When LDL-C is far from target, don't just double the statin and hope. Combination therapy beats simply pushing one drug to the max, because stacking complementary mechanisms gives larger LDL-C reductions than dose titration.
1. https://t.co/foiHGixzoH
2. https://t.co/6GMETc6MQW
A calcium score of zero is one of the most reassuring numbers in cardiology.
A new study just showed what it actually buys you in untreated, low-risk adults. Over 5 years their plaque roughly doubled— almost all the soft kind a scan can't see.
Zero isn't a clean bill of health. 🧵
Elon just created 4,400 millionaires in a single day.
400 of them are now worth over $100 million.
These aren't VCs. They're SpaceX employees, and the list includes welders, technicians, and cafeteria staff, because for two decades the company paid every level of the workforce in stock instead of higher salaries.
Juan Hernandez immigrated from Mexico and took a $28 an hour contractor welding job in 2015. He says he didn't even know what SpaceX was. The company gave him a $10,000 equity grant and let him buy more shares through payroll deductions. That stake is now worth $880,000.
Trevor Hise's parents wanted him to take a stable job at General Electric. He picked SpaceX instead, stayed 12 years, and accumulated over 100,000 shares. At the $135 listing price that's $13.5 million. He's 37 and semiretired. His words: "The magnitude of this has been ridiculous."
The most telling detail came before the listing. Over 100 employees quietly banded together and negotiated a group wealth management deal covering up to $5 billion, because none of them had ever needed a wealth manager before.
Software IPOs have minted millionaires for 30 years. This is the first one where the money went to the factory floor.
Doctors don't get paid for writing a particular prescription—in fact, that would be illegal.
Influencers get paid when you buy their peptides.
Yet this is rarely discussed, as if physicians are the only ones with potential conflicts of interest. That's BEYOND baffling!
Hate to break it to you: your favorite influencer never took a Hippocratic oath.
@Brady_H This is my kind of 6 pack.
Also, throw in some kefir and granola with some blueberries & raspberries and I'm told it neutralizes the cancer-causing ingredients. 🤣
SpaceX is currently the 6th largest US company with a market cap of $2.3 trillion. There are now a record 12 US publicly traded companies with a market cap above $1 trillion. $SPCX
With the SpaceX IPO, @elonmusk could become the first official trillionaire.
Who did that wealth come from? Did he take it from someone?
The answer: NOBODY! It was created out of thin air, and his innovation adds to the overall economic pie, making us better off in aggregate without taking from anyone.
Here is how wealth creation actually works, and why capital markets and innovation are positive sum games:
1) It’s all "paper" wealth
Elon didn't receive a massive wire transfer today. He owns roughly 4.8 billion shares of SpaceX, shares that were created from thin air and didn't exist decades ago. When public investors priced the IPO at $135/share, the market simply put a higher price tag on what he already owned. It’s all unrealized gains.
If he sells someone will give him $135 cash and they will get $135 of stock. That $135 of stock is net new wealth in the economy, now representing potential future unrealized gains for the new owner.
2) The Economy is Not a Fixed Pie
A common myth is that for one person to get richer, someone else must get poorer. But when a company builds a brand new global capability, like a reusable rocket network or Starlink, the economic pie expands. This might destroy competing companies, but it's what we call "creative destruction" - it destroys other firms in the process of creating something better and more valuable.
3) Market Cap creates "New" Value
Value is driven by expected future productivity. When collective optimism pushes a stock price up, wealth is instantly generated across ALL shareholders simultaneously. No one had to lose a dollar for Elon's paper net worth to rise.
The Bottom Line:
An IPO doesn’t transfer wealth from others; it capitalizes innovation. Musk’s trillionaire status isn't cash taken from the economy, it's the market pricing the future value of the infrastructure he built. It's accretive to the economy as a whole and reflective of the innovative value entrepreneurs create.
💪🏋️🏃🚴♀️🏊 Overview of some metabolic effects of moderate- and high-intensity exercise, and strength training/exercise.
VO2 max = maximum volume of oxygen taken up per minute
🚨 81 scientific studies confirm that exercise is the most powerful cardiovascular drug ever discovered.
No prescription required. No co-pay. No pharmacy line.
And most cardiologists are not prescribing it with enough specificity to actually change outcomes.
I am a cardiologist.
I have seen what happens to patients who treat exercise as optional. I have also seen what happens when they treat it like medicine. The difference is not subtle. It shows up on echo. It shows up on stress tests. It shows up in mortality curves.
Here is what the science actually says.
🔬 The mechanism is not complicated.
Exercise lowers resting heart rate, reduces arterial stiffness, improves endothelial function, cuts visceral fat, lowers LDL, raises HDL, drops blood pressure, and improves insulin sensitivity. All of that at once. No single pill does that.
💓 The data across 81 studies points to a clear hierarchy of what works.
✅ Aerobic training: reduces cardiovascular mortality risk by 35%. That number is not from one trial. It is the aggregate signal across decades of data.
✅ High-Intensity Interval Training: improves VO2 max faster than moderate continuous exercise. VO2 max is now one of the strongest independent predictors of all-cause mortality we have.
✅ Resistance training: reduces all-cause mortality by 23% when performed 2 to 3 times per week. Most cardiologists still do not talk to their patients about lifting weights. That is a failure.
✅ Combined aerobic plus resistance: the evidence shows additive benefit. You do not choose one. You do both.
⚠️ What the studies also show is this. The dose matters.
🩺 150 minutes per week of moderate intensity or 75 minutes per week of vigorous intensity is the floor, not the ceiling.
Patients who exceed that floor by 2 to 3 times see compounding benefit with no signal of harm.
Sedentary patients who add just 30 minutes of brisk walking per day reduce cardiovascular event risk by 19% within 12 weeks.
🫀 The heart is a muscle. It responds to load exactly the way skeletal muscle does. Challenge it progressively and it adapts. Ignore it and it atrophies. That is not a metaphor. That is physiology.
A patient who commits to 150 minutes of aerobic exercise and two resistance sessions per week can lower their systolic blood pressure by 8 mmHg, improve their resting heart rate by 10 to 15 beats per minute, and meaningfully reduce their 10-year ASCVD risk within 90 days.
That is the difference between managing disease and reversing trajectory.
❌ A supplement will not do that.
❌ A detox will not do that.
❌ Hoping your genetics cooperate will not do that.
The tools with the strongest data are unsexy, free, and require your participation.
❤️ Bottom line:
Exercise is not a lifestyle choice layered on top of your medical plan. It is the medical plan.
81 studies. Tens of thousands of patients. The signal is not ambiguous.
Find your 150 minutes. Add the weights. Increase intensity over time.
Your heart will respond. The data guarantees it.
The question is no longer whether exercise helps your heart.
The question is why you are still waiting to start.
#Cardiology #HeartHealth #HeartDisease #CardiovascularHealth #ExerciseIsMedicine #VO2Max #ResistanceTraining #AerobicExercise #PreventiveCardiology #LifestyleMedicine
The older I get, the more I realize the power of always having something on the calendar you're excited about. It can really be anything. Difficult physical challenge, big project, fun trip, ambitious goal, whatever. It creates energy and gets you through the lows. Life hack.
“We instinctively label things good or bad. The problem is we're usually labeling in the short run without knowing what it means in the long run.”
Sometimes It's Better Than You Think: When Plans Break and Something Better Appears | Meaningful Money https://t.co/c41y4jbmCy