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Heart Health

Cholesterol: Understanding HDL vs. LDL

April 12, 2018

About the Author

photo of Ami Bhatt, MD, FACC

Ami Bhatt, MD, FACC, Contributor

Ami B. Bhatt, MD, FACC is the Director of the Adult Congenital Heart Disease Program at the Massachusetts General Hospital and an active clinical cardiologist, investigator, and educator. She graduated from Harvard College, obtained her doctoral … See Full Bio
View all posts by Ami Bhatt, MD, FACC


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AKA : Rama Kambhatla, Dr.
April 24, 2018

I have lived a 19-20 years, with LAD stent and medical treatment:
which “Statins” cannot be over-emphasized. Presently, I am on
Rosuvastatin 10mg and over the few Lipid Profiles, including recent
one, has been reported as optimal numbers, LDL 76, HDL 64, TC 162, Triglycerides 131.

Hal Davis
April 24, 2018

I had no idea there are so many non-medical experts until reading the above comments! We can certainly save a lot of money by not going to a medical doctor and, instead, consult with so many experts. Thank you for your expertise! I bet if anyone follows your advice and has any problems; you can be sued and prosecuted for practicing medicine without a license. By the way, all stains are off patent! The last one to lose patent protection was Crestor and there are 5 generic makers on the market. So they are not the most expenses drugs on the planet!

April 23, 2018

High cholesterol is a marker of increased risk for heart disease, a sort of “canary in the coal mine” that tells you your system is out of whack, your diet is poor, or your sedentary lifestyle is putting you at risk for a cardiovascular event. When we lower cholesterol by prescribing statins we risk masking the symptom while patients may or may not follow through with lifestyle changes. Indeed, there is a real risk that some people may incorrectly assume because they are on the statin, they are safe continuing to eat a poor diet and not exercising. For these reasons, some docs question the value of statins altogether.

Please consider the full story next time you write about cholesterol and cholesterol reducing therapies.


April 23, 2018

This is over simplistic and a mediocre advertisement for “statins”. The most profitable and prescribed class of drugs on the planet. It’s a cash cow. You failed to list the horrific sides. I rather die of a heart attack at 60 than take a statin and risk dying now of rhabdomyolytis, liver damage or diabetes among others. Statins are for people with genetic issues related to cholesterol. Why does cessation of the smoking habit lowers cholesterol? Because it causes inflammation. Its the inflammation that is the problem. Take an anti histamine. Exercise is pretty good tho, but too much cardio is damaging. Go lift some moderate weights with a qualified trainer and look better and live longer. Stop eating junk.

April 18, 2018


Micki is correct.

The information presented and guidelines offered in this article have been contested successfully in recent times, to put it lightly.

Peter Attia and Thomas Dayspring’s work would be a good start to learn more. Please do. You owe it to your Harvard, Yale, MGH pedigree.

April 18, 2018

There’s definitely a lot to know about this issue. I really like all the points you made.

April 13, 2018

Interestingly, cholesterol is controlled by an enzyme, UBIAD1, that also controls calcium behavior and is essential to create the form of vitamin K2 that we make endogenously, Menaquinone-4 (MK-4).
We make MK-4 in tissues throughout the body from menadione (vitamin K3) that is transported there via the lymph system via this UBIAD1.
When CKD patients were given vitamin K2, their cholesterol levels dropped and then, when supplementation stopped, their levels renounded.
Messed up K status leads to weakened bones and ossified arteries, measured as CAC.
The best predictor of a cardiovascular event is CAC. This exceeds all the lipids measures into which cardiology has so invested.
A CAC=0 is a 15 year warranty from death by all causes.
Statins increase CAC.
Vitamin K2 is created from all dietary forms of vitamin K – K1 and all forms of K2 – but this isi mssed because of upstream mistakes surrounding cholesterol understanding.
Fermented full fat dairy is high in long chain K2, yet such as this diatribe would make it seem that reduced fat dairy has better health outcome.
This is incorrect; the K2 is in the fats.
Organ meats are also high in long chain K2.
We have lost many foods high in K2, messed with K actions via bad dietary understanding, and toxic drugs and thus made folks have poorer K status which leads to more CAC, indicative of atheroscerosis.
This article is mainstream understanding, the mainstream narrative, but it is incorrect.
Search K2, UBIAD1, and learn these pathways.
Mainstream cardiology has led us astray.

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