20 Heart-Healthy Actions With Better Risk/Reward Than Statins

Guided_by_Voices

Well-Known Member
Here at Excelmale there are frequent posts discussing the pros and cons of statins, and one in particular several weeks ago where a position paper was cited where the assumption was that statins are not only a viable option but should be the first line of defense against heart disease. As I have stated elsewhere, the best evidence seems to be that from a risk/reward perspective, statins may provide a rounding-error level of benefit for some people but come with potentially catastrophic risks. Rather than rehash that here, this post takes a different perspective by compiling a list of things that everyone can and likely should be doing to create good cardiovascular health which are likely to have a much better risk/reward than statins. My criteria for this list included:

- Little or no risk or side effects
- Multiple independent forms of supporting evidence
- Benefits on other non-CVD aspects of health
- Somewhat controllable
- Clearly better risk/reward than statins (based on TheNNT.com risk/reward as well as other confirming studies) based on around 90 people needing to be treated with statins for one to benefit
- Addresses a root cause, not just a symptom
- Almost never recommended by mainstream medicine (therefore not smoking, duh, is not included)

I will leave it up to each person to investigate the evidence for each of these and come to their own conclusions, however all of them are supported by easily findable combinations of data and logic. The purpose of this is not to give precise guidance but rather to give perspective on many of the things that are far more beneficial than even the best case for statins. These could also serve as a way for you to assess the quality of the medical guidance you are being given. The fewer of these that are recommended by your medical advisors before they jump straight to statins, the worse your medical guidance is likely to be. So here goes...

1. Maximize sleep quality and ensure sufficient sleep quantity. Ensure sleep apnea or other sleep disturbances are eliminated. Optimize circadian rhythms.
2. Keep fasting insulin below 5. There are different recommendation as to what should be the goal here, but 5 is Dr. Bredesen's number so I'll use that one.
3. Get a moderate amount of mid-day sunshine several times per week when the sun angle is above 50 degrees. While this has cardiovascular benefits, it is also especially relevant to optimize immune function via production of Vitamin D and its anti-microbial metabolites.
4. Avoid chronic stress and chronic sympathetic nervous system activation. Reduce known stressors such as barbell training to failure and any form of chronic overtraining. Especially avoid self-imposed stress such as taking on unnecessary debt.
5. Ensure healthy thyroid levels. Low thyroid is a strong predictor of heart issues.
6. Ensure healthy nutrient status, especially magnesium, and vitamins D,K2 and C.
7. Ensure iron overload is not present
8. Minimize risk of food sensitivities leading to chronic inflammation. Be especially suspicious of wheat and whey protein.
9. Take a low-dose PDE5i. As Dr Kendrick has referenced here, (What causes heart disease part XXVIII) this class of drug appears to have a much greater CV benefit and certainly fewer downsides than statins.
10. Adhere to the Maffetone method of cardiovascular training. Avoid exercising at a higher level than your cardiac conditioning can easily support.
11. Do 10-20 pushups, a 1 minute stationary bike sprint or a 10 minute walk before and after every meal, especially higher-carb meals. This is primarily to minimize blood sugar spikes but also has other benefits.
12. Go for a 2-3 hour walk at least once a week
13. Eat within an 8-hour window at least 5 days a week. Do a 24 hour fast once a week.
14. Avoid seed oils, especially corn and soybean oil and especially avoid seed oils in a heated state.
15. Get at least 40 minutes of sauna time per week.
16. Eliminate any form of mid-section bloat which may indicate organ (visceral) fat and/or digestive issues.
17. Avoid chronically inflamed gums. Poor oral health is strongly associated with CVD, although cause and effect may be unproven.
18. Include high-nitrate foods in your diet such as beets. These are nitric oxide pre-cursors.
19. Reduce trigs to below 100.
20. Increase the extra virgin olive oil in your diet
21. Minimize blood sugar spikes and chronically elevated blood sugar. A1C is apparently the best predictor of CVD which makes sense since blood suagr spikes directly damage the endothelium.
22. Consider supplementing with Nattokinase and TUDCA. Nick Norwitz has good videos on the protective mechanisms behind each of these.
23. Avoid chronic, consistent use of Ibuprofen as it can interfere with the clearance of plaque.

