3 ms·

archive just in case https://archive.ph/Od1VS https://archive.ph/Od1VS anybody in the medical field able to give some report on state of the art CV research ?

brandonb 10mo ago
I think the title is deliberately provocative, but they're not wrong. Heart disease is largely solvable from a biomedical standpoint: we have accurate biomarkers (e.g., ApoB, Lp(a), hs-CRP), long-term risk prediction models, precision nutrition, and highly effective next-generation drugs (PCSK9 inhibitors, lepodisiran, etc). But practically speaking, heart disease remains the #1 cause of death due to bottlenecks in care delivery: e.g., 46% U.S. counties have no cardiologists, providing guideline-recommended preventive care would require ~27 hours per doctor per day, and incentives are misaligned (health systems profit when hospital beds are full, not from prevention).
- kiba 10mo ago
  But practically speaking, heart disease remains the #1 cause of death due to bottlenecks in care delivery: e.g., 46% U.S. counties have no cardiologists, providing guideline-recommended preventive care would require ~27 hours per doctor per day, and incentives are misaligned (health systems profit when hospital beds are full, not from prevention). Supposed that we have an incentive aligned health care system. What would that look like? I think one outcome is that the healthcare system eventually expands due to population growth and less death. Accidents happen, rare cases become more common, even as we get good at fixing or preventing them.
- unsupp0rted 10mo ago
  Is it naive to say: 1. Check your ApoB, Lp(a), hs-CRP every 4 months 2. Feed that into a current-gen LLM and ask it to tell you what drugs to take and at what dosages Would that solve about 90% of the issue?
  - brandonb 10mo ago
    I started a company that does exactly that (except we also have doctors who can prescribe the medications, not just LLMs). So I don't think the approach you describe is naive, but others might. :)
readthenotes1 10mo ago
My cardiologist recently told me the disease is mostly from Lipo(a) and small dense Ldl, that it took decades from being able to measure LDL and note the correlation to disease to be able to measure there more specific factors, and even more time to nail down the observations. Lipo(a) is genetic, apparently either you have it or not. Small dense ldl is caused apparently (not a biologist) from high triglycerides, one cause of which is high sugar diet.

brandonb 10mo ago

I think the title is deliberately provocative, but they're not wrong. Heart disease is largely solvable from a biomedical standpoint: we have accurate biomarkers (e.g., ApoB, Lp(a), hs-CRP), long-term risk prediction models, precision nutrition, and highly effective next-generation drugs (PCSK9 inhibitors, lepodisiran, etc). But practically speaking, heart disease remains the #1 cause of death due to bottlenecks in care delivery: e.g., 46% U.S. counties have no cardiologists, providing guideline-recommended preventive care would require ~27 hours per doctor per day, and incentives are misaligned (health systems profit when hospital beds are full, not from prevention).

kiba 10mo ago
But practically speaking, heart disease remains the #1 cause of death due to bottlenecks in care delivery: e.g., 46% U.S. counties have no cardiologists, providing guideline-recommended preventive care would require ~27 hours per doctor per day, and incentives are misaligned (health systems profit when hospital beds are full, not from prevention). Supposed that we have an incentive aligned health care system. What would that look like? I think one outcome is that the healthcare system eventually expands due to population growth and less death. Accidents happen, rare cases become more common, even as we get good at fixing or preventing them.
unsupp0rted 10mo ago
Is it naive to say: 1. Check your ApoB, Lp(a), hs-CRP every 4 months 2. Feed that into a current-gen LLM and ask it to tell you what drugs to take and at what dosages Would that solve about 90% of the issue?
- brandonb 10mo ago
  I started a company that does exactly that (except we also have doctors who can prescribe the medications, not just LLMs). So I don't think the approach you describe is naive, but others might. :)

readthenotes1 10mo ago

My cardiologist recently told me the disease is mostly from Lipo(a) and small dense Ldl, that it took decades from being able to measure LDL and note the correlation to disease to be able to measure there more specific factors, and even more time to nail down the observations. Lipo(a) is genetic, apparently either you have it or not. Small dense ldl is caused apparently (not a biologist) from high triglycerides, one cause of which is high sugar diet.