Understanding cardiovascular disease risk, cholesterol, and apoB

**Peter Attia** (0:11)
Hey everyone, welcome to the Drive podcast. I'm your host, Peter Attia. This podcast, my website, and my weekly newsletter all focus on the goal of translating the science of longevity into something accessible for everyone. Our goal is to provide the best content in health and wellness, full stop, and we've assembled a great team of analysts to make this happen. If you enjoy this podcast, we've created a membership program that brings you far more in-depth content if you want to take your knowledge of the space to the next level. At the end of this episode, I'll explain what those benefits are, or if you want to learn more now, head over to peterattiamd.com forward slash subscribe.
Now, without further delay, here's today's episode.
Welcome to another special episode of The Drive. As the podcast is now over four years old, we realize we've covered certain topics in a variety of ways across multiple episodes. We realize of course at times, it can be hard to piece together this information, and it's also difficult for new listeners to be able to go back and keep track of information that's been covered in great depth in previous episodes. As a result, we wanted to release another episode that is kind of a compilation of clips from previous episodes. We did this before and it was a huge success. So for this one, we want to focus on atherosclerotic cardiovascular disease, ASCVD, cholesterol and ApoB. This episode includes clips on why it is so important to care about ASCVD, the role of cholesterol in ASCVD, and why I don't think anyone should refer to cholesterol as good or bad. And finally, we look at why ApoB is an important metric to track when looking at your lipids.
We put these clips in the order of what we think is the best way to listen to them from top to bottom. And also provide some commentary in between clips to give you a little bit of context. Our hope is that not only will you understand this topic better, but you will also be able to identify some past episodes you may want to go back to and listen more deeply.
Final thing is that some of these clips are taken from AMAs, so if you're not a subscriber, we hope this gives you a little bit of a sneak peek of what's covered in those episodes. This is still a fairly new concept. We've only done this once before. We got great feedback on that, which is why we're doing it again. So if you continue to like this, please tell us. And if you don't tell us why. So without further delay, I hope you enjoy this special episode of The Drive.

**SPEAKER_1** (2:20)
What we thought would be important is just answering the first question, which is why should someone care about this? It's such a complex topic.
Why is it important for people to put the time in, to really think through and understand it?

**Peter Attia** (2:39)
It really starts with the ubiquity of this disease and its assault on human longevity. People have probably heard me say this before, but atherosclerosis is really the only inevitable disease of our species. Cancer, while prevalent with aging, and dementia, while prevalent with aging, do not appear inevitable the way atherosclerosis does. So, not everybody dies from atherosclerosis, but I think to my knowledge, everybody dies with it, assuming they live long enough. So, you have a condition that, as I said, is inevitable, is ubiquitous.
Also, I think based on what you're going to hear me talk about today, we know a lot about this condition and we really have tools to mitigate it. To me, that's the reason you want to really understand this.
The impact is huge and the tools that we have are also huge.
So, again, we talk about longevity. Longevity has two parts, health span, lifespan. The lifespan part comes down to delaying the onset of chronic disease, of which this is the most common chronic disease. So, you can think of a couple of different paths to get there, but really the two biggest risk factors, I am putting smoking aside for a moment, which is a very straightforward behavioral risk factor. In terms of less clear behavioral risk factors, the two biggest are clearly hypertension, high blood pressure, and lipid abnormalities. And that's the one we're going to focus on here. So, atherosclerotic cardiovascular disease, we'll just abbreviate ASCVD for short, is really what we're here to talk about.

**SPEAKER_1** (4:16)
As we get started on this topic, Peter, I think we have people who listen to this podcast of all ages, young, old, everywhere in between.