Of all the AMA's Peter has done this one REALLY should be made public. I have heart disease and this AMA explained it better to me than ANYTHING else I have ever seen. I am a paid subscriber and have watched it at least a dozen times and more-or-less used it to explain heart disease to people who do not really understand what ASCVD actually is. I've even given out my login info to family in order for them to understand exactly what it is I have. I'm sure Peter is doing quite well financially. It wouldn't hurt to release this AMA as a public service and make it free for everyone. I honesty think it could save lives.

“Health is a state of complete mental, social and physical well-being, not merely the absence of disease or infirmity.”

I am 55 now. 14 years ago I went to see an interventional women's cardiologist due to family history of heart disease on my father's side. Lipid panel always good - 174 total cholesterol. Risk ratio low. Don't drink, smoke, and exercised since teens. 3 months ago I insisted on a calcium score. These tests have been around since the 90's. I scored 706. 99th percentile - only one percent of the population had a worse score thsn mine for my age and sex. I wish, and I hope doctors and professionals reading this include calcium scoring as part of the total heart health picture. In my case I clearly lost 14 years of intervention because my bloodwork was excellent and I was female and told i had nothing to worry about. Genetics can not be underestimated in heart disease folks.

I am 59 now, at 50 I was diagnosed with FH. I had a CAC test and my score was almost 800. I had never been overweight, always into health and fitness, so needless to say I was shocked and deeply saddened. I had always lived my life to live to be 104!! I’m hoping I still make it. I had a baby at 40, my son is 18 now and was diagnosed with FH 2 years ago. He also has high triglycerides that I never had. We are both on statins, and I feel horrible about him being on them. He also takes health and fitness seriously, is an accomplished athlete and enjoys real food. I’m praying that there will be more understanding and treatments for our issues very soon. I always pay attention to Dr. Attia since he is one of the only public persona doctors that speaks to cholesterol, FH and heart disease. Thank you

I was hoping to hear some further insight relating to metabolic syndrome, insulin resistance, and a carbohydrate excess diet. How are these things related to ASCVD?

The same bullshit again and again. Atherosclerosis is IN FACT caused by 2 things: 1) endothelian injury (e.g. through sugar intake or smoking), 2) insulin-resistance/hyperinsulinaemia which prevents the healing processes from being sucessfull and actually leading to more damage and at the end causing either a MI or a stroke... Lipids and hypertension are actually a minor issue, and BOTH are actually a downstream effect of insulin-resistance/hyperinsulinaemia/fructose intake. And yes, atherosclerosis PER SE is not inevitably progressive, there have been some very good mouse-model studies which show that after transplanting an aorta from an "atherogenic" mouse into a healthy one will REVERSE the atherosclerosis in about a week... The best way to protect itself from atherosclerosis is to stop eating sugar completely and be sure that you are insulin-sensitive and your insulin is low most of the time...

What causes heart disease is a subject that has fascinated me for the last 24 years. The heart disease maps and 100 year timeline were valuable study tools. I have lived in the two States with the lowest death rates, and now living in a State with high death rates. What a contrast in lifestyle and environment.

At 47 yo I was 100, 99, 98 and 95% blocked in my coronary arteries with NO symptoms until “one day.” I felt absolutely fine, watched my diet and could exercise normally. Less than a year before, I beat my wife and young daughter out of Carlsbad caverns, a very strenuous hike that lasted a couple of hours. I had a quad bypass. Four different doctors told me the first thing that should have brought me to the hospital was an ambulance carrying my dead body. NO symptoms until the day I had them. None. Chest pressure that felt like anxiety. A deep, sternum stretching inhale would relieve it. That was my only symptom until my left ankle swelled up. Ischemic cardiomyopathy. It Fooked my heart. My EF is 20%. I feel great but I’m skating near the edge.