Honorable mentions:

And here are few things that have a bit less evidence or are indirectly helpful but which have little or no downside and which may also help:

- Supplement with NAC. It may lower homocysteine which may be a risk factor and it does lots of other good things such as being a pre-cursor to glutathione (another aspect of immune function.)
- Supplement Glycine. It appears to have anti-inflammatory properties;
- Increase Omega 3 as well as reducing seed oils;
- Supplement Hawthorn berry and/or a low-dose ACE inhibitor and/or ARB to maintain moderate blood pressure and for general anti-aging;
- Swap beer for red wine; and
- Follow Dr. Bredesen's anti-dementia protocol. You can't do the things above if you can't remember them.

Ok, please suggest others I may have missed.
 
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do lot of cold baths and uphill hiking to reduce insulin/hg51ac. Reduce belly fat to reduce inflammation forever, and increase muscle. .
 
So he did niacin, anti-inflammatory drugs (ACE inhibitor and a low dose statin), and also blood sugar control.

The bad thing is that there are no standardized anti-inflammatory protocols developed for cardio vascular disease. They keep focusing on statins lowering LDL.
 
I just realized I forgot to include minimizing blood sugar spikes in this list and that is one of the most important things to do. A1C is apparently the single strongest predictor of CVD of the commonly available blood tests. I also added Nattokinase and TUDCA as high-potential supplements.
 
Last edited:
Here at Excelmale there are frequent posts discussing the pros and cons of statins, and one in particular several weeks ago where a position paper was cited where the assumption was that statins are not only a viable option but should be the first line of defense against heart disease. As I have stated elsewhere, the best evidence seems to be that from a risk/reward perspective, statins may provide a rounding-error level of benefit for some people but come with potentially catastrophic risks. Rather than rehash that here, this post takes a different perspective by compiling a list of things that everyone can and likely should be doing to create good cardiovascular health which are likely to have a much better risk/reward than statins. My criteria for this list included:

- Little or no risk or side effects
- Multiple independent forms of supporting evidence
- Benefits on other non-CVD aspects of health
- Somewhat controllable
- Clearly better risk/reward than statins (based on TheNNT.com risk/reward as well as other confirming studies) based on around 90 people needing to be treated with statins for one to benefit
- Addresses a root cause, not just a symptom
- Almost never recommended by mainstream medicine (therefore not smoking, duh, is not included)

I will leave it up to each person to investigate the evidence for each of these and come to their own conclusions, however all of them are supported by easily findable combinations of data and logic. The purpose of this is not to give precise guidance but rather to give perspective on many of the things that are far more beneficial than even the best case for statins. These could also serve as a way for you to assess the quality of the medical guidance you are being given. The fewer of these that are recommended by your medical advisors before they jump straight to statins, the worse your medical guidance is likely to be. So here goes...

1. Maximize sleep quality and ensure sufficient sleep quantity. Ensure sleep apnea or other sleep disturbances are eliminated. Optimize circadian rhythms.
2. Keep fasting insulin below 5. There are different recommendation as to what should be the goal here, but 5 is Dr. Bredesen's number so I'll use that one.
3. Get a moderate amount of mid-day sunshine several times per week when the sun angle is above 50 degrees. While this has cardiovascular benefits, it is also especially relevant to optimize immune function via production of Vitamin D and its anti-microbial metabolites.
4. Avoid chronic stress and chronic sympathetic nervous system activation. Reduce known stressors such as barbell training to failure and any form of chronic overtraining. Especially avoid self-imposed stress such as taking on unnecessary debt.
5. Ensure healthy thyroid levels. Low thyroid is a strong predictor of heart issues.
6. Ensure healthy nutrient status, especially magnesium, and vitamins D,K2 and C.
7. Ensure iron overload is not present
8. Minimize risk of food sensitivities leading to chronic inflammation. Be especially suspicious of wheat and whey protein.
9. Take a low-dose PDE5i. As Dr Kendrick has referenced here, (What causes heart disease part XXVIII) this class of drug appears to have a much greater CV benefit and certainly fewer downsides than statins.
10. Adhere to the Maffetone method of cardiovascular training. Avoid exercising at a higher level than your cardiac conditioning can easily support.
11. Do 10-20 pushups, a 1 minute stationary bike sprint or a 10 minute walk before and after every meal, especially higher-carb meals. This is primarily to minimize blood sugar spikes but also has other benefits.
12. Go for a 2-3 hour walk at least once a week
13. Eat within an 8-hour window at least 5 days a week. Do a 24 hour fast once a week.
14. Avoid seed oils, especially corn and soybean oil and especially avoid seed oils in a heated state.
15. Get at least 40 minutes of sauna time per week.
16. Eliminate any form of mid-section bloat which may indicate organ (visceral) fat and/or digestive issues.
17. Avoid chronically inflamed gums. Poor oral health is strongly associated with CVD, although cause and effect may be unproven.
18. Include high-nitrate foods in your diet such as beets. These are nitric oxide pre-cursors.
19. Reduce trigs to below 100.
20. Increase the extra virgin olive oil in your diet
21. Minimize blood sugar spikes and chronically elevated blood sugar. A1C is apparently the best predictor of CVD which makes sense since blood suagr spikes directly damage the endothelium.

