Dr. Christopher Labos

There are ways to explain away the French paradox.

And when you actually do genetic studies and more complicated forms of analyses, you see that, no, it is a pretty linear association, which is the more and more you drink, the worse off you're going to be.

Right.

If you go back to the 1980s and 1990s, you had these increasing rates of cardiovascular disease, which was due to a number of factors.

But you had increasing rates of cardiovascular disease, and there weren't very many good medications to do anything about it.

I'm going to ask you a question now.

Do you know when we started giving people with heart disease aspirin?

It's 1988.

which is pretty recent if you think about it.

I mean, for a lot of human history, we basically had nothing to treat heart disease as opposed, you know, apart from, you know, really hoping the patient got better on their own.

So, you know, you had these increasing rates of heart disease.

There really weren't very good medications to treat high blood pressure or cholesterol.

I mean, you had some diabetes medications, but nowhere near as good as the stuff we have now.

And so there was really this searching to be like, well, what can we do?

And a lot of it was, well, let's start cutting fat out of our food because this was very much the era of the, you know, for a gauntlet and steak for breakfast generation.

So it's okay, we got to do something about the fat in our diet and get our cholesterol down.

Long story short, what we have seen now, 40 years after the fact, is that for most people, a lot of their cholesterol is genetically mediated and that if you want to lower someone's cholesterol, which you do if you want to reduce the risk of cardiovascular disease, the best way to do that is with medications that can actually inhibit the enzymes in your liver that are going to manufacture cholesterol internally.

Diet matters a bit.

Maybe it accounts for 10 to 15 percent of your cholesterol.

But if you have heart disease, if you had a heart attack or a stroke, undeniably, you are less likely to have a second event if I can get your cholesterol down to near zero levels.