Dr Brewer's Friday Rant: The Solution To Clogged Arteries

Summary

In this impassioned transcript, the speaker, a content creator and healthcare professional, addresses the ongoing issue of heart disease as the leading cause of death in the U.S. Despite medical advancements, the speaker criticizes the reliance on statins and emphasizes the importance of metabolic disease management. They advocate for lifestyle changes and a better understanding of metabolic health, while also discussing the limitations of current medical practices in diagnosing and treating these conditions.

Takeaways

• 📊 Heart disease, specifically coronary atherosclerosis, remains the leading cause of death in the United States for over two decades.
• 🛡️ Atherosclerosis is largely preventable, yet it continues to be a top killer despite therapies aimed at lowering LDL levels, such as statins and PCSK9 inhibitors.
• 🧬 The 'Four Horsemen of chronic disease' include heart disease, cancer, neurodegenerative disease, and metabolic disease, with heart disease being the most preventable.
• 🤔 There is a debate within the medical community about the best approach to treating heart disease, with some focusing on lipidology and others on metabolic disease.
• 💊 Statins have been widely used for decades but have not eliminated heart disease as the number one killer, suggesting a need to reevaluate their effectiveness.
• 👨‍⚕️ The speaker advocates for a more lifestyle-focused approach to preventing heart disease, believing it to be more impactful than medication alone.
• 👥 There is infighting within the medical community regarding the best strategies for preventing heart disease, with criticism between different factions.
• 👂 The speaker emphasizes the importance of listening to patients' concerns and preferences when it comes to medication, such as statins.
• 👶 A call to action for individuals to educate themselves about metabolic disease, as the medical community may not be fully equipped to diagnose or treat it.
• 🧬 Familial hypercholesterolemia is a genetic condition that affects the metabolism of LDL and can lead to very high cholesterol levels, increasing the risk of heart disease.
• 💊 Cyclodextrin and cavitex are mentioned as treatments that aim to remove cholesterol from the body, but the speaker expresses skepticism about their effectiveness based on current research.

Q & A

What was the main topic of the speaker's 'Ford's Friday morning rant'?

The main topic was the leading cause of death in the United States, focusing on heart disease and the role of LDL in atherosclerosis.

What is the 'Four Horsemen of chronic disease' the speaker mentioned?

The 'Four Horsemen of chronic disease' refer to heart disease, cancer, neurodegenerative disease, and metabolic disease.

Why does the speaker believe that heart disease is the most preventable among the 'Four Horsemen'?

Heart disease, specifically coronary atherosclerosis, is considered most preventable because it is caused by APO-containing lipoproteins, mainly LDL, which can be managed with therapies like statins and PCSK9 inhibitors.

What is the analogy the speaker uses to describe the differing perspectives in medicine today?

The speaker uses the analogy of the 'six Blind Men and the Elephant' to illustrate how different medical professionals may have varying and sometimes conflicting views on the same issue, like the nature of a disease.

What does the speaker suggest as a more effective approach than medication in managing heart disease?

The speaker suggests that lifestyle changes are much more important and effective in managing heart disease than relying solely on medications like statins.

Why does the speaker mention the importance of early management of blood pressure?

Early management of blood pressure is crucial to prevent the stiffening of arterial collagen, which can lead to increased pulse pressure and potentially contribute to heart disease.

What is the speaker's view on the use of high-dose statins?

The speaker does not recommend high-dose statins, preferring lower doses that manage cardiovascular inflammation more effectively.

What is the condition the speaker mentions that can cause heart attacks in teenagers?

The condition is homozygous familial hypercholesterolemia, a rare genetic disorder that leads to extremely high LDL cholesterol levels and an increased risk of heart attacks at a young age.

What is the speaker's stance on cyclodextrin and cavitex as methods for managing cholesterol?

The speaker is skeptical about the effectiveness of cyclodextrin and cavitex for cholesterol management, stating that while they are not dangerous, the evidence does not conclusively support their use for pulling cholesterol out of the body.

What advice does the speaker give to patients who are reluctant to take statins?

The speaker respects patients' decisions not to take statins, comparing the situation to a personal fight and positioning himself as a guide rather than a decision-maker, emphasizing the importance of individual choice.