Carbs (which are just sugar once ingested) adhere to red blood cells causing spikes on the exterior of said cells. These spikes damage arteries when passing through. The body releases cholesterol to repair the damage done by carbs. Now your conventional MD blames cholesterol for what sugar has done and tells you to start taking statins. No mention what-so-ever of the root cause. Stop eating carbs, stop damaging the body every single day, the body can finally heal. That is super simplified, but not a difficult concept for one to understand.

I wish I could pay a lower subscription fee ($50-$60 Canadian per year) and just choose X amount of podcast episodes each month I could listen to. I want to support, but don't need the high detail on all the topics

My cousin was 57 y/o when he had a fatal heart attack. Looked like the picture of health; had just played tennis with his daughter.

My wife was a nurse in a cath lab. (Where they put stents in). Every single patient she ever had was on statins. How good is a drug if everyone that takes it still has heart attacks or needs stents?

Not always able to understand it. My father, a soldier from the age of 15, never smoked or drank. Triple heart bypass at 44. Myself quadruple heart bypass at 48. Never smoked or drank. Have excercised all my life. Physical job also. My 2 other brothers have had stents. They are older and smoked. My father is now 80’anx still alive. I’m only 53 and cycle 10 hours a week. My resting heart rate is 47 and my max which I hit weekly is 182. We are now in a genetic test to see why we got hit with hit. It’s not diet or excercised or weight caused with us anyway.

What I don’t understand is what is the evidence that high blood pressure has directly lead to Death ? Also why are the Blood pressure numbers the same for everyone irrespective of age, sex, body type, health etc.

Would love to hear what to actually do about heart disease for prevention, instead of only talking about what it is

After reading all peter s 9 parts of cholesterol and blood lipids serie i reached to the conclusion that apoB particles and more important lp(a) are the ones penetrating the endothelium and start the process. but as mr thomas dayspring stated without inflammation the artery walls might be very powerful in which case the particles are not crossing that barrier. after these lessons i am more keen and target my particles lowering and make sure my apoB/apoA1 ratio stays lower than .8 2x cold baths / week lowers body inflammation check regularly crp or hscrp stay low with fasting insulin don’t eat sugar stay high on protein and balance carbs and fats, that is energy based on the training days eat smart saturated fats thanks peter for your work!!

My cousin had an aorta dissection at 37 with no previous heart issues and was a swimmer as a teenager. He found out after genetic testing that he had Loeys-Dietz syndrome (LDS).

(Not exactly on this week's topic. Hopefully, enough people will ‘like’ this topic that you will consider it.) A disproportionate number of aging athletes seem to have heart electrical problems (bradycardia-tachycardia, sick sinus syndrome, atrioventricular block, atrial fibrillation or flutter (a-fib), etc.). The conventional medical ‘standard of care’ appears to be pacemaker implantation. There seems to be little research into nutritional prevention or reversal. Please update the latest science on causes and prevention, particularly relating to electrolyte deficiencies and/or imbalances (calcium, copper, sodium, potassium, magnesium, etc.).

I wanted to ask. I recently had stomach inflammation and it went on for like a month and half, I got a blood test and it showed I have high Lp(a) around 55 mg/dL, but I had it tested when I was on meds and I was feeling very sick. Could that possibly have an effect on Lp(a) reading?

What is your take on Dr Nathan Bryan's work in regards to nitric oxide, keeping cholesterol above 200 and no use of statins?

I really wish I had found Dr. Attia years ago. I may have avoided a coronary event. I thought that since I wasn't overweight, ate healthy, and had healthy blood pressure that I was fine.

Give a heads up if you’re just gonna tell us what we already know and then cut it off before we get to the good stuff.

Peter: everyone needs this information. Also Peter: buy a membership for information. Me: heart patient in America still paying off 5 surgeries. Lol 😆

I am a premium member: is it possible to watch the video, or only listen to the podcast at the website??

Skip to 8:30 where you will finally find out about what it is.

