Dr. Peter Attia

So that, you know, really it shouldn't be the leading cause of death. It just simply shouldn't be. But most people don't have the right timeline on it. They don't realize how long this disease is brewing. So how old are you? 42. Okay. So, you know, the probability that a 42-year-old's arteries, let's just say tragically you died in a car accident tomorrow.

If they did an autopsy on you, the likelihood that your coronary arteries would look perfect is very, very low. We know this because during Vietnam, they did autopsies on all these young men that were 18, 19, 20 years old. who obviously were killed in combat, so had nothing to do with their hearts, and they did not have perfect coronary arteries. They all had some evidence of disease.

If they did an autopsy on you, the likelihood that your coronary arteries would look perfect is very, very low. We know this because during Vietnam, they did autopsies on all these young men that were 18, 19, 20 years old. who obviously were killed in combat, so had nothing to do with their hearts, and they did not have perfect coronary arteries. They all had some evidence of disease.

If they did an autopsy on you, the likelihood that your coronary arteries would look perfect is very, very low. We know this because during Vietnam, they did autopsies on all these young men that were 18, 19, 20 years old. who obviously were killed in combat, so had nothing to do with their hearts, and they did not have perfect coronary arteries. They all had some evidence of disease.

And those guys were not going to die of heart attacks for another 40 or 50 years, to be clear. But what it showed us was how long it takes for this disease to progress below the naked eye. So in the instant that a person has a heart attack, there's an enormous and abrupt change with clotting factors and all these sorts of things. But all of that is precipitated by decades of buildup.

And those guys were not going to die of heart attacks for another 40 or 50 years, to be clear. But what it showed us was how long it takes for this disease to progress below the naked eye. So in the instant that a person has a heart attack, there's an enormous and abrupt change with clotting factors and all these sorts of things. But all of that is precipitated by decades of buildup.

And those guys were not going to die of heart attacks for another 40 or 50 years, to be clear. But what it showed us was how long it takes for this disease to progress below the naked eye. So in the instant that a person has a heart attack, there's an enormous and abrupt change with clotting factors and all these sorts of things. But all of that is precipitated by decades of buildup.

And by buildup, I mean sort of impossible-to-see processes that eventually can become visible on certain elaborate scans. We do want to start preventing this stuff early by managing those four variables. And if we do, I think we get to take that one off the table.

And by buildup, I mean sort of impossible-to-see processes that eventually can become visible on certain elaborate scans. We do want to start preventing this stuff early by managing those four variables. And if we do, I think we get to take that one off the table.

And by buildup, I mean sort of impossible-to-see processes that eventually can become visible on certain elaborate scans. We do want to start preventing this stuff early by managing those four variables. And if we do, I think we get to take that one off the table.

Yeah, so again, you look at each of those risks individually. So first, someone's smoking. If they are, I want them to not smoke, and we're going to do whatever steps we have to do to get them off cigarettes. What's their blood pressure? Again, if someone's got elevated blood pressure, first-line therapy is not to turn to medication. It's actually to look at exercise, sleep, and weight.

Yeah, so again, you look at each of those risks individually. So first, someone's smoking. If they are, I want them to not smoke, and we're going to do whatever steps we have to do to get them off cigarettes. What's their blood pressure? Again, if someone's got elevated blood pressure, first-line therapy is not to turn to medication. It's actually to look at exercise, sleep, and weight.

Yeah, so again, you look at each of those risks individually. So first, someone's smoking. If they are, I want them to not smoke, and we're going to do whatever steps we have to do to get them off cigarettes. What's their blood pressure? Again, if someone's got elevated blood pressure, first-line therapy is not to turn to medication. It's actually to look at exercise, sleep, and weight.

Those three things can fix blood pressure in many cases. But if it can't, the amount of medication we have that can address blood pressure without inducing symptoms. Because that's the other thing you always have to think about, right? Anytime you're giving somebody a medication, you have to be able to do it in a way that it doesn't create another problem.

Those three things can fix blood pressure in many cases. But if it can't, the amount of medication we have that can address blood pressure without inducing symptoms. Because that's the other thing you always have to think about, right? Anytime you're giving somebody a medication, you have to be able to do it in a way that it doesn't create another problem.

Those three things can fix blood pressure in many cases. But if it can't, the amount of medication we have that can address blood pressure without inducing symptoms. Because that's the other thing you always have to think about, right? Anytime you're giving somebody a medication, you have to be able to do it in a way that it doesn't create another problem.

And a lot of the early generations of these drugs, they cause problems. They'd make you feel horrible in some other way. So if your choice is walk around with high blood pressure, even when you've corrected for body weight, exercise, and sleep, or don't, you're better off fixing it, even if it means taking medication. Metabolic health, I think, is the toughest one to fix, truthfully.

And a lot of the early generations of these drugs, they cause problems. They'd make you feel horrible in some other way. So if your choice is walk around with high blood pressure, even when you've corrected for body weight, exercise, and sleep, or don't, you're better off fixing it, even if it means taking medication. Metabolic health, I think, is the toughest one to fix, truthfully.

And a lot of the early generations of these drugs, they cause problems. They'd make you feel horrible in some other way. So if your choice is walk around with high blood pressure, even when you've corrected for body weight, exercise, and sleep, or don't, you're better off fixing it, even if it means taking medication. Metabolic health, I think, is the toughest one to fix, truthfully.

And it requires everything from being in energy balance, doing the right kind of exercise, so the right balance between exercise that generates muscle mass and exercise that generates energy.