What is the speaker's view on the medical community's ability to diagnose metabolic disease?

The speaker believes that the medical community, including family practitioners, cardiologists, and internists, often lacks the knowledge to accurately diagnose metabolic disease, which he sees as a significant problem.

Outlines

00:00

📰 CDC Mortality Report and Preventable Heart Disease

The speaker begins by discussing a CDC report on mortality data from 2023, highlighting heart disease as the leading cause of death in the United States for over two decades. The focus is on coronary atherosclerosis, which is responsible for most cardiovascular disease deaths. The speaker emphasizes the preventability of heart disease through lowering LDL levels, mentioning therapies like statins and PCSK9 inhibitors. However, they question why heart disease remains a top killer despite these therapies, suggesting a need to reassess the approach to prevention.

05:02

🤔 The Debate on Statin Usage and Metabolic Disease

The speaker delves into the debate surrounding the use of statins and the broader issue of metabolic disease. They express concern about the infighting within the medical community and the lack of consensus on the best approach to treating heart disease. The speaker advocates for a more significant focus on lifestyle changes as a preventative measure, arguing that medications have not been as effective as hoped. They also discuss their personal stance on statin use, recommending them for secondary prevention in patients with existing plaque but emphasizing the importance of individual choice and patient autonomy.

10:05

💊 Statin Dosing and the Importance of Lifestyle Changes

Continuing the conversation on statins, the speaker addresses questions from the audience about their use, side effects, and alternatives. They discuss their preference for lower dose statins for managing cardiovascular inflammation and their reluctance to use high-dose statins. The speaker also emphasizes the importance of lifestyle changes, such as exercise and diet, in preventing metabolic disease, and they express frustration with the lack of progress in this area despite decades of medication use.

15:07

🧬 Familial Hypercholesterolemia and Cyclodextrin

The speaker discusses familial hypercholesterolemia, a genetic condition that affects the metabolism of LDL cholesterol, and its implications for heart disease. They mention the development of therapies like PCSK9 inhibitors in response to this condition. The speaker also addresses questions about cyclodextrin and a product called Cavitex, which are being marketed as a means to remove cholesterol from the body. While they do not consider cyclodextrin to be dangerous, they express skepticism about its effectiveness based on the current state of research.

Keywords

💡Heart Disease

Heart disease, specifically coronary atherosclerosis, is the main topic of the video. It is defined as a condition where the arteries of the heart become clogged, leading to most cardiovascular disease deaths. The video emphasizes that heart disease has been the leading cause of death in the United States for the past two decades, highlighting the significance of prevention and treatment strategies.

💡Mortality Data

Mortality data refers to statistics related to death rates. In the context of the video, the CDC's National Center for Health Statistics released preliminary mortality data from 2023, which is used to discuss the prevalence of heart disease as the leading cause of death.

💡Atherosclerosis

Atherosclerosis is a medical term describing the process of plaque building up inside the arteries, which can restrict blood flow and lead to heart attacks and strokes. The video script discusses atherosclerosis as a major contributor to heart disease and emphasizes its preventability.

💡LDL

LDL, or low-density lipoprotein, is often referred to as 'bad cholesterol.' The script explains that LDL particles can penetrate artery walls and initiate atherogenesis. The video discusses therapies aimed at lowering LDL levels, such as statins and PCSK9 inhibitors, as a means to prevent atherosclerosis.

💡Statins

Statins are a class of drugs used to lower blood cholesterol levels and reduce the risk of cardiovascular diseases. The video mentions statins as a common therapy for lowering LDL levels, but also discusses the controversy and patient hesitancy regarding their use.

💡Metabolic Disease

Metabolic disease in the video refers to conditions arising from metabolic processes in the body, which can include diabetes, obesity, and cardiovascular diseases. The speaker suggests that focusing on metabolic health is crucial for preventing heart disease and criticizes the medical community's approach to diagnosing and treating these conditions.

💡Familial Hypercholesterolemia

Familial hypercholesterolemia is a genetic condition characterized by high levels of LDL cholesterol in the blood. The video script mentions it as a significant risk factor for heart disease, with some individuals having LDL levels significantly higher than normal due to genetic variations.