Honorable mentions:

And here are few things that have a bit less evidence or are indirectly helpful but which have little or no downside and which may also help:

- Supplement with NAC. It may lower homocysteine which may be a risk factor and it does lots of other good things such as being a pre-cursor to glutathione (another aspect of immune function.)
- Supplement Glycine. It appears to have anti-inflammatory properties;
- Increase Omega 3 as well as reducing seed oils;
- Supplement Hawthorn berry and/or a low-dose ACE inhibitor and/or ARB to maintain moderate blood pressure and for general anti-aging;
- Swap beer for red wine; and
- Follow Dr. Bredesen's anti-dementia protocol. You can't do the things above if you can't remember them.

Ok, please suggest others I may have missed.
Can you post your recent cholesterol panel
 
Can you post your recent cholesterol panel
My HDL runs in the 40-70 range, LDL is 160-210 and total is usually 220-280, however of all the CVD related numbers (insulin, trigs, CRP, A1C) I put all my focus on those I just listed and pretty much zero focus on cholesterol, although I am going to get an Oxidized LDLD test soon.

On another related topic, for any test number it is key to get multiple tests over a fairly long period of time to see how much natural variation there is. MY HDL moves around without changes on my part that I can identify.
 
My HDL runs in the 40-70 range, LDL is 160-210 and total is usually 220-280, however of all the CVD related numbers (insulin, trigs, CRP, A1C) I put all my focus on those I just listed and pretty much zero focus on cholesterol, although I am going to get an Oxidized LDLD test soon.

On another related topic, for any test number it is key to get multiple tests over a fairly long period of time to see how much natural variation there is. MY HDL moves around without changes on my part that I can identify.
What are your numbers for insulin, trigs, CRP and A1C along with the ranges.
 
At last check, 5.8 for fasting insulin, 89 for trigs, .5 for CRP and 5.1 for A1C. Those are all comfortably in-range AFAIK, although a little lower would obviously be nice.
My A1C is 5.2. I really would like 4.7. I try to keep my trigs 60. The last lab it was 70 which I think is too high. I do follow a low-carb diet with lots of good, healthy non-sarchy vegetables.
 
My A1C is 5.2. I really would like 4.7. I try to keep my trigs 60. The last lab it was 70 which I think is too high. I do follow a low-carb diet with lots of good, healthy non-sarchy vegetables.
I'm increasing my berberine and fish oil to try and lower my trigs. I'm also trying to avoid meals that mix carbs and fat to a great degree, which I think may be one of the drivers of higher-than desirable trigs. My biggest issue AFAIK is stubbornly high resting heart rate (70-75). It used to be in the 50's before TRT.
 
I'm increasing my berberine and fish oil to try and lower my trigs. I'm also trying to avoid meals that mix carbs and fat to a great degree, which I think may be one of the drivers of higher-than desirable trigs. My biggest issue AFAIK is stubbornly high resting heart rate (70-75). It used to be in the 50's before TRT.
I'm not a fan of berberine, I never used it but people I know that do tell me it doesn't work. It doesn't mean that's true though. I do take two teaspoons of MCT oil, fish oil and 1 tsp of cod liver oil after breakfast and after dinner. My resting heart rate is usually the higher 50s or low 60s. When I have my wellness exam my blood pressure was only 105/49 which I think is too low. I have the reverse white coat syndrome. My blood pressure is always lower at the doctor's office.
 
Berberine is one of very few things that is even claimed to lower triglycerides so I think it's worth a try.
Please keep us informed and let us know if the Berberine works for you.

Berberine is a natural compound that effectively lowers LDL ("bad") cholesterol, total cholesterol, and triglycerides, often acting as a potent alternative to conventional lipid-lowering drugs. Studies show it can reduce LDL by 20–25% and triglycerides by 23–35%, typically taken as 500 mg, two to three times daily before meals.
PubMed Central (PMC) (.gov)
PubMed Central (PMC) (.gov) +5
 

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