In 2023 I took a 12-month hiatus to recharge after building startups nonstop since graduating college. During that period of time, I had a rule that I would only commit to something if its gravitational force was completely inescapable. The opportunity to join USV was that thing for me, but along the way I explored a variety of different startup ideas.
One of those ideas was around helping people not die of heart disease. I published some of my early learnings on this blog last October, and it was one of the most-read articles I've written. I had an idea to create a service that would help people understand their risk factors and get screened for heart disease, and then generate personalized plans for them so they wouldn't succumb to the world's leading cause of death.
Every time I told someone about the idea and what I had learned, they soaked it all up. But when I asked if they ever got the tests I recommended, they usually didn't. So I wrote up a very long treatise on how to avoid dying of heart disease, and I was going to post it on a domain I bought, https://t.co/DhpvDWUmNo, but I never got around to it because I had moved on from pursuing the idea. But I put a lot of work into the document that synthesized a lot of my learnings and experience. Over the past year, it has made its way around my circle of friends, and I finally decided I'd try to make it legible and publish it for anyone interested.
I still think this is a problem that needs to be solved and that someone should build a company that is consumer-first and exclusively focused on helping people not die of heart disease. If you're interested in doing this, please reach out to me because I'd love to help you and share all the work I did. Someone needs to put the https://t.co/DhpvDWUmNo domain name to work.
I also want to thank some people who helped me along my heart health journey: Harvey Hecht, James Min, @Drlipid, Arthur Agatstan, Andrea Klemes, Louis Malinow, @jwessler, @neilparikh, @smart, Alan Tisch, David Kopp and Carrie Weprin.
If you have a heart, I hope you find this helpful. And if you care about someone else's heart, I hope you share it with them this Holiday season.
Happy Thanksgiving, and don't die of heart disease!
one theory: in an era of everything being hyper-optimized to oblivion, the top ~50 players, aside from sinner and alcaraz, are close to evenly matched on any given day
this french open has shattered the record for most five set matches. never seen anything like this. absolutely insane and a feat of endurance and athleticism.
@VedhasD@pitdesi our opening line for every groupme pitch was “social media is making communication sterile. people are afraid to broadcast what they really want to say and share. group chats are the only place where you can be your true self online.”
social media in its purest form - sharing with real friends - is incredibly fun and is a great example of “technology can bring people closer together”
we need platforms that bring it back in new ways and we need less mindless scrolling that makes us feel like garbage
Social media is increasingly anti-social
Only 7% of Instagram time & 17% of Facebook time is spent on content from friends or followed accounts. The rest is algorithmic video from strangers.
This is what happens when you condition algorithms on looking time rather than real social engagement. TikTok set the template; everyone copied it.
And over half of the long posts on Meta are written by AI. People are not engaging, or even creating the content on those platforms anymore.
Real human content and conversation has migrated away from these platforms to substack, discord, etc. https://t.co/qQzCIsxtPS
Should you track your sleep? @TheEconomist
It can be helpful in some people, but, as noted:
"As many as 30% of those who track their sleep report feeling anxious about the data they collect, a phenomenon researchers called orthosomnia."
https://t.co/a2Wx3rsn0A
after doing this shit for a hot minute all i know is there is no right way to do things and that there are infinite wrong ways to go about it
getting to the right outcomes is all that matters at the end of the day
and hopefully enjoying the ride
The fallacy of this is that more creates more. More hours, more hiring, more something.
And it is true in a sense. If you put in more work, more work will happen. But I think for most startups, the leverage is really in how differently you approach the problem, how well you cultivate your team, and the strategy.
Any large company can outspend you on hours. They have thousands or tens of thousands more people, spending more hours. If hours worked were the metric, every large company and government organization would always win and do the best work. More hours, better output.
This thinking is often representative of younger founders, where the startup becomes their identity and life. They have a hard time doing anything else, and cannot understand that your work is not the person that is you. But activities outside of work can grow you as a person too and make you do better work.
I���ve never worked this way. As a designer, I always saw the need to take a step back, to take a break. At times, I might work 12 hours or 16 hours, or whatever amount was needed, but it wasn’t the norm. You just can't grind design, you need inspiration. But taking that step away from the work, would give me more perspective, inspiration and I could approach the problem differently or I could just see the solution.
Grinding is never good for any creative problem, and startups or creating new products are often mostly about creative problem solving. Grinding works ok for email jobs, or where you just executing on very clear playbook.
With Linear, we’ve never worked this way. We work reasonable hours, 5 days a week. All of us founders have families. Many of our employees have families. I personally stop every evening, spend time with the family, cook dinner for the family, eat dinner together, and focus on things outside of work. Sometimes I work in the late evenings or weekends, but to me the pride is that I don’t need to. Company should be succesful without it.
My goal is to build a company that is sustainable in the long term, and doesn’t require heroics or personal sacrifices every single day.