💡Prevention

Prevention is a key theme in the video, with the speaker advocating for a focus on lifestyle changes and metabolic health as opposed to solely relying on medication. The script discusses the importance of early intervention and management of conditions like pre-diabetes to prevent the progression to more severe diseases.

💡Cyclodextrin

Cyclodextrin is a compound that has been suggested for its potential to help remove cholesterol from the body. The video script mentions it in the context of a product called Cavitex, discussing its use and the skepticism around its effectiveness in treating plaque.

💡Pulse Pressure

Pulse pressure is the difference between systolic and diastolic blood pressure readings. The video script explains how pulse pressure can increase due to arterial stiffness, particularly with aging, and suggests managing blood pressure early in life as a preventative measure.

💡Lifestyle

Lifestyle is emphasized as a critical factor in preventing heart disease and metabolic conditions. The speaker argues that lifestyle changes are 'multiple times more important' than medication, urging viewers to take control of their health through diet, exercise, and other lifestyle interventions.

Highlights

Heart disease remains the leading cause of death in the United States for the last two decades.

Coronary atherosclerosis is the most preventable cause of cardiovascular disease death.

Therapies that lower LDL levels, such as statins and PCSK9 inhibitors, can prevent atherosclerosis.

Despite medical advancements, heart disease continues to be a top killer, indicating a need for better prevention strategies.

The importance of lowering LDL cholesterol as a preventive measure for atherosclerosis-related mortality is emphasized.

The analogy of the 'six blind men and the elephant' is used to describe differing perspectives in medicine.

Lipidologists and metabolic disease communities have contrasting views on the nature and treatment of heart disease.

The speaker criticizes the reliance on medications like statins for heart disease prevention, citing their limited effectiveness.

The speaker advocates for a greater focus on lifestyle changes as a more effective prevention method than medication.

The speaker discusses the challenges of diagnosing and treating metabolic disease in the current medical community.

Familial hypercholesterolemia is highlighted as a genetic condition often misdiagnosed, leading to high LDL levels.

The development of PCSK9 inhibitors is linked to the understanding of familial hypercholesterolemia.

Cyclodextrin and cavitex are discussed as substances with potential in cholesterol management, though not conclusively effective.

The use of cyclodextrin in delivering fat-based medications is explained, and its safety is confirmed.

The speaker expresses skepticism about the effectiveness of cyclodextrin-based products for cholesterol reduction.

A call to action for individuals to educate themselves about metabolic disease due to the medical community's limitations.

The transcript concludes with a discussion on the importance of managing blood pressure early to prevent arterial stiffness.

