You’re already accustomed to “biohacking” yourself with compounds and have the discipline to manage doses, timing, blood markers etc, so you’re one of the very rare people your age well positioned to manage your long term health at a time, like a great investment made very early, when your foresight can pay off like a lottery win later.
Once plaque deposits in your blood vessels, it’s mostly permanent. It starts early in life. It’s mostly genetic. The less you have, the healthier you’ll be for a lifetime. The ideal would be stopping it before it starts. Your cardiovascular system will never be as clean as it is today.
Limited resources, not the science, is the reason the guidelines don’t focus on stopping it early. But if your father was a cardiologist, I’m certain he’d have you on lipid lowering meds to protect your arteries while they’re in such good condition.
There are 3 “levels” of preventing cardiovascular disease:
Primordial
Primary
Secondary
“Secondary” prevention is AFTER you have a heart attack or stroke and manage to survive. That’s when a cardiologist visits you in the hospital, and tries to get you to take the meds necessary to stop any more plaque from accumulating.
Sounds pretty stupid to wait until this point right? Yet it’s the first time most people finally get what they need to stop plaque accumulation from adding to their heavily clogged arteries.
It’s done this way because at this point, insurance / government accountants calculate its finally worth to paying for meds needed to (hopefully) prevent another very expensive heart attack.
“Primary” prevention. There are clear guidelines, treating people based on their LDL levels and “10 year risk”. The obvious weakness here is it doesn’t think beyond the next ten years, and many risk factors (Like PED use) aren’t in the risk formula. Now doctors can put someone into a higher risk group based on factors not included in the formula, so they more aggressively lower LDL, but the reality is most doctors don’t even follow the existing guideline, and it’s extremely rare to find one who goes beyond them. So basically, medicine does a terrible job at primary prevention, and it’s rare for them to even consider doing something until someone’s over 40. Why wait for decades of heart disease to develop first? Because at 40, instead of 20, that patient might have a heart attack in the next 10 years, before that doctor retires.
Finally the highest, leading edge standard, Primordial prevention. Preventing cardiovascular disease (cvd) before it develops. The standard applied by the worlds leading preventative cardiologists, and the one used for the wealthy where only the science is followed, and resources aren’t limited. CVD has been found I children as young as 8. In the Korean war, 23 year old soldiers were found with heavily clogged arteries.
25 years ago, “primordial prevention”, getting LDL <40 (the absolute ideal) wasn’t possible, the meds (pcsk9) didn’t exist. Below <55 came with the cost of high side effect risk statins. Ezetimibe was side effect free but $500/mo. That’s a lot to impose on someone in their 20s and easy to argue it would be better to wait.
But you’re lucky. Today, it’s a different story. Ezetimebe is $10/mo. Rosuvastatin has very low risk of sides, Pitavastatin has an even lower risk. Odds are overwhelming you could take it for life and never experience any negative side effect.
Taking these two tablets (or one Combo), like a “cardiovascular vitamin” daily, you’ll be embracing the standard that will probably become the norm 20 years from now.
Why accept accumulating plaque when you don’t have to, and can do so without paying a price in side effects, only having to manage the small task of taking a pill or two daily? You have a brand new car, why not keep it perfect with some preventative maintainance, instead of waiting until it’s falling apart and can never be fully restored to original condition?
I realize this may sound extreme or like some unsubstantiated by science fringe approach, but it’s not. Search “Primordial prevention cardiovascular disease” and you’ll immediately discover all the leading cardio organizations are moving in this direction. It’s just not implemented yet, but it will be. For you though, by then the early window of opportunity will be closed.
I’ve attached an easy to read article on the topic if you’re interested in digging further.
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