Article Medically Reviewed by Dr.Chen, Our Chief Medical Officer
Dr. Eugene Braunwald
If living 100+ is on your horizon, have you considered the role of LDL cholesterol in achieving this milestone?
Dr. Eugene Braunwald, a titan in the field of modern cardiology and chairman of medicine at Harvard Medical School for over two decades, explored this question in his intriguing 2022 article published in the European Heart Journal. Despite groundbreaking strides in cardiovascular disease treatment, heart disease steadfastly remains the leading cause of mortality in the US, with the American Heart Association citing cardiovascular diseases as the culprit behind approximately 920,000 US deaths annually.
One important risk factor in heart disease development is LDL cholesterol. Various therapeutics exist to manage LDL levels, yet astonishingly, an American Heart Association survey revealed that up to half of heart attack patients were previously unaware of their LDL levels or remained inadequately treated.
The conversation around cholesterol, including recent discussions in the New York Times, suggests that an LDL level below 100 is considered “healthy” for most. Yet, this oversimplification, alongside apathy and non-compliance, contributes to the less-than-ideal management of at-risk individuals.
Oftentimes, healthcare providers and medical societies oversimplify risk assessment or disease definition. For example, the American Diabetes Association defines diabetes as someone whose HbA1C is above 6.5%. However, diabetes is a progressive disease, and one should think of chronic disease on a continuum in which patients who are considered “normal” with an A1C of 6 – 6.5% actually are not “normal” and have prediabetes. This should signal a clear call to action as this prediabetes will eventually turn into diabetes if left untreated.
Dr. Braunwald supports the concept of “cholesterol years” in his article—a measure of disease burden intertwining LDL levels with age. He cites that a lifetime LDL exposure of 7 gram-years could precursor the onset of atherosclerotic cardiovascular disease (ASCVD). For example, a patient with “normal” LDL cholesterol of 100 mg/dL would reach the ASCVD threshold at the age of 70 and be at risk for heart attacks. To forestall heart disease and embrace a century of life, Dr. Braunwald suggests treating this “normal” patient with a potent siRNA drug targeting PCSK9 twice a year, lowering LDL from 100 to 60 mg/dL. This would delay heart disease till the age of 100.
At Human Longevity, our mission is to extend your longevity and enhance your health span. We proactively address disease prevention and wellness, moving beyond the reactive measures of traditional medicine which wait till someone develops full-blown diabetes or gets their first heart attack. Our pioneering multimodal testing—spanning whole genome sequencing, advanced imaging, and comprehensive biomarkers—forecasts your disease risks to tailor a personalized health strategy.
For cardiovascular wellness, we consider an array of factors including genetic predispositions, calcium scores, cardiac echoes, ApoB, L(p)a, and more, crafting a 360-view of your cardiovascular health to produce an individualized plan for your target LDL level.
Together, let’s chart a course towards a healthier, longer life.