop” or “The brain stops developing at 18” and so on.
Almost nothing in the body is really like this, though. You can quit smoking later in life and it will help. You can eat better later and it will help. You can exercise and it will help. Very few things are “the damage is done”.
The only constraints are that the later you start the more risks you face. E.g. if you first deadlift in your 50s and you decide to follow Starting Strength you’re going to have trouble.
If you start exercising in your 20s, and never stop, it will be so much easier to maintain fitness in 40s 50s etc. The challenge is that the benefits are not yet visible in your 20s (when you’ll probably be healthy and at a proper weight regardless). Gotta lay that foundation for older age though!
EDIT - I misread the comment. It’s never too late to start, just be careful for injuries as that will block your ability to exercise.
Is having someone you can describe as "my dermatologist" a common thing? Probably not for most people who don't have a chronic skin condition of some kind, I would think.
> It's not sexy, and as a result an overwhelming majority of the population is unaware about how to avoid succumbing to it
When I started building an ECG Holter in my early 20s, I tried to get some friends to use it and kept hearing "yeah, but it’s not exactly sexy to wear that thing." That’s when it hit me how little people care about prevention until something goes wrong. We still have a huge awareness gap to close.
The value of the biomarkers are they applicable for all age range? What if someone already had a heart attack, then what should be the normal values post incident?
The title of the article says "don't die of heart disease", but given that we all have to die at some point, if you could choose what natural cause to die of, wouldn't you pick heart disease? It is the best way to die. The worst is stroke. So once you cross a certain age, say 60, don't worry about heart disease, worry instead about stroke.
Sometimes I think the way this type of thing is framed is misleading. There's a list of putative causes of death and there's an assumption that they're equally systemically impactful, and you can go down the list and just lower the probability of each and lower your overall likelihood of death.
That's not totally off, but the thing about cardiovascular disease is it affects everything because it's how your body distributes oxygen. Stop distributing oxygen and you die.
That's not to say other organs aren't important, it's just that if you replace "cardiovascular" with "oxygen distribution" it becomes apparent that almost by necessity it's going to include a lot of deaths.
I agree, but both are heart disease and both can be prevented in similar ways. My dad and my father in law both died from heart disease. My fil was on the surface less healthy. He had an extreme high stress job with exposures to environmental factors that made it worse, was partially disabled with bad knees, etc. i believe he was on blood thinners for almost 20 years.
He got up to make a sandwich for my mother in law, who was very sick, and don’t come back. Massive heart attack and aortic rupture - he was dead before he hit the ground.
My dad had a lot of stress over his career and his share of health issues but found a happy medium and improved his health greatly stating about in his late 40s. He was basically walk/running 2-5 miles a day for several years after retirement. He had a major stroke, recovered somewhat, and then ended up almost dying from a kidney stone and resulting infection. (He could not communicate pain as part of his aphasia.) long story short, he suffered in a lot of ways (pain, disability, loss of dignity) for 4 years before finally succumbing.
In online discussions, we tend to boil everything down to death. Reality is that longer you can put off complications, the better you will be when something more severe happens or you get sick. As you age, each time something happens, your recovery is a little less robust. Go to the doctor, take your statins and take care of yourself.
Yes but there are habits that are especially important for preventing stroke, such as getting 7-9 hours of sleep, monitoring and controlling risk factors related to blood vessel health that affect the brain uniquely, such as preventing irregular heart rhythms (atrial fibrillation), anti-inflammatory diet choices focused on brain health, and so on.
If you have a massive banger and die immediately that is a pretty good way to go.
However, many people suffer from heart failure which, despite the name, means partial heart failure. The permanent breathlessness gives them a terrible quality of life. They can live with this for decades sometimes but it's not much fun.
I think you are confusing "getting a stroke" and "dying from stroke". If you get a heart attack and don't die from it you might become a burden on your family too.
Curious about how accessible these tests are in Europe. Living in a country (NL) that doesn't value annual checkups makes me assume detailed, preventative blood testing like this is hard, let alone possible to get in non-extreme situations.
I recently did a comprehensive panel of my own volition with Quest Labs and was pleasantly surprised by the entire process. It was super easy to schedule, affordable, and their online platform is surprisingly sleek.
Stop drinking. Replace cheese and butter with olive oil in copious amounts. Only eat fish meats. Don’t smoke or vape. Eat salads and other prebiotics. Get some cardio - even walking your dog is great. Your brain fog will lift, your skin will clear, your mood will improve and your doctor will gasp at how clear your carotids are next time they’re ultrasounded.
What if heart disease saves me from dementia? I'm not just being contrarian. I think about this a lot of the time. I'm already 40. I'm being healthy now, but whatever damage has already been done is baked in. (plus whatever is in my genetics) A quick death at 65-70 might be much more preferable to a slow terrible decade-long decline.
