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Summary of Transcript:
Of lp, little has been recognized and accepted by many current guidelines.
This podcast, website, and weekly newsletter focus on translating the science of longevity into something accessible to everyone. This podcast episode features an interview with Dr. Tom Dayspring, a diplomat of the American Board of Internal Medicine and the American Board of Clinical Lipidology and a Fellow of the American College of Physicians and the National Lipid Association. The discussion focuses on recognizing the importance of atherogenic lipoproteins, using Apo B as a laboratory surrogate, the relevance of HDL cholesterol, risk assessment, therapies, and evolving data around omega-3 fatty acids, and the recent addition to the lipid drug story, Benbendoic Acid.
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Summary of Description:
In this episode of The Peter Attia Drive, world-renowned lipidologist Tom Dayspring returns to update the current lipidology thinking as a follow-up to his 2018 five-part podcast series. Tom discusses the growing consensus that atherogenic lipoproteins are essential drivers of atherosclerotic vascular disease, providing insights into risk assessment and the most recent developments in lipid-lowering drug therapies. He emphasizes apolipoprotein B (apoB) and lipoprotein(a) (Lp(a)) as key metrics in assessing risk. He overviews the different pathways among various lipid-lowering drugs, including PCSK9 inhibitors, EPA and DHA, and bempedoic acid.
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Understanding Lipidology and Cardiovascular Disease with Tom Dayspring
World-renowned lipidologist Tom Dayspring recently returned to give an update on the current thinking in lipidology as a follow-up to his 2018 five-part podcast series. In this episode, Tom discussed the growing consensus that atherogenic lipoproteins are essential drivers of atherosclerotic vascular disease.
Apolipoproteins and Lipoprotein Metrics
Tom further emphasized apolipoprotein B (apoB) and lipoprotein(a) (Lp(a)). ApoB is preferred over LDL-P, and the therapeutic goal for apoB concentration is below 0.8 g/L. He provided insights into risk assessment, including which lab metrics to use, how to interpret them, and the appropriate therapeutic targets.
Drivers of Atherosclerosis
Tom also discussed the different drivers of atherosclerosis. He provided an overview and current thinking on high-density lipoproteins (HDLs) and whether it is a useful metric. Additionally, he discussed lipoprotein(a), considered the most dangerous particle many people have ever heard of, and whether low-density lipoprotein triglycerides (LDL-TGs) are useful.
Lipid-Lowering Therapies
Tom also discussed the most recent developments in lipid-lowering drug therapies—from the continued evolution of PCSK9 inhibitors to the latest understanding of EPA and DHA and the most recent addition of bempedoic acid to the list of therapeutic agents. He also discussed the different pathways among various lipid-lowering drugs and the underappreciated treatment for hypercholesterolemia—fibrates.
Tom’s podcast is a great resource for those looking to understand lipidology and cardiovascular disease better. He provides a comprehensive overview of the field’s current thinking and insights into the various risk assessment metrics and therapeutic targets. He also provides a detailed explanation of the various lipid-lowering drug therapies available and their various pathways.
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Source Description
World-renowned lipidologist Tom Dayspring returns to update the current thinking in lipidology as a follow-up to his 2018 five-part podcast series. In this episode, Tom discusses the growing consensus that atherogenic lipoproteins are essential drivers of atherosclerotic vascular disease. Tom further emphasizes apolipoprotein B (apoB) and lipoprotein(a) (Lp(a)). He provides insights into risk assessment, including which lab metrics to use, how to interpret them, and the appropriate therapeutic targets. Additionally, Tom discusses the most recent developments in lipid-lowering drug therapies—from the continued evolution of PCSK9 inhibitors to the latest understanding of EPA and DHA and the most recent addition of bempedoic acid to the list of therapeutic agents.
We discuss:
00:00:00 – Intro
00:03:45 – The latest in the field of lipidology and cardiovascular disease
00:09:30 – Apolipoproteins—the key to understanding lipid biology
00:16:30 – ApoB as a preferred metric over LDL-P
00:21:45 – Therapeutic goals for apoB concentration
00:34:15 – Drivers of atherosclerosis
00:37:00 – Overview and current thinking on high-density lipoproteins (HDLs)—Is it a useful metric?
00:55:00 – Lipoprotein(a)—the most dangerous particle you’ve never heard of
01:13:15 – Are low-density lipoprotein triglycerides (LDL-TGs) a useful metric?
01:17:45 – Tom’s preferred lab measurements
01:21:30 – The latest in lipid-lowering therapies
01:30:45 – The different pathways among various lipid-lowering drugs
01:38:15 – The latest on EPA and DHA
01:49:45 – Fibrates—an underappreciated treatment for hypercholesterolemia
Show notes page: https://peterattiamd.com/tomdayspring6/
About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 30 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice extensively deals with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease) while improving healthspan (quality of life).
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