Why Blame LDL for Arterial Plaque? – FORD BREWER January 7, 2020 35 By Bertrand Dibbert CategoryArticles BlogTagsbrad bale doneen beat heart attack gene coconut oil fife aha cv inflammation prevention ford brewer prevmed heart attack stroke prevention how to drop your arterial age 20 years how to reverse arterial calcification how to reverse arterial plaque how to reverse arteriosclerosis insulin resistance johns hopkins uk physician metformin weight loss niacin plaque removal why blame ldl for plaque yt:cc=on 35 Comments Teresa Biber says: February 10, 2019 at 3:39 pm Im new to your channel, what tests would I ask my dr to run that would check for inflammation markers like this? Reply Dr. Don Bonner says: February 10, 2019 at 3:40 pm Great video and I couldn't agree more concerning inflammation and Elevated insulin levels. Reply Sawmiller Smith says: February 10, 2019 at 3:41 pm I never though LDL was bad. I believe it does what it was made to do. I think they need to look for the cause. I noticed those who were in prison who about starved to dead lived into a very old age. Their was a guy here who lived t be 110 and was in WWII in a japanese prison for 4 years and ate nothing but rice and water. But I don't think anyone could or want to eat rice and water for 4 years just so they could live to be 110 either. Reply Dr. Don Bonner says: February 10, 2019 at 3:42 pm Dr. Brewer how do you treat high levels of LPa. I use niacin, but this is one of the few instances where I will use low dose statin therapy. Reply Peter says: February 10, 2019 at 4:20 pm Thanks for recommending "Beat the Heart Attack Gene." Reading now. Very comprehensive and informative… Reply Trail Guy says: February 10, 2019 at 4:24 pm can you tell me what dosage of ramipril you take? Reply kinpatu says: February 10, 2019 at 4:25 pm I’m on rosuvastatin-20 following angioplasty. Standard of care in cardiology is to accept an increase in LFT transaminase to 3x upper limit of normal before modulating the statin. Your thoughts? I am on ezetimibe as well, but I don’t take the prescribed dose because it really drives up my AST/ALT and my LDL is at 20~40mg/dL on a reduced dose, while keeping my AST/ALT around 1x ULN. Reply Robin Rae says: February 10, 2019 at 4:46 pm Excellent!! I'll share this on the Lipoprotein (a) foundation website. There they recommend very low LDL goals since LPa rides on the LDL. I don't understand how some of us with high LPa (at times) have no CVD Or signs of inflammation while others with high LPa DO Have severe CVD and have had bad heart events while otherwise being very healthy with diet and lifestyle. Very confused. Reply Allen Crusifulli says: February 10, 2019 at 4:59 pm Dr Brewer ..I have a Lp(a) of 57 but my Cardio CRP is 0.3. Im worried about it although my cardiologist says that all I need is a statin and not to worry. My Triglycerides and insulin levels are low.. I've been on 2 grams of time released niacin for over a month now along with 1000 mg of L-carnitine , vitamin C and L- lysine.. Even though my cardiologist told me not to worry I'm still going to continue taking these supplements..Any comments? thank you.. Reply Bart Robinson says: February 10, 2019 at 5:14 pm That was another great video and very easy to understand just got to convince my doctor and cardiologist!!! Reply frank mucci says: February 10, 2019 at 5:50 pm Great presentation thank you Reply Bill Barhorst says: February 10, 2019 at 6:44 pm I had emergency quadruple bypass surgery in October. My total cholesterol going into the hospital was 129 and LDL was 83. My cardiologist wants to “drive my LDL into the basement” and was considering PCSK9 inhibitor gene therapy to get the LDL below 40. Fortunately my LDL dropped to 20 on 40 mg of Lipitor and oatmeal. I believe my previous prediabetes damaged my arteries and that keeping my carbs low is a better approach than driving LDL so low. Currently my A1C is 5.8 without medication. I’d appreciate your opinion, Doc. Reply CLAUDIO FOSSATI says: February 10, 2019 at 7:47 pm Hi Doc, are you going to go deeper into dysfunctional HDL? Thanks, always interesting videos posted. Reply MrJoeyBoombotz says: February 10, 2019 at 9:09 pm "The 'bad' cholesterol, LDL was a phrase made up by a marketing executive. Reply Jake Hesseltine says: February 10, 2019 at 10:30 pm Dr Brewer, how do I determine if I have Familial Hypercholesterolemia? I am 39yo and I have CVD on both sides of the family and my LDL has always been high. I'm very active physically and have recently started a LCHF diet and it really sent my LDL through the roof. It doesn't appear that I have any form of pre-diabetes. I have not gotten all of the inflammation tests done you've recommended (I did get some). I did get a cac score of 60 last month and the CIMT was clean. After my most recent lab results prompted a statin (10mg of crestor) and I've added Niacin (500 for now…going to 1000). I've also changed my diet away from red meat, butter, bacon