My grandfather always said "there's something to be said for a good coronary." He was in his 70's when he said it, and his point was that he had a good run, and there's an argument for going out while things are still good rather than slowly dying over six months in a nursing home (which is what actually happened).
New medical discoveries happen regularly; you might also die right before the discovery of a preventative/cure for dementia. Living people have options, dead people have none.
Also, given the preferences you expressed in your comment, you especially should want to avoid strokes, or the many side effects of heart disease, which can make you less healthy for a long time.
Heart disease can be a slow decade long death, where you become incapable of physically doing anything. It's not just a heart attack out of nowhere and you're dead.
Actually, there is. You have to search for "pressure". For example, "Other Tests: There are some other things that are important to know as well. You must know your blood pressure".
It is a long read and I want to make time for it. Quick search check and calc (for calcify etc.) and diet appear alot in the article which is not surprising based on other things I have watched on the subject.
This is all very interesting, but far too detailed and technical for 99% of people. The TLDR should include an easy to understand summary without jargon like "VO2" and "a set of HIIT at Zone 4".
My dad would disagree--he's 84, was on statins for years and they did terrible things to his body. I'm sure the drugs kept him alive, but the side effects, as he describes them, particularly to his legs and kidneys, were pretty severe. He only got better when he stopped taking them.
I believe statins reduce risk by about 30%, so there's a roughly 30% chance the statins have done good things for your dad.
(I think that's what the stats mean, right? I'm open to correction on this. I do believe the statin studies, I'm not a science denier. I think what I've said matches the science, as far as I understand.)
Love the chart at the bottom--it really puts on display media bias and lack of integrity and using fear to push idiotic policies which area really just a way to put everyone in the pocket of government and keep them there permanently with zero real improvement to public health. Fear get eyeballs. the Covid mass hysteria proves that, too.
As far as heart disease goes, yes, it's the big killer and it's time people started waking up from the media haze, but to do that, you have to admit you were wrong, and for many, that is far too tall a hill to climb.
Walking and eating sensibly is free. Even a balance oatmeal, rice & beans with infrequent meat servings would defend against heart disease better than expensive medicine, at less than $1 / day.
Promoting good habits is good but this is health advice from an unlicensed commenter to say rice and beans is better than taking a statin. Consult your doctor if you’re curious what to do.
Yes, our system is most definitely stacked against the poor, but it's important to also remember that we all have free will and that some choices fully within our power are much better than others.
I think the point is it is cheap to prevent. The weird tip is doing a different test to the standard one, which costs little for typical HNers (but admit every $ counts for many people esp. with current inflation, poverty, bad governance) but sounds like on par with a dentist doing anything beyond a checkup.
I don't like this kind of content. The author might have a personal motivation for it, but for the general public, it's just more mental load.
We are all going to die one day.
When I was younger, I would fret over this kind of article. Great, one more thing I have to worry about. Now I just mostly ignore it. It's impossible otherwise. If I dedicate hours and days and months to all the heart best practices, what about when the liver, esophagus, kidney, bladder, brain articles come out?
We all know the good practices. Don't be a dumbass. Don't drink too much, exercise and so on. Besides that, I'm very much going to be reactive, as the article cautions against. I just don't have time or mental energy to do otherwise.
> We all know the good practices. Don't be a dumbass
In theory yes, but in practice we are all dumbasses to some extent.
I used to have your attitude until I saw a friend die of a heart attack at an early age - and it appeared to me that he would have survived if he had an indication. So, now I have changed my attitude to one of more data does not hurt.
I share your general emotional reaction, but to be fair, heart disease is far and away more important than other type of disease. More people die of it in the US than die of all cancers combined: https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
My in-laws are over 95. They refuse to go to an elderly home and as a result make everyone miserable, starting with themselves and inflicting infinite suffering on their children who each have a family of their own, and need to take care of them all of the time.
I don't want to do that to my own children. I don't want to not die. I don't esp. want to die but I'm not really afraid of it, it's just a normal part of life.
Preventing heart disease is probably a good thing, but if one prevents every ailment conceivable then how does this work eventually?
You're almost certainly going to die by or before 110, anyway. (Ir)Regardless of your efforts, or lack thereof, our bodies typically give out in the 100-110 year range with very few exceptions.
I am not a statin skeptic--or rather, I don't want to be a statin skeptic. I've done the research and it makes sense to me, but I still feel some social and psychological pressures to reject statins.
When I see that it is widely accepted that ApoB is better to measure than LDL-C, but the industry continues to measure LDL-C, but not ApoB, I wonder why. It makes me skeptical.
