Thanks, Eric. Fascinating stuff! Though I’m far from an expert in the field, here are some of my takeaways:
1. Individuals with mutations that reduce risk provide valuable clues that may lead to drugs that produce similar effects in the rest of the population. So it’s important for people to volunteer for studies, contribute tissue to biobanks, and so on.
2. New medications may have side effects like high blood sugar. And, even when these side effects aren’t seen, we need to understand if that’s because of the dose or something else.
3. Lipoprotein(a) seems to be a significant risk factor, but more investigation is needed to understand its role and the benefits of lowering it.
4. We’re not yet sure how far to go with decreasing LDL cholesterol, which is included in lipid panels.
5. The role of inflammation requires further study as another risk factor. Colchicine may help, particularly for people who’ve had cardiovascular events.
6. Age-related CHIP mutations in stem cells are related to several conditions, including CV disease and blood cancer, and may eventually be measured and used clinically.
DM, stage 4 kidney disease, post cardiac surgery and restored orthopedist, told the yoimg PA in hypertension nephrology who said he did not opt for medical degree that he needed to follow your interviews my old cardiology friends don’t dabble in preventive thoughts, but if nephrology sub specialist it is essential. Kidney docs need to know pots, they do know SGLT-2 good. It took me four years to fund one to prescribe even after credence trial showed renal disease not an issue. When I tried to teach residents the need for critical reading if current literature that was harder than most anything . I followed looking for chip in kidney disease
(Comment on https://erictopol.substack.com/p/pradeep-natarajan-preventing-heart. I recommend Ground Truths for Dr. Topol's interviews with key players across medicine and notes about Covid and other conditions.)
Thanks, Eric. Fascinating stuff! Though I’m far from an expert in the field, here are some of my takeaways:
1. Individuals with mutations that reduce risk provide valuable clues that may lead to drugs that produce similar effects in the rest of the population. So it’s important for people to volunteer for studies, contribute tissue to biobanks, and so on.
2. New medications may have side effects like high blood sugar. And, even when these side effects aren’t seen, we need to understand if that’s because of the dose or something else.
3. Lipoprotein(a) seems to be a significant risk factor, but more investigation is needed to understand its role and the benefits of lowering it.
4. We’re not yet sure how far to go with decreasing LDL cholesterol, which is included in lipid panels.
5. The role of inflammation requires further study as another risk factor. Colchicine may help, particularly for people who’ve had cardiovascular events.
6. Age-related CHIP mutations in stem cells are related to several conditions, including CV disease and blood cancer, and may eventually be measured and used clinically.
7. Lots more to come on polygenic risk scores (here’s a good explainer: https://www.genome.gov/Health/Genomics-and-Medicine/Polygenic-risk-scores) and drugs like GLP-1.
I find summarizing helps me understand complex topics like this. Apologies if I got any of it wrong.
DM, stage 4 kidney disease, post cardiac surgery and restored orthopedist, told the yoimg PA in hypertension nephrology who said he did not opt for medical degree that he needed to follow your interviews my old cardiology friends don’t dabble in preventive thoughts, but if nephrology sub specialist it is essential. Kidney docs need to know pots, they do know SGLT-2 good. It took me four years to fund one to prescribe even after credence trial showed renal disease not an issue. When I tried to teach residents the need for critical reading if current literature that was harder than most anything . I followed looking for chip in kidney disease