There are times when our team is heroic. Launches, incidents, some other work that just needs to be done. They will work late into the night because they know it is the right thing. But we don’t require that every day or every week, and the more this happens, the more I think it is a failure of our company and leadership. The team and the leaders should always keep a reserve to use when something is needed.
Our thinking was also that quality, which we value, doesn’t emerge from working more or stressing people more. It emerges when you create the conditions for it to emerge. Often it is the appreciation, space, time, and how the person feels. A person who is rested will do better work.
I wouldn’t attribute much of our success to working a lot. The success came from having clear thinking, ideas, and focus to do the right things.
I sometimes wish we could move the culture more toward a Zen master.
Real mastery is not exerting the most effort. It is achieving the outcome with the least necessary effort.
For 63 years, medicine couldn’t lower lipoprotein(a). Now everyone is trying at once.
Three Phase 3 trials. Over 32,000 patients. 35+ countries. Drugs hitting 80 to 94% Lp(a) reduction. The first results from 8,323 patients land this summer.
But that’s the injectable chapter. Behind it:
-> @EliLillyandCo is testing the first oral Lp(a) pill. No needle. Daily dose. 86% reduction in Phase 2.
-> And behind that: gene editing. One infusion. Potentially permanent.
-> @CRISPRTX cut Lp(a) by 73% in humans with a single dose (CTX320, Phase 1).
-> @editasmed just showed ~90% reduction in primates by editing LDLR regulatory regions instead of the Lp(a) gene itself.
-> @EliLillyandCo is developing its own one-time gene edit through Verve.
1 in 5 people carry elevated Lp(a). It’s over 90% genetic. Diet and exercise don’t touch it. 0.1% of Americans have ever been tested (Cleveland Clinic, 71 million records).
One blood draw. $25. Once in your life.
@nickbaum benefits meaningfully outweigh the risks. you’re doing this once every five years or so. not making a hobby of it.
the expanded lipid panel will show you your risk factors. the CTA will show you the presence and state of disease.
push him to prescribe it.
Be like Jack. Get your CAC scan now. 15 mins & $150 can save your life. Heart attacks are a totally preventable killer! Time to cover the cost w insurance - widespread mammogram for the heart will save 50k lives & $10B per year! ❤️🇺🇸🚀@American_Heart@Ctr4HeartAtkPrv@DrOz
the @thestatusai team has their finger on the pulse of the future of consumer. the things they ship are so insanely novel and they are relentless inventors of new categories and experiences.
Status has raised $17M in seed and Series A funding led by @AbstractVC, @generalcatalyst and @usv to let anyone step inside their favorite stories, become famous, and live a million different lives.
We quietly launched Status last year and grew to over 1 million users in 19 days - making us the fastest growing AI app since ChatGPT.
But we hit a (predictable) snag - the app was incredibly expensive to run. How do you serve millions of users without degrading the product with a cheap LLM?
So the team locked in: we rebuilt the whole experience, and our technical bets paid off. Our users now spend 35 minutes on average to (90 minutes each day for power users!), and millions of characters and worlds have been created. All by our users.
The next frontier of entertainment is mobile-first and deeply personal. Traditional mobile games take years to build and rarely stick. TV shows are fleeting in the age of streaming. Status is different. It is not a game you finish, it is a world you can live in.
Status is a new category entirely: Immersive Social Entertainment, and we believe strongly that it is the next great entertainment paradigm. We’ve 10x’d to millions in annual revenue in Q1 2026, we're just getting started.
On Status, you can be anyone.
Just had my first visit with a cardiologist to discuss how to reduce my risk of heart disease for the next 40+ years.
Take care of your heart and read @jaredhecht’s stellar advice below.
Steve @smart is a generational talent. He is the best consumer founder I have ever known. From @GroupMe to @splice to @flybladenow and now @joinsuppco, he builds category defining companies loved by tens of millions of people. The scale and breadth of his impact is truly profound and awe inspiring. He's also a standup human being, infectiously charismatic, and I am enormously lucky to be his Partner and watch him thrive throughout the years.
A huge congratulations to the entire team at SuppCo on their acquisition by @function. This is the culmination of years of hard work. No doubt that together they will continue to transform the world of supplements and help people everywhere take charge of their own health outcomes.
Today, we're announcing $30M in new funding to build the AI OS for Research.
2.5M researchers start their work with Consensus every month. Their work is the foundation that all progress is built upon.
We could tell you our story. We'd rather they did👇
when i first saw @ndrewpignanelli pitch @intelligenceco i was blown away by how he uses ai to run his company
he and the team have been focused on making the things they practice each day easily accessible to every company builder out there
Announcing Cofounder 2: Run an entire company with agents.
It's the infrastructure for the one person billion dollar company - orchestrating agents across engineering, sales, marketing, ops, and design.
(and yes that's my real grandma in the video)