When I see that the purpose of statins is to reduce plaque buildup in the arteries, and that we have the ability to measure these plaque buildups with scans, but the scans are rarely done, I wonder why. Like, we will see a high LDL-C number (which, again, we should be looking at ApoB instead), and so we get worried about arterial plaque, and we have the ability to directly measure arterial plaque, but we don't, and instead just prescribe a statin. We're worried about X, and have the ability to measure X, but we don't measure X, and instead just prescribe a pill based on proxy indicator Y. It makes me skeptical.
In the end statins reduce the chance of heart attack by like 30% I think. Not bad, but if you have a heart attack without statins, you probably (70%) would have had a heart attack with statins too. That's what a 30% risk reduction means, right?
As you can see, I'm worried about cholesterol and statins.
If you fix it without statins through better lifestyle and diet, that is the preferrable route.
As to why medicine is like this, it's because it's conservative, usually about 17 years behind university research[0], and doctors are shackled to guidelines in most health systems or risk losing their licenses. It isn't a coincidence that the article author had his out-of-pocket concierge doctor tell him the more up-to-date stuff.
[0] https://pmc.ncbi.nlm.nih.gov/articles/PMC3241518/
https://jamanetwork.com/journals/jamainternalmedicine/fullar...
Meta-analysis conclusion: This literature-based meta-analysis did not find evidence for the benefit of statin therapy on all-cause mortality in a high-risk primary prevention set-up.
I ALSO want to not be a statin-skeptic but, like you, these things look very weird to me. The most prescribed drugs in the country and we don't even try to check if they are addressing the actual problem?
The primary thing I did was ask a cardiovascular surgeon in my network to send the lab requisition form to a lab. This is the gate for much of this stuff, even if you pay out of pocket. If someone knows a simple “pay and play” testing service that would be fantastic.
Most doctors recommend against these and against the full body MRI one can get because they believe you’ll always find things you don’t expect and that will make you indulge in interventions that have weak support, resulting in deleterious iatrogenic effects.
I found that I had no such impulse with the data I had. But a friend of mine, supplied with evidence of a little arrhythmia went through a battery of tests and experimentation. He was in line for getting a cardiac ablation when he finally quit his job and stopped having the problem. So I get why they say that. There’s people like that.
Anyway, if you’re curious what you can get for $800 email me and I’ll post here. I’d do it proactively but I’m traveling so it will take a little work.
Right.
Hang on a second.
This guy is making a big big claim.
The central point of his article is that he went to a doctor who followed the guidelines, tested him and found he wasn't at risk for heart disease.
But then he went to another, very expensive concierge doctor, who did special extra tests, and discovered that he was likely to develop heart disease and have a heart attack.
Therefore he is arguing that THE STANDARD GUIDELINES ARE WRONG AND EVEN IF YOU DO EVERYTHING RIGHT AND YOUR DOCTOR CONFIRMS IT YOU MAY BE LIKELY TO DIE OF HEART DISEASE ANYWAY, SO ONLY THE SPECIAL EXTRA TESTS CAN REVEAL THE TRUTH.
I want a second opinion from a doctor. Is this true? Is this for real? Because it smells funny.
The claim on an individual level is not objectionable to me. The question is that if we extrapolate it out to the population and actually take this action for everyone, do we make people better off? This is what clinical trials (or at least large observational studies) try to achieve. Right now, it is not clear.
His evidence is also kinda weak. And appeal to authority largely about someone who he's paying to tell him he has health problems. The incentives aren't aligned.
I also disagree that the 50the percentile is the breakpoint between healthy and unhealthy. There's a lot more to deciding those ranges beside "well half of the population has better numbers"
If there are two contradictory conclusions you should ask for the third one, independent on the previous ones.
Going deep on biomarkers, blood tests, and debates about optimal levels is okay for some people who derive motivation from obsessing over topics, but I’m starting to notice a trend where people obsess about these things for a couple years before burning out and moving on to the next topic.
The best thing you can do for yourself is to establish healthy diet and lifestyle habits that are sustainable. A lot of people who jump from obsession to obsession do a great job at optimizing for something for a few years, but when their life changes they drop it completely and fall back to forgetting about it.
Fad diets are the original example of this: They work while the person is doing it, but they’re hard to maintain for years or decades. CrossFit and other exercise trends have the same problem where some people get extremely excited about fitness for a couple years before falling off completely because it’s unsustainable for them. Some people are able to continue these things for decades, but most people do it for a short while and then stop.
I’m now seeing the same pattern with biomarker obsessives: They go a few years obsessing over charts and trying things for a few months at time, but when the interest subsides or they get busy with life most of it disappears.
The most successful people over a lifetime are those who establish healthy habits that are easy to sustain: Eating well enough, reducing bad habits like frequent alcohol or fast food consumption, some light physical activity every day, and other common sense things.
