STATIN EDUCATION: Statins enter every cell in the body including the brain as they can pass thru the BBB. Most of the statins CV benefit comes from reducing apoB, by inhibiting hepatic cholesterol synthesis which in turn upregulates LDL receptor (LDLR) expression thereby inducing clearance of apoB-particles. The liver, because of its size and density, has far more LDLRs than other peripheral tissues. Normally all cells make all the cholesterol they ever need and thus do not need circulating cholesterol. Although rarely needed, any cell can also upregulate LDLR to acquire any cholesterol they might need. Since part of AD pathology is related to XS brain cholesterol, some degree of brain cholesterol synthesis inhibition by statins is desirable. That can be monitored by watching plasma desmosterol (cholesterol precursor molecule in brain). @drterrysimpson@nationallipid@society_eas@ASPCardio@escardio@atherosociety@FamilyHeartFdn@FHPatientSafety
@LoganHaskett inhibitors also show no dementia signal at very low LDL. Observational studies suggesting otherwise are confounded and largely reflect reverse causation, not harm from low LDL.
@LoganHaskett body cholesterol, most of which is intracellular and structural in every cell. People with lifelong PCSK9 loss of function variants often have LDL levels in the 20–40 mg/dL range from birth with no increased risk of dementia or cognitive decline. RCTs with statins and PCSK9
Today marks a milestone in women's health, with the FDA's actions to initiate removal of HRT black box warnings, approval of the first generic Premarin in more than 30 years, and approval of a new non-hormone menopause treatment. More options, better access, informed decisions. https://t.co/2q3OnxyOXe
@RazorbackMBB@CoachCalArk@HunterYurachek This worker at Primetime in the palace was actively denying open seats to elderly and disabled guest after his supervisor told him all ADA seating was full around the arena. Bad!!
Rather sad how far behind so many primary care and even cardiologists are behind with lipid education. Patients must be their own advocates and DEMAN these tests
@_CynthiaThurlow Cynthia’s simple statement needs to be repeated constantly. Anyone not adding apoB to their lipid panel is potentially being improperly evaluated. DEMAND IT from providers.