Transcripts

the uh what what we're calling the

Ford's Friday morning

rant um and you know I'm not much of a

Ranter um but I get emotional I you know

as a content creator on YouTube I Follow

other other healthc care uh and

especially prevention content

creators I've got this email in my uh

inbox

uh The Weekly Newsletter from one of

them I'm not going to name the name many

of you will recognize it as I get into

it recently the cdc's I'm going to read

it for for a second and then talk about

it the cdc's national Center for Health

statistics released its preliminary

report on mortality data that's death

rate data from

2023 once again heart disease reigned

Supreme as the leading cause of death in

the United States it's a sorry

distinction that it's held firmly for

the last 20 years last two decades

Health heart disease and more

specifically coronary

atherosclerosis uh clogging of the

arteries of the heart which is

responsible for the majority of deaths

from cardiovascular disease is easily

the most preventable of all the quote

Four Horsemen of chronic

disease many of you may know who I'm

talking where this came from now um for

example heart disease or that is heart

disease cancer neuro degenerative

disease and metabolic

disease it is caused by APO containing

lipoproteins 90 to 95% of which are

LDL and uh which penetrate artery walls

and initiate

atherogenesis again plaque in the

arteries thus therapies for lowering LDL

levels such as statins pcsk9 Inhibitors

and

others have the power to virtually stop

atherosclerosis in its

tracts so why does this disease remain a

top killer a study published last month

provides some insights along with

further evidence of the importance of

lowering LDL as a means of preventing

atherosclerosis related

mortality you

know I know I overuse the analogy of the

six Blind Men and the Elephant but it's

so

so uh appropriate for what's going on in

medicine today the um the

lipidologists see and hear and feel

LDL just like one of the Blind Men felt

the elephant's tail and said this is a

rope this disease is a rope but then

you've got other folks who are up in the

front feeling the trunk saying no no no

this is uh this is like a snake this is

not a rope it moves on its own and that

may be the metabolic disease community

in my perspective the metabolic disease

Community is far more correct we've had

decades what 50 years 40 Years of trying

medic ations like

statins as we continue to try Statin

what has that done that Reliance on

medications what has that done for heart

attack and stroke I mean you read it

right here it's still the number one

killer I would agree it is

preventable I wouldn't agree that it's

easy but I would say that it's

simple the patients that I see the folks

that focus on metabolic disease that is

is the issue an another concern that I

have is again the fighting the the

infighting the the backbiting that you

have in our

community on one side with the

lipidologists uh you get a lot of uh of

criticism of the low carb Community I

was just out at low carb USA in San

Diego got tons in tons of U criticism

there because I do use STS uh I don't

use high do statins my goal is not to

Pound Down

apob um and here's the thing given what

I do I recommend statins for um people

that have plaque already you're no

longer a primary prevention patient

you're a secondary preven prevention

patient meaning you've got

disease

but uh at times in my practice I've had

over 50% of my patients that had plaque

say doc I know you would recommend it I

know you use it yourself but I've heard

a lot of bad things about statens I

don't want to do that and I'm totally

okay with that U my response is always

that yep I'm okay with that you're L

Luke Skywalker and and I'm Yoda so it's

your fight I'm here to help I don't make

all your decisions for you and here's

the other thing about it I also feel

like lifestyle is so much more important

multiple times more important we've

given statins and medications decades to

fix this problem but they haven't done

it on the other

hand what have we done in terms of

metabolic disease very very little and

in fact we've gotten much much

worse so I'm going to hold off on that

and see if we have any uh comments or

questions Cindy are you seeing any

you are will you read read a couple to

me no

okay okay so hold on let

me okay Sandra Bagwell you normally

speak to heart and artery what do you

think about dios Simon dios Simon for

the Venus insufficiency and does Venus

insufficiency go along with artery

issues uh usually there are two very

very different different issues um and

I'm not familiar with uh

Daimon Kyra 777 I'm back to the gym and

walking very good thank you so much Kyra

oh my gosh we got a lot of stuff here a

lot of questions or a lot of comments

Bibiana Bon hello Greg Strano what is

pulse pressure and how do you reduce it

so Greg pulse pressure is where you take

the top number the systolic like

hopefully 120

and subtract the bottom number the

diastolic uh hopefully 80 so if your

blood pressure is 120 over 80 your pulse

pressure is 120 minus 80 which is

40 um when you so and you're asking how

to reduce it here's one of the more

common things that happens especially as

we age the collagen the connective

tissue in Our arteries like and like the

big one in the the aorta it gets stiff

so instead of pumping into a very soft

flexible wall that expands to um to

accommodate for the increased

volume uh when you pump into a stiff uh

artery the blood pressure shoots up so

the biggest thing to do is not get old

not get stiff collagen so and how do you

do that one of the key things is

managing your blood pressure early uh

when in your 50s your 60s you start

getting pre-diabetic uh starting to

develop blood pressure problems is one