The most important factor is making it something easy to comply with. The $300 biomarker panels are interesting, but most people don’t want to pay $300 every year or more to get snapshots that depend largely on what they did the past week. Some people even get into self-deceiving habits where they eat well for a week before their blood tests because the blood test itself has become the game.
Long story short care about your health. If you don't do already, maybe now is a good time to start.
What you put into your body: no processed food, cook yourself, lots of variety of veggies and fruits, little meat, little alcohol.
What you do with your body: regular exercise, low stress, enough sleep.
What you do with your mind: good social environment, good relationships.
And an apple a day keeps the doctor away!
Not all things labeled "processed foods" are bad, it seems. There are enough scientists that say the distinction is often hypocritical (example from an article: a factory-made carrot cake is labeled UPF, but a home-baked one isn't, even though they're practically the same thing). Sugar, fats, and lack of fiber make factory-food unhealthy, they say. Others add that we can't feed the growing metropolitan areas without it.
WRT the carrot cake, I will say that while there is only a minimal physical difference, there is a practical difference. Making a carrot cake at home is a commitment, and most people won't frequently go to the trouble except on special occasions... But one from the grocery store can be acquired casually and without effort, and it's easy to eat a lot more of something when it requires no effort.
>a factory-made carrot cake is labeled UPF, but a home-baked one isn't, even though they're practically the same thing).
Actually they are not. "Practically" is carrying a lot of weight there. The factory baked cake will have a lot more extraneous ingredients and usually has a larger quantity of sugar and fat. Similar to how restaurant food generally has a lot more salt and fat than home cooked food.
"Long story short" should probably be followed by a short version of the long story.
> lots of variety of veggies and fruits, little meat
This is wrong. Our bodies evolved to rend flesh and eat meat. They are optimized by millions of years of evolution to process and run on meat.
The biochemical pathways of carb-heavy diets put more oxidative stress on the body.
This is wrong. Our bodies evolved to eat a diverse omnivorous diet and complex carbs + the antioxidants present in vegetables and fruits are anti-oxidative.
Vegetables aren't "carb-heavy". And we don't need to recreate blindly the circumstances evolution had to adapt us to. E.g., our bodies evolved when the population was much smaller, but I don't think you want to argue for mass extinction.
podcast science is a bit low-brow for hn brother
There's something I deeply don't understand about this.
> I shared these results with a leading lipidologist who proclaimed: “Not sure if the lab or the primary care doc said an LDL-C of 116 mg/dL was fine but that concentration is the 50th percentile population cut point in the MESA study and should never ever be considered as normal.
> It’s also important to note that, according to a lipidologist friend, an ApoB of 96 is at a totally unacceptable 50th percentile population cutpoint from Framingham Offspring Study.
So... the exact median value is "totally unacceptable" and "should never ever be considered as normal"? I'm open to the possibility that the US population is so deeply unhealthy that this is true, but then that needs to be argued for or at least mentioned. Like, you can't say "you're exactly average in this respect" and expect your and that's terrible to be taken seriously without any followup.
Or if I'm misunderstanding what's meant by "50th percentile population cut point" then again, I think this jargon should be explained, as it's plainly not the usual meaning of "50th percentile".
I'm not sure that non-medically indicated CT scans are a great idea, as you're at least doubling your yearly dose of radiation in the year of the CT scan. Perhaps it's warranted, but the article doesn't seem to balance that at all against doing a CT scan "every 1-5 years".
Yes - in addition, medical professionals warn against “overdiagnosis” from unnecessary screenings.
This can happen when we choose to treat otherwise benign issues that would have had few negative consequences for our health or longevities. Those treatments can have negative effects that are worse than the ailment we’re trying to treat.
I know it’s a natural tech-guy impulse to quantify everything and get access to as much data as you can, but that myopic focus can actually lead us to optimize for the wrong thing.
[1]https://pmc.ncbi.nlm.nih.gov/articles/PMC4077659/
[2]https://pmc.ncbi.nlm.nih.gov/articles/PMC6135119/
I agree. I’m a physician and this is sticking out to me as bad advice. You’re dramatically increasing your risk for cancer by getting unneeded regular CT scans, in addition the not insignificant risk of detecting incident findings, which will put you at increased risk via biopsies, unneeded test etc.
Diet and exercise I agree with, everything else take with a grain of salt.
Great post but quite surprised there is no mention of cutting red meat. There is a lot of evidence that especially the American diet is dangerously high in red meat to the point of elevating Heart Disease risk.
IMO, I think that is more of a saturated fat issue, and only a subset of the population is like that. Others solve their health issues through eating a lot of red meat.
Also processed red meats or processed meats in general. Processed meats are the ones strongly linked with heart disease. At least for those who dont want to go vegetarian.