to fish, avocado, eggs, olive oil, etc form my fats. Below are my basic lipid numbers. I really just want to know how much focus I need to be placing on LDL? Thanks for all that you do! October 2018 (Pre Keto)Total Cholesterol: 284HDL: 63LDL: 209Tri: 58 January 2019Total Cholesterol: 460HDL: 61LDL: 379Tri: 88 Reply Z50-Z6 says: February 10, 2019 at 10:40 pm Ok, so in May 2018 I had a Cardiac calcium score of 6,114. I had no symptoms, and only got the test done because I brought it up with my C. Up till that time, he had been watching my aortic valve stenosis wait for it to reach a certain % before replacing it which he estimated to be 3 or 4 years off. But my score changed all that. With me sitting there still absorbing that astonishing score he called his 1st call cardiac surgeon and made an appointment for the following week. The day before the surgery he did my cath: L=99%, R=100%, and Aortic artery =75%. Yet I had no symptoms. Long S.S. I had an AVR with a 3-way side of cabbage. All went extraordinarily well. Never had any pain. Not even 1 aspirin’s worth. I’m doing very well! However, what about all this calcium that is still in my heart. I’ve been going hard core to reduce inflammation. I’m in deep ketosis right now. I have a Dr. Boz ratio of 14.375, BG/KETONES. You sound doubtful as to whether or not that matters, since stabilized plaq isn’t a problem if I understood you right. If I understood you correctly, then what else can I do to reduce or eliminate inflammation? I’m 8lbs from my intermittent goal of 170. The BMI chart says 161 and I may just keep going till I get there. I’m thinking about the CIMT test, but I don’t know where to get it. I’m in Tampa, and I know you’ll be in Orlando soon, but while I would love to attend that dream summit, it’s simply out of my league. So where can I go to get just the CIMT? My C. Says I’m the most proactive patient he’s ever had. I deeply appreciate any suggestions you are willing to make. In Florida, old, 74, but not dead………………………………………..YET! Reply Radnally says: February 11, 2019 at 12:54 am So plaque formation and an eventual rupture is due to inflammation which is caused primarily by IR? Did I understand this correctly?Thanks. Reply Hiker Bro says: February 11, 2019 at 1:12 am Dr David Diamond seems to think that the real problem seems to originate in the vasa vasorum. CHD patients seem to have a higher levels of clotting factors. If I understand his theory, small clots form in the vasa vasorum, which becomes damaged. Cholesterol and calcium rush in to patch the damage. The inflamatory response and the inflamatory effect of insulin accelerate the damage in a circular reaction. He cites undamaged endothelium as evidence to support this theory as well as lower numbers of heart attacks and strokes among those patients who managed to reduce their fibrinogen and HCF3 numbers. I apologize not not having video links for reference. Do you think these ideas hold water? (Also, Dr. Diamond has a personal and familial history of FH). Reply David jones says: February 11, 2019 at 1:14 am I like the video as it reinforces my position. However, I'm always willing to listen other views and data.Btw: check out Siim lands book that just came out today. So far I think he did a great job. Probably not for casual readers. Reply David jones says: February 11, 2019 at 2:53 am I think you mentioned a study before that talked about Necrosis of the media due to microvascular damage that first occurred in the media. I also remember another paper on the slippery hair like fibers that line the intama that are very sensitive to damage as well as extreamly difficult to observe. It mention how VGF's were associated because the lack of regrowth. I thought both were very interesting. The nano bacteria theory sure seems plausible as well.So many things interdependant.Thanks again for the video. Reply Tom Deck says: February 11, 2019 at 5:04 am There is a disconnect these days between what is known about cardiovascular health and a person getting an endless set of standard blood panels at their primary care doctor's office for his/her annual physical. Thanks for helping to educate people on what is important and thus how they can frame conversations with their doctors. Reply gary smallwood says: February 11, 2019 at 4:35 pm That's what many doctors do not speak of is inflammation and that can cause a widow maker.Like my dad had a infected heart and that's is what caused his blockages.The muscles around his arteries has gotten infected and closed down shutting down blood flow until after a while the heart pumps harder and faster and gets (Many time doctors mistakenly call this afib and give toxic afib meds out). damaged and weakens and turns into a rubber non working heart.Most times if the heart infection goes away the person symptoms will go away unless poiymenant damage set in. Reply doom says: February 11, 2019 at 9:13 pm Hi, I just found your channel. Thanks for all