#52 - Ethan Weiss, M.D.: A masterclass in cardiovascular disease and growth hormone - two topics that are surprising interrelated

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.7 • 7.3K Ratings

🗓️ 6 May 2019

⏱️ 174 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, Ethan Weiss, Hopkins trained preventative cardiologist at UCSF, discusses two topics that on the surface may seem unrelated which is cardiovascular disease, and the role of growth hormone and IGF in disease. Ethan provides a masterclass in everything from acute coronary syndrome to all of the complex nuances around stent placement, as well as how calcium scores and results from CT angiograms shape his treatment of patients. He also shares how his idea to study the sex differences in blood clotting as it relates to coronary disease lead him to pursue the field of endocrinology, and specifically what he found with respect to the effect of growth hormone and IGF on the liver, the brain, and overall human longevity.

We discuss:

Mutual love for hockey [7:15];
Ethan’s background and interest in cardiology [13:15];
Clinical definitions of a heart attack, clotting, and plaque: What causes the acute event? [24:15];
Defining coronary disease and myocardial infarction: The evolving nomenclature [32:00];
What happens when someone comes to the ER with a STEMI (ST elevation myocardial infarction)? [47:15];
Stents [54:45];
Treatment protocol for both acute and chronic coronary artery disease: History, controversy, and important distinctions [1:06:30];
Using stents to treat stable angina: What we learned from the COURAGE AND ORBITA trials [1:15:30];
The “art” of longevity: The challenge of preventative medicine and understanding risk [1:31:45];
Understanding CAC scores, and CT angiogram results [1:40:15];
How sex differences in clotting and heart disease got Ethan interested in growth hormone and IGF [2:01:00];
Impact of growth hormone on the liver [2:07:00];
Growth hormone and insulin sensitivity [2:18:00];
The role of GH and IGF on chronic disease and cancer [2:23:30];
Will taking growth hormone promote longevity? [2:32:30];
GH and IGF as a treatment for early stage dementia? [2:34:30];
What happens to IGF while fasting and what about fasting improves longevity? [2:35:15];
The importance of becoming scientifically literate and making science more exciting for future generations [2:38:30];
Ethan’s new company: Keyto [2:43:45]; and
More.

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Transcript

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0:00.0	Hey everyone, welcome to the Peter Atia Drive. I'm your host, Peter Atia.
0:10.0	The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking,
0:15.7	along with a few other obsessions along the way. I've spent the last several years working
0:19.6	with some of the most successful top performing individuals in the world, and this podcast
0:23.8	is my attempt to synthesize what I've learned along the way to help you live a higher quality
0:28.3	more fulfilling life. If you enjoy this podcast, you can find more information on today's
0:32.5	episode and other topics at peteratiamd.com.
0:41.6	Hey everybody, welcome to this week's episode of The Drive. I'd like to take a couple of
0:45.6	minutes to talk about why we don't run ads on this podcast and why instead we've chosen to
0:50.3	rely entirely on listener support. If you're listening to this, you probably already know,
0:55.0	but the two things I care most about professionally are how to live longer and how to live better.
1:01.1	I have a complete fascination and obsession with this topic. I practice it professionally,
1:06.0	and I've seen firsthand how access to information is basically all people need to make better
1:11.0	decisions and improve the quality of their lives. Curating and sharing this knowledge is not easy,
1:16.3	and even before starting the podcast, that became clear to me. The sheer volume of material
1:20.9	published in this space is overwhelming. I'm fortunate to have a great team that helps me
1:25.7	continue learning and sharing this information with you. To take one example, our show notes are
1:31.2	in a league of their own. In fact, we now have a full-time person that is dedicated to producing
1:35.9	those, and the feedback has mirrored this. So all of this raises a natural question, how will we
1:41.9	continue to fund the work necessary to support this? As you probably know, the tried and true way
1:47.4	to do this is to sell ads, but after a lot of contemplation, that model just doesn't feel right
1:53.3	to me for a few reasons. Now, the first and most important of these is trust. I'm not sure how you
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