My question would be: why the explosion of heart attacks from the late 19th century onward? What changed in our lifestyles? Smoking might been a factor….

long term plant based diet is the way to go to prevent this. my dad has a major heart attack at 48 which required triple bypass surgery. I am now 47 and have (at according to heart CT Scan), zero artherosclerosis. I was shocked. I expected to have some buildup. I have been vegetarian for over 20 years now, and during various periods, vegan off and on. I really think this helped me prevent this and delay onset as both my parents have heart issues. Anyway, my suggestion is for people to eat as much plant based whole unprocessed foods as possible and start as early as possible

Isn't that an Ayrton Senna helmet in the background? I'm 72 and have been a runner all my life. I have an ascending aorta that is a bit larger than normal but not enough for surgery, One cardiologist said slow jogging at most. My second cardiologist said running would be ok, but come back in one year for an echo. The key was no growth in the aorta diameter in the prior year. I'm checking BP daily and watching sodium intake.

So if a person doesnt live in ur area, do u an “angies list” for us to find a dr like the two of u based on where we live?

What's with the focus on Statins and LDL still? This is old medicine. “In the Get with the Guidelines study database which included 231,896 patients admitted to 541 United States hospitals with a diagnosis of acute coronary syndrome, 136,905 According to this study about half of the patients admitted to the hospital with an acute coronary syndrome had LDL cholesterol levels in the normal range.” This is consistent with growing data that treating patients with statins based off the standard lipid panel does not reduce mortality,” (Maiolino et al, 2015) From the BMJ in 2016 a large systematic review finally put to rest the long held assumption that high LDL leads to death. “High LDL-C is inversely associated with mortality in most people over 60 years. This finding is inconsistent with the cholesterol hypothesis (ie, that cholesterol, particularly LDL-C, is inherently atherogenic). Since elderly people with high LDL-C live as long or longer than those with low LDL-C, our analysis provides reason to question the validity of the cholesterol hypothesis. Moreover, our study provides the rationale for a re-evaluation of guidelines recommending pharmacological reduction of LDL-C in the elderly as a component of cardiovascular disease prevention strategies,” (Ravnskof, Diamond, 2016) A paradigm shift from the American College of Cardiology. They state they have perhaps been wrong about saturated fats over the past 40 years and they are not linked to heart disease. They also suggest that focusing on the standard lipid panel is inadequate and small LDL size is more indicative of heart disease risk rather than just using standard LDL as a risk factor tool, (Saturated Fats and Health: A Reassessment and Proposal for Food-Based Recommendations: JACC State-of-the-Art Review) The Brits are onto it as well. “Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions,” (BMJ, 2017)

Hi Peter, I am not a member but I am a physician. You have great insight but I think Ivor Cummings inside out versus outside in is key to ASCVD understanding. We see this with neovascularization in the eye and cotton wool spots but don't recognize the same thing is happening from the vaso vasorum to the tunica media of coronary arteries. Also HTN is mainly hyperinsulinemia. Wish I could see the whole interview because you have great insight.

Please make this one open access.

have Alan Flanagan one to discuss the diet/heart hypothesis and the role of LDL in the developement of heart disease.

The cholesterol theory is extremely flawed. I suggest Peter Attita read "The Clot Thickens" by Malcom Kendrick, MD which very logically lays out a thrombogenic theory of heart disease. Perhaps Peter might invite Dr. Kendrick to his show.

Unbelievable! I have to be a member to watch it all??

Yeah no membership for me. I'd rather listen to a podcast with ads than start a subscription.

Carbs. I once did Vegan hoping to knock my Doc's socks off. I could handle it fir a month. after testing he phoned me and told me that my cholesterol is suddenly so high that they wanted to wash out my blood. He wanted to hospitalise me. went keto in 2012 and got another call and he said it looked as if my results didn't belong in my file. my cholesterol halved to 6 and my trigs were for the first time in my life 0.7. it was always around 3. so I knew in my Knower that carbs would kill me off quickly. He said the blood doesn't lie. Tim Noakes was my hero.

