July 2, 2018

Podcast

Ron Krauss, M.D.: a deep dive into heart disease (EP.03)

"Anybody interested in this field should probably understand the origins." —Ron Krauss

by Peter Attia

Read Time 6 minutes

Whenever I’m stumped on a patient case, or in my thinking about lipids, Dr. Ron Krauss is one of the first people I turn to for insight. I’m not alone. Ron is recognized globally for his research into lipidology and has worn many hats in his career, including clinician, lipidologist, nutrition, genetics, and drug researcher. He received both his undergraduate and medical degrees from Harvard and is board certified in internal medicine, endocrinology, and metabolism. He’s currently the senior scientist and director of atherosclerosis research at Children’s Hospital in Oakland.

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My hope is that both the curious patient and the physician can get a lot out of this episode by being more informed about dyslipidemia and the interventions used to reduce the risk of atherosclerotic disease, cerebrovascular disease, and peripheral vascular disease.

We discuss:

  • The pathogenesis of atherosclerosis;
  • How early atherosclerosis begins;
  • Ron’s motivation for getting into lipidology;
  • How reading an article series in the NEJM in 1967 had a profound impact on him and his career;
  • The “battle” between LDL particle size and particle number;
  • The use of statins;
  • The role of chronic inflammation in atherosclerosis;
  • Why niacin may have been unjustly dismissed as a therapeutic option;
  • The HDL paradox: why drugs that raise HDL-C seem to elevate (or have little impact on) heart disease risk;
  • Mendelian randomization: nature’s randomized trial;
  • How PCSK9 inhibitors work and why they may be underutilized;
  • Lp(a); and
  • More.

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