Processed meats are so bad, they should be eliminated entirely from everyone's diet. The World Health Organization has classified processed meat as a Group 1 carcinogen. No amount of it is considered safe.
Unprocessed read meat is still a problem and WHO advises less than 350g a week. Which is 12–18 ounces of cooked meat. 12g is about one adult serving of steak. So you really are looking at 1.5 servings per week of unprocessed red meat to be safe. At most! You probably should try for less or closer to 12g.
And really if you're at a healthy weight, then I'm not sure how helpful this is. Obesity is a bigger risk factor. This is a bit of the elephant in the room for heart health. Not only should we not be eating things associated with heart disease but also we need to keep ourselves at a healthy weight.
I was planning to start getting scans ordered for specific risks like aneurysm or heart attack but what holds me back is the idea the scans will harm me worse than those things.
It is very difficult to have any level of confidence with the medical industry so my current approach has been to eat as healthy as possible while staying as fit as I can without undue extreme stress.
A relevant anecdote. I’m very athletic and skinny, eat well, have a resting heart rate in the 40s, but was recently prescribed a statin at 30, due to my very high LDL cholesterol and lipoprotein A.
My family has a history of cardiovascular disease despite us doing what we can w.r.t eating and exercise. I’d encourage you to get some tests at least.
My mother similarly was put on statins and is getting a cardiovascular work up (calcium scan) because she now has early atherosclerosis. She eats super healthy and is a former olympic sprinter..
Bonus anecdote: In my free time I do shifts as an EMT with my fire dept (911), that is a big wake up call to wanting to be as healthy as can be. The number of patients I see who are 50+, nearly all are on 5-10+ meds, few are just one 0, 1, or 2. At that age I see type 2 diabetes, hypertension, high cholesterol, and more.
> scans will harm me worse than those things
There are two known harms from scans:
- Radiation. This is why people shouldn't get these scans several times a year, but 1-2 are very unlikely to move the needle. The average radiation from a full chest CT is just under the average dose for ~2 years of normal background radiation. (I don't know if a CTA uses less than average.)
- Acting on something you would otherwise have ignored, where ignoring it might have been the right answer. The main problem here is that it's hard to get a medical opinion saying "you should ignore this" because of perverse incentives: there's an aversion to recommending doing nothing because that could lead to a lawsuit, whereas "overtreatment" will not get a doctor sued. However, you can make a deliberate decision to do this anyway even after getting the scan; seek second and third opinions, consider alternatives, weigh risk versus reward, make a considered decision.
As someone who would like to do this but has generally been choosing the easy paths - curious what your diet and exercise regime looks like.
> Sticking to a Mediterranean diet that is light on carbohydrates and saturated fats is almost always the safest bet. Almost every health diet is some permutation of this.
A permutation that's currently making the rounds in the press (even though the original research is from 20 years ago) is the "portfolio diet":
https://jamanetwork.com/journals/jama/fullarticle/196970
https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.0...
Some press mentions:
https://www.health.harvard.edu/heart-health/the-portfolio-di...
https://www.nytimes.com/2025/11/04/well/eat/health-benefits-...
https://www.cnbc.com/2025/11/05/the-portfolio-diet-what-it-i...
This is a lot of words to say eat a plant-based/vegan diet.
The "be an advocate" thing is both true but also incredibly selfish and egotistical.
If everyone did that, the whole system would grind to a halt. Doctors aren't in a rush because they enjoy so, they are because they're already overworked. 1 out of every 25 patients (their family) demanding extra attention is possible although still a burden. 21 out of every 25 is not possible.
Fabulous information, but lacking information isn’t the issue. The behavioral changes are obvious and well evangelized : lose weight, regular activity (walking), and if necessary, take meds. (Yes I know your marathon runner cousin who died suddenly of a heart attack, but these are still your best odds)
Telling people what to do rarely fixes anything. People need dozens of impressions for those changes to sink in. Friends, family, social outings, commercials, movies, songs all promoting overindulgence won’t be overcome with a helpful pamphlet or nagging.
This site isn't necessarily meant to have a big sociological impact; it provides enough information that someone with sufficient motivation, but a lack of resources and expertise can take concrete steps to reduce their risk. That seems useful to me.
Managing stress shouldn't be overlooked
“Stress” is so abused and nebulous that it’s impossible to define. Nearly every condition is worsened by “stress” but there’s no way to measure it. And there’s no conclusive way to manage stress either. Medication, psychotropics, self medication, mediation. Nearly all of those are more broadly abused and yet stress “worsens”.
One person may run an intense soup kitchen 15 hours a day and feel little stress, and another can sit at a computer for 9 hours sending pointless emails and feel tremendous stress.
Fortunately, as you mention in your last sentence, stress is introspectable.
