Coming up on today's show.

No, there's nothing else that tracks with

L.D.L. cholesterol.

Because it's not a real number, it's a fictitious number.

It's obtained by something called a Frida Well calculation.

The L.D.L. cholesterol-reducing franchise.

Statin drugs, PCSK9 drugs, all that stuff, pay huge amounts of money.

Just a few years ago, it wasn't uncommon for

farmer to make many tens of billions a year.

It's because it pays so well, that's where all the attention is focused.

Someone comes in and says, hey, I'm 52 and my dad dropped dead suddenly at 56 of a heart attack.

Do I have that in store also? So we do a CT heart scan to generate a

carnary calcium score and his score let's say is 400 which is a high score and if you do

nothing a score of 400 year late is 525% higher year later 625 or whatever and

every year you're closer to dying what if we put you on baby aspirin a high

dose of a cholesterol drug like lipitore 40 milligrams, cut the fat and

saturated fat in your diet, and had you exercise. How fast does that score go up?

25% per year. It has no impact whatsoever on that measure. The good news is you

your family your listeners have magnificent control over cardiovascular risk and

sadly the last person to ask is the cardiologist or the

general practitioner or the primary care doctor. They don't know.

Dr Davis, as a cardiologist, what do you think is most important for us to be

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