your videos. Extremely valuable information you provide the world! Reply L Dean says: February 12, 2019 at 12:34 am How do we know that the "cracks" in the endothelium are what "allows" LDL to get into the intima? What if LDL belongs in the intima as part of endothelial healing, BUT damaged LDL gets there and fails to produce the desired results? Your body senses this failure and asks for more LDL and get is it, but that LDL is damaged too. This sets up a chain reaction of your body desperately wanting functional LDL but keeps getting supplied with damaged detrius instead. This fits in with the model of "hot" plaque as an arterial zit. What is curious to me is that an LCHF diet "cured" my adult acne. When I eat too much sugar I get zits again. I don't need a "crack" in my skin to get a zit, they just form. Skin cracks usually scab up and heal. Zits only become really inflamed when they get infected, but many of my zits never get infected. What if heart attacks are just arterial boils that "pop". Maybe stable plaque is just like a blackhead that never gets infected. Maybe our skin and arteries are a lot alike??? Reply imaseeker100 says: February 12, 2019 at 2:17 pm Excellent video. Subscribed. Reply jm 20 says: February 13, 2019 at 4:33 am IMHO, small dense LDL & Lp(a) are still important, although not nearly important as controlling inflammation. I think it’s important to keep small dense LDL & Lp(a) as low as possible. The reason is because at some point in our life, we are going to be in an inflammatory state. People just get sick. So many CV events happen to people who are sick or are just getting over an illness. My father had an MI 3 weeks ago from the flu. His small dense LDL & inflammatory markers were not perfect, but they were not horrible, either. It’s important to keep the plaque burden low & stable because we all get sick with viruses. Reply mattmoo1007 says: February 13, 2019 at 1:45 pm Dr. Brewer, it would be interesting to get your opinion regarding Ivor Cummins assertion that a major factor in plaque is the continual onslaught of the glycocalyx by the sugar in the SAD. Around the 8 minute mark Ivor presents his data to support this position. https://www.youtube.com/watch?v=vBKa6d6j9_8&t=1114s Reply Annette Fowler says: February 14, 2019 at 7:34 pm THANK YOU Reply Taylor White says: February 15, 2019 at 6:54 am What's the scoop with the gut dysbiosis write in? Articles i have read have made me suspect that it can be associated with liver function and insulin resistance. Personally i'd love a video on the dysbiosis topic. Two family members of mine has intestinal dysbiosis. Reply Ten Minute Tokyo 2 says: February 15, 2019 at 8:05 pm I think it is far more a lack of exercise than diet. Reply Ten Minute Tokyo 2 says: February 15, 2019 at 8:23 pm Hey doc, people who live in smoggy areas have a 27% higher incidence of ❤️ disease. Reply Hotwheel66 says: February 18, 2019 at 6:38 pm Has anyone ever had a Calcium score test post Heart attack to prove the calcium score theory? Reply Naji Fakhouri says: March 10, 2019 at 10:19 pm Hi Dr. Ford…what are your thoughts on PCSK9 inhibitors? It’s a powerful LDL lowering medication but it doesn’t address inflammation. Reply Taylor White says: March 12, 2019 at 7:39 pm Is smoking in general a cause of significant CV inflammation, or just nicotine? For example, will nicotine patches (nicotine, no smoking) cause issues, or nicotine-free smoking? Long before I became interested in CVD, I wondered whether all forms of smoking / 'vaping' / etc. damage vasculature, as they almost always involve an array of hot chemicals, often including burnt plant material (not good stuff) coursing through all of your veins and arteries. I always suspected that this might be a much bigger issue than, say, lung cancer from smoking, even though most think only of lung health in relation to all forms of smoking. Reply S LF says: March 31, 2019 at 2:43 pm Good morning Dr. Brewer. I am so glad I found your channel. My friend in his 50s is very physically active, has poor sleep habits, stressful work, diet was more inclined to sweets( which he has stopped) fruit smoothies which he was unaware were heavy with added sugar. He reports no ETOH in the last 3 yrs. Non smoker. His recent labs 1 month ago were abnormal in some areas: total cholesterol of 174, HDL 35, triglycerides 198, LDL 99, vit D level of 12.4. A1C is 4.8%. AST of 44. Other than abnormal labs, he has decreased energy, fatigue, icteric sclera, low mood. His PCP recommended ViT D 50,000IU weekly and Niacin 2-6Gm/d. No CArbs, no sugar Diet. What are your thoughts on Niacin with the elevated AST? Fmhx of heart dz.. He has been strict with the dietary changes but less inclined to take the VitD and Niacin. He wants to know if dietary changes like flaxseed oil, ViTD enhanced mushrooms, Mediterranean diet will make a significant improvement in his labs and overall health? 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