How exactly stress corresponds to biomarkers doesn’t matter if your desire is to lower it.
The issue is that many of us don’t pay attention to how we keep our body & mind throughout the day, or do so on a very superficial level. So strain on the body can accumulate for a long time.
“Stress management” is a lifetime skill. It doesn’t come in bulletpoints, it’s as broad as “living happily”.
Edit: That said, this can make the advice “be less stressed” a bit vacuous.
But people do get scared when random health issues flare up and become more conscious of how they deal with stress in life.
So it’s not bad to keep reminding people either :)
Managing cortisol shouldn't be overlooked
> The behavioral changes are obvious and well evangelized : lose weight, regular activity (walking), and if necessary, take meds.
More specifically, it’s “change your diet and eat/drink less”, which is the hardest part. Diet’s impact eclipses regular activity, and it’s consequences build up and compound over decades.
I might just be tired, but this seems highly repetitive. The author mentions friends in the field and concierge doctors multiple times in as much as I read.
Feels like the whole thing could be shortened to just say "here's the tests you run, the drugs you might take, the lifestyle changes you should consider".
It’s also demonizing doctors and the healthcare system a bit too much for my liking.
I’m located in Europe, so I may have a slightly different view, but my doctors clearly care and discuss with me about prevention, risks, tradeoffs, …
They praise the methods of the „good“ doctors and stamps the others as driven by financial gain. Who says the expensive ones are any better in this regard? Who says they are more or less exaggerating the importance of test results to make you come back?
Right? It started okay even if a bit too verbose, then there was a second introduction. There I lost interest.
Somewhat related, one of my thoughts was “what if these concierge doctors just keep running tests until they find something, anything, to justify their fees”?
Triglyceride-to-HDL Ratio (TG/HDL)
Interpretation: • < 2.0: Insulin sensitive • 2.0–3.9: Moderate insulin resistance risk • ≥ 4.0: High likelihood of insulin resistance
Your ratio = 5.0 → Suggests likely insulin resistance.
For what it's worth, this article by the doctors at Barbell Medicine has been my go to recommendation for what to prioritize for health and longevity: https://www.barbellmedicine.com/blog/where-should-my-priorit...
If you dig into research and follow the low-risk experiments that people do online to reduce their Lp(a), you can find techniques and evidence to do so. It doesn't have to be an impossible-to-fix issue.
I like this list of experiments by Greg Muschen: https://x.com/gregmushen/status/1924676651268653474
Very interesting, but do the numerous mentions of taking action in your 20s, 30s and 40s mean it's too late for someone in their 50s?
Nitpick: he mentions LDL-C but the test results don't mention that at all. Only later do I see that is "LDL Cholesterol".
In general, when science is done, recruitment requirements force the experimenters to bucket the participants. One thing that often happens is an open bucket, say 35+.
The resulting science is then reported as “When you cross 35, your chances of being pregnant immediately drop” or “The brain stops developing at 18” and so on.
Almost nothing in the body is really like this, though. You can quit smoking later in life and it will help. You can eat better later and it will help. You can exercise and it will help. Very few things are “the damage is done”.
The only constraints are that the later you start the more risks you face. E.g. if you first deadlift in your 50s and you decide to follow Starting Strength you’re going to have trouble.
If you start exercising in your 20s, and never stop, it will be so much easier to maintain fitness in 40s 50s etc. The challenge is that the benefits are not yet visible in your 20s (when you’ll probably be healthy and at a proper weight regardless). Gotta lay that foundation for older age though!
EDIT - I misread the comment. It’s never too late to start, just be careful for injuries as that will block your ability to exercise.
It's a bit like saving money.
No, it is never too late to take action. Even taking action after a stent procedure reduces further risk:
https://www.nhs.uk/conditions/coronary-heart-disease/treatme...
There are some points on this post that confuse me.
> In early 2023 during a routine skin check at my dermatologist [...]
Are routine skin checks a thing?
> [...] I’ve spoken with several of the world’s leading cardiologists and lipidologists [...]
How come?
> Are routine skin checks a thing?
If you have a dermatologist, I would imagine so.
Is having someone you can describe as "my dermatologist" a common thing? Probably not for most people who don't have a chronic skin condition of some kind, I would think.
Was this written via LLM? There’s a link early on to some ai search tool which kinda made me question the validity of everything mentioned.
You should always have questioned the validity, but now you feel the need because of LLMs.
> It's not sexy, and as a result an overwhelming majority of the population is unaware about how to avoid succumbing to it
When I started building an ECG Holter in my early 20s, I tried to get some friends to use it and kept hearing "yeah, but it’s not exactly sexy to wear that thing." That’s when it hit me how little people care about prevention until something goes wrong. We still have a huge awareness gap to close.
