Busting the LDL Cholesterol Myth: It is NOT What You Think!

“I look at cholesterol as a first responder. Once inflammation starts in the blood vessels and injury occurs, cholesterol is sent to patch it up—that’s the beginning of those plaques. If plaques are active and inflammation doesn’t subside, the immune system, of course, gets involved,” says Dr. Regina Druz, challenging the conventional view that LDL cholesterol is simply a villain in heart disease.

 

In this episode, Dr. Druz is joined by Dr. Ernst Schaefer, a leading expert in lipidology and co-founder of Boston Heart Diagnostics, to explore a more nuanced take on cholesterol and heart health. What if cholesterol’s role is more complex than we think? They discuss the hidden risks of small dense LDL particles, which can be far more harmful than LDL alone, and how these particles drive inflammation and plaque formation in our arteries. Together, they encourage listeners to look beyond traditional cholesterol measures and consider cardiometabolic health as a whole. 

 

With heart disease on the rise, how can we make sense of cholesterol management in a way that truly supports long-term health? Dr. Druz and Dr. Schaefer share fresh insights into personalized strategies, new risk assessment tools, and lifestyle shifts that can help you take charge of your heart health. This episode is a must-listen for anyone ready to rethink cholesterol and approach heart health with deeper understanding and practical tools.

 

Quotes

• “The most important risk factor is high blood pressure, a disease that occurs on the arterial side of the system. Diabetes is also very important, but it only occurs in about 10% to 15% of the population. Smoking is very significant as well. LDL cholesterol really is the factor that allows us to distinguish between populations. We know that if we’re effective in lowering LDL, or if we look at populations with very low LDL, their risk is very low. You can markedly lower risk by treating high LDL through lifestyle changes and, sometimes, medications.” (09:42 | Dr. Ernst Schaefer) 
• “I look at cholesterol as a first responder. Once inflammation starts in the blood vessels and injury occurs, cholesterol is sent to patch it up—that’s the beginning of those plaques. If plaques are active and inflammation doesn’t subside, the immune system, of course, gets involved. Cholesterol, in many ways, acts like a firefighter arriving at the scene, attempting to put out the fire, but sometimes the fire is too intense for resolution. It’s essential for adults to understand that, as you mentioned, high blood pressure is also a critical factor.” (11:04 | Dr. Regina Druz) 
• “Almost all the risk associated with LDL is due to elevated small, dense LDL, which is very important. That’s the most atherogenic particle.” (18:16 | Dr. Ernst Schaefer)
• “The best predictor of mortality for disease is disease itself. The coronary artery disease unfortunately will lead, if unmanaged or not mitigated, to heart failure or potentially a myocardial infarction, even a small one. And so, these are very sensitive measures. We don’t necessarily measure them on every single patient, but we measure them strategically to understand where our patients are on a continuum.” (56:37 | Dr. Regina Druz) 

 

Links

https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/

PREVENT TM Online Calculator

http://www.reynoldsriskscore.org

www.mesa-nhlbi.org

 

Connect with Dr. Regina Druz:

Website: http://holisticheartcenters.com

YouTube: https://www.youtube.com/@holisticheartcenters

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