
Dr Rob π«π©Ί π¦πΊ
@drhungo
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Primary Care Physician | Educator | ASCVD, π«Failure, Diabetes | Addicted to πββοΈ π &ππΌββοΈ Follows Jesus, loves family, tweetsβ medical advice @RACGP
New South Wales
Joined September 2015
The LDL Cumulative Exposure Hypothesis. The longer your arteries are exposed to high LDL-C, the β¬οΈ the risk of atherosclerosis. π. π¬ Early & sustained LDL lowering = lifelong CV benefit. π #CardioTwitter #MedTwitter #FOAMed #MedED @ACCinTouch
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π€ GPCE Melbourne 2025. β
6 hrs on Lipids & CV Prevention.β
1 hr on Heart Failure.β
Dinner deep-dive: New ASCVD therapies. Donβt miss it!. ππΌ SPEAKER50EDU to get 50% off your Session Pass. #GPCEMelbourne #MedTwitter #CardioTwitter #meded #FOAMed
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π°οΈ Atherosclerosis isnβt random. Itβs driven by:. β’ Particle Count β ApoB particles π§ͺ. β’ Permeability β Endothelial dysfunction (obesity βοΈ, hypertension π, diabetes π©Έ, genetics 𧬠). β’ Passage of Time β Cumulative exposure β³. Plaque builds silently for decades. Know
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RT @drbennisahmed: Finerenone Reduces New-Onset Atrial Fibrillation Across the Spectrum of Cardio-Kidney-Metabolic Syndrome: The FINE-HEARTβ¦.
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RT @drpablocorral: βοΈEffect of Lipid-lowering Therapies on Lp(a) Levels: A Comprehensive Meta-analysis of RCTs. βοΈNew evidence just publishβ¦.
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π₯ Atherosclerosis Starts Young: Time to Treat BP Like LDL. New EHJ editorial: life-course blood pressure matters as much as cholesterol π§ π«. π§ Even modest BP elevations in youth/adulthood = β plaque later in life. β οΈ Calls for early, sustained prevention β not just midlife
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π§ LDL-C Still Predicts Risk at 80+: Age β Immunity. π Copenhagen General Study (n=91,131):. πΊ LDL-C predicts MI & ASCVD across all ages β incl. 80β100 y/o. π‘ NNT to prevent ASCVD over 5 yrs:.β’ Age 80β100: 42.β’ Age 50β59: 345. π Lower LDL = lower risk, even in late life
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π Statins & T2DM: Risk Real, but Worth the Trade-Off?. π JUPITER & meta-analyses confirm:. π©Ί Statins slightly β new-onset T2DM (HR ~1.28) in π₯ at risk of diabetes . βοΈ But benefits far outweigh risks:. β
39% β in major CV events. π NNT: 134 events prevented / 54 new T2DM
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Air pollution: a global driver of atherosclerosis. 𧬠Review of epidemiological & mechanistic evidence:. ποΈ PM2.5 & traffic exposure β β carotid IMT, coronary calcium & arterial stiffness. βοΈ Mechanism ππΌ Oxidative stress, lipid oxidation, inflammation, endothelial dysfunction
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𧬠Genetic testing in severe hypercholesterolemia isnβt just academic ππΌ it changes lives β€οΈ . In a landmark study of π₯ with LDL-C β₯190 mg/dL, ~1 in 5 had an FH mutation. Carriers had CAD 22 years earlier βΌοΈ.& ~3x risk ππΌ despite similar LDL. π‘ Early ID = early action.
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π¨ Heart rate lowering (HRL): not always cardio-protective. π©Ί Meta-analysis of 157,764 π₯ βHR. β
Benefit in post-MI & heart failure.β βStroke & mortality in hypertension.βοΈ β central BP ππΌ potential harm if poorly selected. π Benefits of HRL = highly context-dependent.
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