Is there any good evidence that presents a case for heart attack or stokes, that have nothing to do with food being the primary driver? I find it hard to believe all heart attacks or strokes can be traced back to some type of metabolic or diet related cause? To me this statement is almost as controversial and unfounded as the belief that all forms of cancer are diet related, (that is has something to do with what we eat, but how do you explain cancer in infants or baby's ? )

Is air conditiond (cooled) room is good for heart attack patient? Just curious

It sounds like your'e basing this on the previous false claims by Ancel Keys that cholesterol we consume causes plaque.

Thx guys, many interesting points I’ve always been perplexed by

Dude only smiles in the thumbnails.

Does Peter Attia ever actually give actionable advice?

I got nothing out of this podcast. What is the best diet to prevent or mitigate heart disease once you have it? If LDL-C in the diet leads to an increase in ApoB particles, then you would want a diet low in saturated fats. But I don't think Dr. Attia advocates for that, does he? And, I could name about a dozen studies that concluded that saturated fat in the diet, dairy, and/or meat do not cause heart disease, heart attacks, stroke, CVD mortality or all-cause mortality. And in the case of dairy, it reduces the risk of stroke. Maybe the best diet is low carb AND low fat.

What’s the trade off list like for lifelong statins? Muscle pain will make me quit lifting. So lean muscle and strength will crash after 60.

Fantastic thanks Petey

Vegetable and Seed oils ,need to be eliminated from the diet!

Why is such an essential thing, made in our body, by our own cells become so deadly? I really have difficulty believong what you say.I don't believe the cause of Atherosclerosis is cholesterol.

Please have a discussion on Kraft insulin Assay Test

Sweet Ayrton helmet

This guy is pharma's best bud. His info and theories have been debunked. Unsubscribe before you become misinformed

If a narrowing of the arteries has begun, can this be reversed or do interventions only prevent it progressing further?

Many people died in front of me (aka in my Time. What should i do know? At first, i thought they are kidding me. I thought they are hiding to peek a boo. Some are yes they live again but i don't want to catch them. But some people are really dead, i believe. If they are dead, what i'm supposed to do?

I loved the book but was nearly shocked when towards the end you said your wife gets you Deli meat. Aren’t they the very definition of the processed foods not to have !!!

Look up Dave Feldman here on KZfaq for interesting dialogue around cholesterol.

Nothing worth, only general definitions, statistics and unfullfilled promises. I learnt nothing, what a deception.

There was a lot of clickbait here. Peter was smiling in the thumbnail

what is the root cause of oxidized cholesterol and alterosclorosis.

I think the main cause of heart disease is stress and high blood pressure.

So, money is more important than education?

Thank you for a technically detailed podcast. I understand you have become interested in regenerative farming. You could invite the brilliant biologist, George Monbiot, to your podcast. It would be interesting (and brave).

question: my cholesterol numbers are absolutely fucked, unheard of levels. all genetic tho. If plaque is building inside of my arteries will i start to see things such as a higher resting heart rate or higher blood pressure? what are some warning signs I can look for.

I had such pain in my thighs, I couldn't walk when I was on a statin. I literally couldn't take a step.

Why not focus on hyperinsulinimia and diabetes as root cause for hypertension and oxidized lipid

so whats the solution? why dont other mammals have heart atttacks?

How is atherosclerosis inevitable. I thought that atherosclerosis doesn't progress if you have an ldl-c under 67mg/dl. What if you stay bellow that level your whole life?

What are you selling today?

Serrapeptase fixes atherosclerosis

Son in law had doubts widow maker at 35!

I have read that 90% of heart attacks people survive these days? Not 50% mortality. Are you looking at old data?

High Blood presure and high cholesterol.

sir my age being 37 and maximum heart of about 183 .what would be my zone in term of heart rate plz

So, you can lower your chances of heart disease by paying for a subscription.

Dose cardio after resistant training affects muscle gain negatively?

