Had a Heart Attack today at age ~30. Be safe guys.

[dinfar1337]

There are certainly other factors

genetic factors play a big role, chembb mentioned and he talks like he takes his bloodwork seriously.

sadly its most likely he drew the short end of the stick in this steroid abuse game

 

[Wizbang]

Familial hypercholesterolemia and hypertension are huge factors but both are manageable.

 

[Ghoul]

This is an important question, the ratio between HDL and LDL is telling variable it seems.

Not a reflection on you as many primary care doctors still look at this.

Cardiologists don't.

It was dropped from all clinical guidelines over a decade ago as it's been established that it's irrelevant.

Shows just how out of the loop so many primary care doctors and by extension, patients are.

“There really is **no significance for cholesterol/HDL ratios. You won’t find them in the guidelines. You won’t find them used in clinical trials. It’s not recommended because it’s not useful and it could be misleading.” — Dr. Neeland

There’s More to Heart Disease Risk Than Cholesterol

If you’ve had your cholesterol checked, you might wonder how important your cholesterol levels are for determining heart disease risk. It’s just one of many factors.

www.uhhospitals.org

 

[newguy2]

Be aware that, especially for those under 45, a zero CAC may give false reassurance.

There's been a flurry of studies on this in the last year, and while 85% of patients under 45 have a zero CAC score, in one study 25% of under 45's with 0 CAC had significant blockage of arteries. 10% had blockages greater than 70%!

The main risk factor was high LDL.

All the research and data is pointing to future guidelines targeting LDL much earlier, as early as 18, and driving it lower. (after all, it's not hard to understand preventing buildup from the start is the best approach). Guidelines are conservative, prioritize conserving resources, and because they require a lot of consensus always lag a decade or more behind the leading edge science.

https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehaf497/8228645?redirectedFrom=fulltext&login=false

Thanks man I appreciate it. Bummer that this test may be pointless, I already paid for it so I'll go through with it.

I always appreciate the advice, I have pita on the way and will be starting it asap. My ldl is usually 100 so want to get that down.

 

[ChemBB]

This is really scary. There’s nothing on your labs that would suggest something like this was imminent or even possible. I assume your BP was also controlled / normal?

My BP rode high, but usually in the 130/80 territory

I was RX'ed 200mg labetalol but I stopped taking it a week ago because of beta agonism reduction on fatloss and my BP was still fine without it

Also take 20mg Cialias daily

Damn.. Without indiscretions, what were you on? I'm on Telmisartan/Ezetimibe, but that made me think about adding a statin and maybe aspirin.

I'm a huge advocate for sharing as much info in public places without identifying information, to help others make informed decisions and reduce harm

Thousands of people can potentially read your posts over time from Google searches

So I'm happy to share my meds

The ones newly prescribed ones are the bottom 5, and 200mg Labetalol is being replaced by Metoprolol

 

[newguy2]

As weird as it sounds, I've had 2 other near-death experiences, and I sort of made my peace while it was happening that maybe this was the one, and if so I had a pretty good run.

This is going to sound dumb, but I was planning on competing next year for the first time and I think I'm more upset about how that's going to work now (if at all), and what my fitness/BB'ing is going to look like moving forward.

I don't really have any other hobbies/interests =/

Not sure if you already mentioned it but would you share your gear history. I know it is person dependent but have you run multiple gram cycles for years? Not come off for extended periods? Moderate usage? Just curious how that has factored in.

 

[RockyP]

Not a reflection on you as many primary care doctors still look at this.

Cardiologists don't.

It was dropped from all clinical guidelines over a decade ago as it's been established that it's irrelevant.

Shows just how out of the loop so many primary care doctors and by extension, patients are.

“There really is **no significance for cholesterol/HDL ratios. You won’t find them in the guidelines. You won’t find them used in clinical trials. It’s not recommended because it’s not useful and it could be misleading.” — Dr. Neeland

There’s More to Heart Disease Risk Than Cholesterol

If you’ve had your cholesterol checked, you might wonder how important your cholesterol levels are for determining heart disease risk. It’s just one of many factors.

www.uhhospitals.org

Absolutely. Someone with total cholesterol of 240 and HdL of 60 is worse off than a person with hDL 25 and total cholesterol of 100

 

[Wizbang]

A Supplement to consider:

CoQ10 (ubiquinol form) - Statins reduce this so supplementing is helpful 100-200mg/day.

 

[Wizbang]

Brilanta must be the new Plavix aka Clopidigrel hmm

 

[RockyP]

A Supplement to consider:

CoQ10 (ubiquinol form) - Statins reduce this so supplementing is helpful 100-200mg/day.

That’s in my stack. Along with cialis 5 mg daily, pita 4 mg daily, and just added vascepa. Zetia and bemp acid on deck if needed. Luckily my BP is 115/60. But I’ve got low HDL and family history of heart disease so I’m super aggressive. Gear is < 600 mg weekly. No orals. And on Reta 2 mg.

 

[Wizbang]

That’s in my stack. Along with cialis 5 mg daily, pita 4 mg daily, and just added vascepa. Zetia and bemp acid on deck if needed. Luckily my BP is 115/60. But I’ve got low HDL and family history of heart disease so I’m super aggressive. Gear is < 600 mg weekly. No orals. And on Reta 2 mg.

Reta is something I am looking at alot lately in the low dose category

 

[RockyP]

Reta is something I am looking at alot lately in the low dose category

All the GLP-1 will help metabolically but Reta seems to have an impact on lipids as well as liver fat deposits beyond the effect of just weight loss.