The value of the biomarkers are they applicable for all age range? What if someone already had a heart attack, then what should be the normal values post incident?
The title of the article says "don't die of heart disease", but given that we all have to die at some point, if you could choose what natural cause to die of, wouldn't you pick heart disease? It is the best way to die. The worst is stroke. So once you cross a certain age, say 60, don't worry about heart disease, worry instead about stroke.
Sometimes I think the way this type of thing is framed is misleading. There's a list of putative causes of death and there's an assumption that they're equally systemically impactful, and you can go down the list and just lower the probability of each and lower your overall likelihood of death.
That's not totally off, but the thing about cardiovascular disease is it affects everything because it's how your body distributes oxygen. Stop distributing oxygen and you die.
That's not to say other organs aren't important, it's just that if you replace "cardiovascular" with "oxygen distribution" it becomes apparent that almost by necessity it's going to include a lot of deaths.
I agree, but both are heart disease and both can be prevented in similar ways. My dad and my father in law both died from heart disease. My fil was on the surface less healthy. He had an extreme high stress job with exposures to environmental factors that made it worse, was partially disabled with bad knees, etc. i believe he was on blood thinners for almost 20 years.
He got up to make a sandwich for my mother in law, who was very sick, and don’t come back. Massive heart attack and aortic rupture - he was dead before he hit the ground.
My dad had a lot of stress over his career and his share of health issues but found a happy medium and improved his health greatly stating about in his late 40s. He was basically walk/running 2-5 miles a day for several years after retirement. He had a major stroke, recovered somewhat, and then ended up almost dying from a kidney stone and resulting infection. (He could not communicate pain as part of his aphasia.) long story short, he suffered in a lot of ways (pain, disability, loss of dignity) for 4 years before finally succumbing.
In online discussions, we tend to boil everything down to death. Reality is that longer you can put off complications, the better you will be when something more severe happens or you get sick. As you age, each time something happens, your recovery is a little less robust. Go to the doctor, take your statins and take care of yourself.
> worry instead about stroke.
You say that as if stroke is orthogonal to heart disease. Much of what prevents one prevents the other.
Yes but there are habits that are especially important for preventing stroke, such as getting 7-9 hours of sleep, monitoring and controlling risk factors related to blood vessel health that affect the brain uniquely, such as preventing irregular heart rhythms (atrial fibrillation), anti-inflammatory diet choices focused on brain health, and so on.
If you have a massive banger and die immediately that is a pretty good way to go.
However, many people suffer from heart failure which, despite the name, means partial heart failure. The permanent breathlessness gives them a terrible quality of life. They can live with this for decades sometimes but it's not much fun.
Funnily enough, the things you can do to prevent stroke line up entirely with the things you can do to avoid heart disease.
The article doesn't mention antioxidants at all, which help prevent atherosclerosis.
Dementia seems a pretty awful outcome too. I hope my heart gives out before my brain.
Alzheimer's too.
Why is heart disease a “good” cause of death?
Less suffering. Stroke on the other hand... you become partially disabled, which causes suffering not just for you, but also for your loved ones.
I think you are confusing "getting a stroke" and "dying from stroke". If you get a heart attack and don't die from it you might become a burden on your family too.
Curious about how accessible these tests are in Europe. Living in a country (NL) that doesn't value annual checkups makes me assume detailed, preventative blood testing like this is hard, let alone possible to get in non-extreme situations.
I recently did a comprehensive panel of my own volition with Quest Labs and was pleasantly surprised by the entire process. It was super easy to schedule, affordable, and their online platform is surprisingly sleek.
I love this sort of documentation-style guide to medical issues. Reminds me of https://www.fourmilab.ch/hackdiet/e4/
Stop drinking. Replace cheese and butter with olive oil in copious amounts. Only eat fish meats. Don’t smoke or vape. Eat salads and other prebiotics. Get some cardio - even walking your dog is great. Your brain fog will lift, your skin will clear, your mood will improve and your doctor will gasp at how clear your carotids are next time they’re ultrasounded.
What if heart disease saves me from dementia? I'm not just being contrarian. I think about this a lot of the time. I'm already 40. I'm being healthy now, but whatever damage has already been done is baked in. (plus whatever is in my genetics) A quick death at 65-70 might be much more preferable to a slow terrible decade-long decline.
My grandfather always said "there's something to be said for a good coronary." He was in his 70's when he said it, and his point was that he had a good run, and there's an argument for going out while things are still good rather than slowly dying over six months in a nursing home (which is what actually happened).
New medical discoveries happen regularly; you might also die right before the discovery of a preventative/cure for dementia. Living people have options, dead people have none.
Also, given the preferences you expressed in your comment, you especially should want to avoid strokes, or the many side effects of heart disease, which can make you less healthy for a long time.