Interesting

I'm 5 minutes in and nothing new has been said

"Zero cholesterol in the blood stream is life " my new slogan

That video was ten minutes waste of my life that I’ll never get back..

Sudden cardiac episodes are shooting up significantly. The poison shot is showing its true colors.

Peter ignores the toxic effects of statins such as cognitive decline, accelerated deposition of calcium on the artery walls, destruction of the myelin-sheath, kidney and liver damage, permanent motochindria damage, increse in blood glucose, increase in insulin resistance, early onset diabetes and the associated heart disease that brings, thinning of the cardiac muscle, increase in Lp(a), and others, and Peter also ignores that the statin does not address root cause of the problem. Referring to Dayspring is embarassing because while a 300 pound cardiologist might have some nice graphics to show, his results are tragic.

So I guess this was an ad.

Heart disease is one of our biggest enigmas. It could be brought on at any time and at any age, regardless of nutrition, fitness, genetics and lifestyle. It's quite challenging to get a stranglehold on it and certainly most frustrating to those who make a concerted effort in living as healthy a lifestyle as possible...

Dont waste your time. No info here. Just folks who like to hear themselves talk. Whatever Attia is doing, its just about making money. Hence, no info given here in a 15 min vid.

Does regular use of high thc concentrates cause heart issues?

Why did I waste time watching this. Smoking, high blood pressure, bad lipid profile. I learned this from my DENTIST in the 1970s. His prevention plan was high impact exercise to develop a cardiovascular system that had a very high capacity. No action items were given in this video.

So when ornish published in the lancet reversal of our number one killer you all just side step that? Get a grip

Malcolm Kendrik has a better view what is going on than Thomas Dayspring and Attia. He does not make a business of the info. Sorry.

Peter, you’re wonderful but… This is not helpful. It’s too long-winded. Get to the point. More than giving hacks, but far less than an epistle. Heart disease: What is it? How dangerous? Who gets it-risk factors? How do you get it? How best to avoid it? You use 10x the words necessary. Your listeners then get lost or just give up. Constructive criticism: You often ramble.

too long spent setting up, just cut to the chase ;-)

This is so typical and frustrating. Probably one of the most important health topics and you suck us in and give a sales pitch to a paid membership- wtf?! To me this is overall the most discouraging and disappointing things about the medical profession: There are wildly divergent arguments about heart disease and how to prevent it. Specifically around diet. Don’t eat meat, only eat meat, don’t eat fats, you need to lower cholesterol, no you should not take statins, you need more fat in your diet. Exercise regularly, cardio really does not help, drink alcohol in moderation, don’t drink any alcohol, loose weight, no don’t loose weight as you get older. And with all of these arguments the theme seems to be about how to make a buck or generate “clicks”. Overall Americans are not very healthy, it does not seem that there is much of a collective agreement on how to make the U.S. population healthier. The food pyramid is apparently a scam. The only thing that is generally agreed upon is to quit smoking. Overall frustrating. I am about 60lbs overweight (slightly obese) and my doctor has said basically nothing about losing weight, changing my diet or recommending any type of tests to see how the arteries in my heart are doing. And I think this is typical doctors are afraid to confront patients

Owe Peter , why do you delete my comment? It was a intelligent insight . It would be very interesting if you done a talk on the possible cardiac effects after having the covid vaccine no?

Does that guy have a fake nose on?

Your heart wears out Da !!! That’s it, it just wears out after beating for 65 years !! Just living to 65 is a miracle! Stop worrying about this worldly life, and focus on your eternal life by accepting Jesus Christ as your savior and live eternally

I'm curious, what is Peter drinking?

Listening to Peter Atilla just gets on my nerves. He just doesnt get to the point. Its meandering, rambling, long delivery, anecdotes, questions that are non-sequiters.

💯👍

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Charging people for information even though KZfaq already pays you? Talk about greed.

WHAT A WASTE OF TIME. CHAT CHAT CHAT GIVE ME MONEY. JUST A WASTE.

EATING ANIMAL PRODUCTS