@adssx do you how big the HDL effect is from flozinz? Do you think it’s helpful HDL up or just spurious (like the first gen CETP drugs seem to have perhaps been)

The effect of SGLT2i on HDL does not seem to be clinically significant: https://www.atherosclerosis-journal.com/article/S0021-9150(23)05153-5/fulltext

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New treatment cuts cholesterol by nearly 50%, without statins or side effects

Inhibition of PCSK9 with polypurine reverse hoogsteen hairpins: A novel gene therapy approach

https://www.sciencedirect.com/science/article/pii/S0006295225002382?via%3Dihub

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Just wanted to report that my insurance covers Nexlizet with NO prior authorization for $10/month ($25 for 90 days). I could have saved so much money by asking my doc years ago to “just prescribe it and see what happens”.

I figured for sure they wouldn’t do it since my LDL is already low and I’m on Repatha. Lesson is, don’t assume your insurance won’t cover it if you want to try bempedoic acid. And now I’ll be using the branded med rather than a foreign generic with the associated potential risks.

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Consensus is that statins have a material effect on lifespan and healthspan.

Curious thoughts about this study that seems tl suggest they do for people who already have CAD but dont have a significant effect for those who dont.

So tear it apart :wink:

https://www.jacc.org/doi/abs/10.1016/j.jcmg.2025.05.018?utm_source=signals.superpower.com&utm_medium=newsletter&utm_campaign=cholesterol-genes-drugs-cancer-clues-and-women-bodybuilders&_bhlid=25104835387f7d8d78d10130c3479b0ca0173506

Which age group makes up the overwhelming majority of deaths from ASCVD? Old people.
Which age group already mostly has CAD? Old people.
Old people who don’t have any calcified plaque in their blood vessels already either have low LDL-C or are genetically protected from the negative effect of cholesterol through various mechanisms in which case statins don’t have much of an effect.

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Association of dietary omega-3 fatty acids intake with all-cause and cardiovascular disease-specific mortality among individuals with cardiovascular disease

In the separate analysis of individual subtypes of the omega-3 fatty acid family, the consumption of alpha-linolenic acid (ALA) was obviously inverse-associated with CVD-specific mortality (HR of 0.64, 95% CI: 0.44–0.95). Nonetheless, the consumption of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and docosapentaenoic acid (DPA) did not show a significant association with mortality risk (P > 0.05).

In the dose-response relationship analysis, total omega-3 fatty acid intake and ALA intake were observed to have an “L”-shaped nonlinear relationship with cardiovascular mortality, with the inflection points at 2.12 (g/day) and 2.03 (g/day), respectively. In summary, our research indicates that both total omega-3 fatty acids and ALA are inversely linked to the risk of all-cause mortality and cardiovascular mortality in patients with CVD.

We recommend a daily intake of 2.12 g of total omega-3 fatty acids, with an optimal intake of 2.03 g/day for ALA for CVD patients.

Open access paper:

https://www.nature.com/articles/s41598-025-21193-1

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Does this mean we should swap out Omega-3 fish oil for ALA? I take 2 g a day of Omega 3 fish oil and I wonder if switching to ALA makes sense.

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Another data point for @adssx 's crusade against DHA.

EPA looks somewhat better

DPA not so good either

Surprisingly ALA is somewhat good.

Total Omega 3 are important though.

As confirmed by the KP plots.

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It’s easy to get enough ALA by adding 1 teaspoon of chia seeds and 1 teaspoon of flaxseeds to your smoothie.

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