 

[Ghoul]

Thanks man I appreciate it. Bummer that this test may be pointless, I already paid for it so I'll go through with it.

I always appreciate the advice, I have pita on the way and will be starting it asap. My ldl is usually 100 so want to get that down.

No not pointless! If you have a positive CAC score you can definately use that as a guide (and insurance approval) for more aggressive treatment (pcsk9) and advanced imaging.

It's just that if it's zero, you can't assume you're in the clear and don't need to do anything else, especially as an AAS user.

AAS use by default puts us all in, at least, the lower end of "high risk", but unfortunately the risk scores and guidelines don't explicitly address it, though a (good) cardiologist would use this info to follow "high risk" guidelines for treatment decisions despite other factors putting you in a low risk category.

Not all the things that make AAS use a cardiovascular risk factor are understood yet. Some are obvious like lipids, BP, inflammation, but from the limited research there's even more going on, because risk appears higher than those other traditional factors can account for.

I've seen theories, for example, that micro vessels within heart muscle tissue may be harmed by AAS use in unique ways, hinted at in autopsies of young bodybuilders, but the mechanism isn't understood yet.

 

[Avies48]

Absolutely. Someone with total cholesterol of 240 and HdL of 60 is worse off than a person with hDL 25 and total cholesterol of 100

Im having a hard time with this statement… how is this?? U mean ima die soon? Hdl of 55 toal cholesterol of 250… ldl of 177 for 20 yrs… should i be expecting imminent death??

 

[RockyP]

No not pointless! If you have a positive CAC score you can definately use that as a guide (and insurance approval) for more aggressive treatment (pcsk9) and advanced imaging imaging.

It's just that if it's zero, you can't assume you're in the clear and don't need to do anything else, especially as an AAS user.

AAS use by default puts us all in, at least, the lower end of "high risk", but unfortunately the risk scores and guidelines don't explicitly address it, though a (good) cardiologist would use this info to follow "high risk" guidelines for treatment decisions despite other factors putting you in a low risk category.

Not all the things that make AAS use a cardiovascular risk factor are understood yet. Some are obvious like lipids, BP, inflammation, but from the limited research there's even more going on, because risk appears higher than those other traditional factors can account for.

I've seen theories, for example, that micro vessels within heart muscle tissue may be harmed by AAS use in unique ways, hinted at in autopsies of young bodybuilders, but the mechanism isn't understood yet.

This is why I consider myself very high risk. Family history of heart disease. Low HDL even off gear. I aim for LDL under 60. Luckily my Lp(a) is super low, ApoB under 90, and normal BP. But I keep my foot the the floor at all times mitigating (trying to) risk.

 

[RockyP]

Im having a hard time with this statement… how is this?? U mean ima die soon? Hdl of 55 toal cholesterol of 250… ldl of 177 for 20 yrs… should i be expecting imminent death??

I certainly hope not. But all the data and research shows that LDL would be better off under 100. Likely under 70 if you use PEDs.

 

[Banana Joe]

I just wanted to write, that I have a personal interest in this topic, and will follow because of this. And then I see you commented in my very thread just two days ago, after I had posted, that I just came back from the cardiologist...

Post in thread 'Reta Microdosing (<1.5mg) to improve lipids?'

Sep 18, 2025

For anyone interested or wanting to hate on me more, LOL:

I went to see a cardiologist yesterday, and after looking at me in general, reviewing my bloodwork, checking my arteries (100% clear) etc. he was not worried about my high-ish LDL (or low HDL), even considering my family history.
He said I could take a LDL lowering drug for preventive measures, but also that he would not urge me to do it.

He even said outright he did not expect me to have that blood pressure (131/80*) based on how I look. I guess I should take that as compliment...


I think I am gonna get on something but I am...

• Banana Joe

Keep us updated and I wish you a speedy and complete recovery! Maybe you can figure out where things went south, so others can take notice.

All the best!

 

[Avies48]

I certainly hope not. But all the data and research shows that LDL would be better off under 100. Likely under 70 if you use PEDs.

Man … maybe my repatha should be refilled.. and i should actually take it?

See my issue is i took 1 statin one time for a week and ended up Getting clots…

 

[ChemBB]

bumping cardio to max 1hour daily
omega 3's dosing at 1-2g a day of epa/dha
obviously your beta blockers
stress testing your max heart rate and vo2 max preferably in a clinical setting with nurses/doctors around(inexpensive maybe 100-150$)
W 333
and looking at heart rate data, blood oxygen levels etc through a smartwatch(my inexpensive xiaomi watch does this accurately and the watch cost like 40$)

The watch is a great investment, everyone should get a cheap smart watch with fitness abilities IMO

I actually bought a Galaxy Watch 7 for $100 for this reason. It can do HR, oxygen, and if you jailbreak it BP + Afib detection

Cardio, I already do 30-40 min daily

Take huge doses of EPA/DHA, twice a day 1800/2400mg

Ubiquinol 200mg daily (thanks whoever mentioned that on MESO to me)

Very clean diet, here's my current daily food

 

[Wizbang]

The best advice I can give despite all my postings in here is this @ChemBB, this has happened, give yourself a couple days to rest and recover, there will likely be a psychological aspect to this (there was for me) that took some time to come to terms with and tomorrow is a new day.

The gym will always be there, listen to the doctors for now, advocate but listen to advice, do the cardiac rehab as instructed and keep your stress low, your body just went through some shit and now it needs to chill out.