Heart disease can be a slow decade long death, where you become incapable of physically doing anything. It's not just a heart attack out of nowhere and you're dead.
There doesn't seem to be any mention of hypertension on that page.
Actually, there is. You have to search for "pressure". For example, "Other Tests: There are some other things that are important to know as well. You must know your blood pressure".
If you're going to press ctrl+f and post a critique, I recommend including a synonym or two in your search terms.
It is a long read and I want to make time for it. Quick search check and calc (for calcify etc.) and diet appear alot in the article which is not surprising based on other things I have watched on the subject.
This is all very interesting, but far too detailed and technical for 99% of people. The TLDR should include an easy to understand summary without jargon like "VO2" and "a set of HIIT at Zone 4".
A key takeaway is: don't be afraid of taking statins if you need them. I fell for the "statins are bad" BS for years and have paid the price.
My dad would disagree--he's 84, was on statins for years and they did terrible things to his body. I'm sure the drugs kept him alive, but the side effects, as he describes them, particularly to his legs and kidneys, were pretty severe. He only got better when he stopped taking them.
I believe statins reduce risk by about 30%, so there's a roughly 30% chance the statins have done good things for your dad.
(I think that's what the stats mean, right? I'm open to correction on this. I do believe the statin studies, I'm not a science denier. I think what I've said matches the science, as far as I understand.)
What price have you paid?
Love the chart at the bottom--it really puts on display media bias and lack of integrity and using fear to push idiotic policies which area really just a way to put everyone in the pocket of government and keep them there permanently with zero real improvement to public health. Fear get eyeballs. the Covid mass hysteria proves that, too.
As far as heart disease goes, yes, it's the big killer and it's time people started waking up from the media haze, but to do that, you have to admit you were wrong, and for many, that is far too tall a hill to climb.
Tl;dr be affluent enough to be able to afford great medical care and have enough free time for preventative actions
Walking and eating sensibly is free. Even a balance oatmeal, rice & beans with infrequent meat servings would defend against heart disease better than expensive medicine, at less than $1 / day.
Promoting good habits is good but this is health advice from an unlicensed commenter to say rice and beans is better than taking a statin. Consult your doctor if you’re curious what to do.
It’s safer than taking unlicensed tech advice from an Internet forum
And not smoking or drinking saves you money!
Yes, our system is most definitely stacked against the poor, but it's important to also remember that we all have free will and that some choices fully within our power are much better than others.
Lentils/legumes are cheap. There is probably no better bang for the buck. Yogurt is also cheap.
90 day supply of Atorvastatin costs $10. Running costs a pair of shoes.
I think the point is it is cheap to prevent. The weird tip is doing a different test to the standard one, which costs little for typical HNers (but admit every $ counts for many people esp. with current inflation, poverty, bad governance) but sounds like on par with a dentist doing anything beyond a checkup.
A colleague of mine was a vegan, took care of himself, still died of pancreatic cancer. It is what it is.
You should try www.betterbrain.com/insurance! It covers this set of bloodwork and 92% of covered patients pay $0
I don't like this kind of content. The author might have a personal motivation for it, but for the general public, it's just more mental load.
We are all going to die one day.
When I was younger, I would fret over this kind of article. Great, one more thing I have to worry about. Now I just mostly ignore it. It's impossible otherwise. If I dedicate hours and days and months to all the heart best practices, what about when the liver, esophagus, kidney, bladder, brain articles come out?
We all know the good practices. Don't be a dumbass. Don't drink too much, exercise and so on. Besides that, I'm very much going to be reactive, as the article cautions against. I just don't have time or mental energy to do otherwise.
> We all know the good practices. Don't be a dumbass
In theory yes, but in practice we are all dumbasses to some extent.
I used to have your attitude until I saw a friend die of a heart attack at an early age - and it appeared to me that he would have survived if he had an indication. So, now I have changed my attitude to one of more data does not hurt.
I share your general emotional reaction, but to be fair, heart disease is far and away more important than other type of disease. More people die of it in the US than die of all cancers combined: https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
> Don’t Die!
Why the f* not.
My in-laws are over 95. They refuse to go to an elderly home and as a result make everyone miserable, starting with themselves and inflicting infinite suffering on their children who each have a family of their own, and need to take care of them all of the time.
I don't want to do that to my own children. I don't want to not die. I don't esp. want to die but I'm not really afraid of it, it's just a normal part of life.
Preventing heart disease is probably a good thing, but if one prevents every ailment conceivable then how does this work eventually?
You're almost certainly going to die by or before 110, anyway. (Ir)Regardless of your efforts, or lack thereof, our bodies typically give out in the 100-110 year range with very few exceptions.
If you prevent every ailment you don’t become frail and just take care of yourself.