of the most common causes or one of the

most common causes for that that again

goes

unrecognized is undiagnosed pre-diabetes

so we're having some problem holding the

I'm going to have a next week I'm GNA in

fact this week I got a little stand to

hold my iPhone but I forgot it so we'll

hopefully we'll have it ready for next

week always heroic if you want to give a

life advice to a teenager what would you

give oh gosh hold

your that's a good question I'm GNA have

to think about that

one Kyra 777 I'm on 80 milligrams of

statins just had a bypass surgery I

don't feel comfortable taking them any

advice please well Kyra I can't advise

you uh over the internet I will say I've

been uh public before many many times I

don't use high do statins um the the

Statin that comes in 80 milligrams is

the most common one is a lipor or a

torvest Statin I don't use that one

either I uh because it's not as quite as

good at cardiovascular inflammation

which is my major Focus point the lower

dose statins do manage uh cardiovascular

inflammation so I usually use 5

milligrams of Crestor or um I use um

another another one called paben or it's

also the brand name is

lavalo um again I can't advise you on

what to take glad to hear you're back at

the gym and walking

though um orokin tablets can be taken

instead of

natto um I'm not familiar with oroy it

sounds like it may be a brand of

nyise um

so let me see if there's anything else I

want to respond to if not I'm going

to to talk for a minute about

cyclodextrin and

cavitex before I do cap walks should I

up my Statin dose I have PLA and take a

low dose Statin I have zero side effects

and I'm not a Statin hater oh and I'm

very active well I mean again cap walks

I I don't advise individuals on their

care I think I just told you what I do

in terms of

Statin and Kyra yes I responded to your

question Paulette Jackson I have

familial hyper

cholesterolemia found out I have severe

mitro valve calcification I gladly went

on 40 milligrams of Crestor have an echo

study scheduled I'm

77

um poet thank you so much for sharing

that um

most folks are not aware of familial

hyper cholesterolemia if you have an LDL

of 180 or above you have a very good

probability of having hyper cholesterol

familial hyper cholesterolemia it's not

just high cholesterol it's a genetic

variation in which we can't we don't

burn or metabolize our LDL as

efficiently as most people do there are

over

2,000 uh genetic variations or SN IPS uh

the the scientists call them that can

cause this um the

pcsk9 actually were developed out of a

knowledge of this

problem

um I can tell you I've got a ton of

patients with familial

hypercholesterolemia uh most of them

have LDL levels 180 to the low 200s now

I can tell you that's what we call a

garden variety or

heterozygous uh familial

hypercholesterol Amia that means you got

that Gene that hyper cholesterol Gene

from either your mom or your dad but you

didn't get one from both of you from

both of them that's about one in 300 to

one 500 families now and and

people now we know that cholesterol does

matter because you have what we call

homozygous uh familial hyper cholesterol

Amia that's one

in uh 300 * 300 or 500 * 500 it's very

very rare I think it's about

34,000 those people can have heart

attacks in their teens in their early

20s and teens and they have cholest LDL

cholesterol not total LDL cholesterol in

the

500s so again we know that there's

something going on with LDL it's just

that the

most of the existing medical community

does not know how to diagnose metabolic

disease that's not me just saying that

that's clearly uh data from and evidence

from Johns Hopkins from Mayo from plenty

of other known academic medical

institutions that just say look the

docks that we're relying on to diagnose

metabolic disease that is family

practitioners

cardiologists uh internists three4 of

them don't know how to diagnose

metabolic disease that's a big problem

and in my mind that is the biggest

problem that we have in at least in

medicine today so don't depend on the

medical community learn what you need to

learn about metabolic disease I'm going

to just make one more comment uh briefly

about uh

cyclodextrin uh before we wrap up today

um I'm getting a lot of questions about

it and it's like cyclodextrin are

they're similar to the they're I think a

polysaccharide uh they are similar to

APO A1 and APO the proteins that form

HDL and

LDL why do I say that they have a side

that we call lipophilic Fat loving and a

side that we call hydrophilic water

loving what has that geekiness got to do

with anything well that's how you get uh

cholesterol or

triglycerides and water to mix so

somebody put two and two together it's

now a very very common way of delivering

medications fat-based medications to the

human body you see it with uh steroid

pills you see it with a ton of things

somebody got the big idea of saying

let's give a lot of

this as something that's going to pull

cholesterol back out of the body uh I've

seen a brand named C avidex recently and

because one of my spaces is to talk

about plaque uh I get question after

question over the past few weeks because

cedex has really started

pushing uh their

product um and what what do I think

about it I think about it what I thought

three or four years ago the the research

the evidence hasn't changed very much it

appeared

optimistic but was it conclud Ive that

this stuff's going to work no not at all

um is the stuff dangerous cyclodextrin

cavitex no it doesn't it's not it does

not appear to be dangerous at all again

it's used in multiple medications so if

you want to pay thousands of dollars or

hundreds of dollars and have what I hear

what I just listened to was an enema

using cyclodextrin cavitex then have at

it

see you next week