Does Inflammation Come First in Heart Disease?

Dr. Kumar’s Take:

This 2004 paper flips the traditional heart disease narrative on its head. Instead of blaming cholesterol as the cause of atherosclerosis, the authors suggest that inflammation comes first, and the body raises cholesterol levels as part of its effort to repair inflamed or damaged tissues.

Actionable Tip: Rather than focusing only on lowering cholesterol, it may be wiser to target root causes of inflammation — through diet, sleep, stress reduction, and addressing chronic infections or metabolic dysfunction.

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How Our Ancestors' Genes May Be Fueling Today’s Heart Disease

Dr. Kumar’s Take:

This fascinating study explores how traits that once helped our ancestors survive—like high cholesterol levels or better salt retention—may now be working against us. These genetic adaptations, once useful in fighting off infections or surviving heat and dehydration, are mismatched with today’s lifestyle of overnutrition and processed food. The result? Increased risk for heart disease, high blood pressure, and stroke.

Actionable tip: If heart disease runs in your family, it may not just be diet—your genes might be playing a role. But healthy lifestyle choices like reducing processed foods, staying active, and managing stress can help offset these inherited risks.

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Can One Simple Blood Test Predict Your Heart and Metabolic Health?

Dr. Kumar’s Take:

Many people believe that lowering their LDL cholesterol is enough to protect their heart—but this study tells a deeper story. Researchers found that the triglyceride to HDL cholesterol ratio (TG/HDL-C) is a powerful marker for heart disease, stroke, and metabolic syndrome, even when LDL is under control. This simple blood test could help catch risk earlier and personalize prevention.

Actionable Tip: Ask your doctor about your TG/HDL ratio next time you get blood work. A higher number may mean higher risk—even if everything else looks “normal.”

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Statins and Diabetes: What You Should Know Before Starting

Dr. Kumar’s Take:

This review confirms that statins slightly increase the risk of developing type 2 diabetes—especially in people already at risk. For every 100 to 200 people who take a statin for 5 years, one extra person may develop diabetes. While that risk is small, it’s real.

Key Takeaways:

✔ Statins may raise diabetes risk by 10–20%, especially at high doses.
✔ The risk is higher in people who already have risk factors for diabetes.
✔ Lifestyle changes like diet and exercise can help cancel out this diabetes risk.

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Red Yeast Rice May Lower Heart Risks in People with Metabolic Syndrome

Dr. Kumar’s Take:

A large review of 30 clinical trials suggests that red yeast rice (RYR) may reduce the risk of heart attacks and death in people with metabolic syndrome—a group of conditions that raise the risk of heart disease, diabetes, and stroke. This natural supplement, commonly used in Chinese medicine, appears to improve blood sugar, cholesterol, and blood pressure without increasing side effects. Still, most of the data come from studies in China and vary in quality, so caution is warranted. For those who cannot tolerate statins, RYR might offer a gentle alternative—but it’s important to talk with your doctor first.

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Do Plant Sterols Really Help Your Heart? A Closer Look at the Evidence

Dr. Kumar’s Take:

Plant sterols and stanols are natural compounds found in certain foods that can lower LDL cholesterol by about 10% when taken at recommended doses. While this sounds promising, there is no strong evidence that they actually reduce the risk of heart attacks or strokes. Some recent genetic studies even suggest that in certain people, high levels of plant sterols in the blood could increase heart disease risk. If you’re generally healthy and not on medication, sterol-fortified foods might help bring your LDL down. But if you’re at high risk for heart disease, it’s best to talk to your doctor before supplementing with plant sterols.

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Does Ezetimibe Really Help Prevent Heart Disease?

Dr. Kumar’s Take:

Ezetimibe lowers LDL cholesterol, but that alone doesn’t make it a game-changer for preventing heart attacks or saving lives. When used by itself, it hasn’t been shown to prevent heart disease or reduce death rates. However, adding ezetimibe to a statin may offer a small but meaningful benefit in high-risk patients, especially those who’ve already had a heart event. If you’re doing well on a statin, ezetimibe is not usually necessary. But if your cholesterol remains high or you’re statin-intolerant, this might be a reasonable add-on — with modest expectations.

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What 50 Years of Fibrate Research Tells Us About Heart Risk

Dr. Kumar’s Take:

This large review study looked at over 53,000 patients to see if fibrates—older cholesterol medications—still offer heart protection. The results were mixed. Fibrates have historically been used for lowering high triglycerides. In this review, they reduced heart attacks and related events, but only in studies where they also lowered LDL cholesterol. Lowering triglycerides alone didn’t seem to reduce heart risk.

In today’s world where many people are already on statins, fibrates may offer little extra benefit unless they’re clearly improving LDL levels. This doesn’t mean fibrates are useless—but they might be most helpful in specific cases where LDL is still high, statins aren’t tolerated, and patient’s are at high risk for heart disease.

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Can Fiber Lower Your Risk of Heart Disease? What 31 Meta-Analyses Say

Dr. Kumar’s Take:

This study reviewed 31 meta-analyses and found a strong connection between high fiber intake and a lower risk of heart disease and stroke. Adding more fiber—especially from oats and psyllium—can improve your cholesterol and may help you live longer. Aim for at least 25–38 grams of fiber a day from whole foods like fruits, vegetables, beans, oats, and seeds. Supplements like psyllium can also help, especially if you’re trying to lower LDL cholesterol.

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Do CETP Inhibitors Really Help the Heart? A Look Beyond Cholesterol

Dr. Kumar’s Take:

This study gives us updated insights into a controversial class of cholesterol-targeting drugs—CETP inhibitors. CETP stands for Cholesteryl Ester Transfer Protein, a protein that helps move cholesterol between different lipoproteins like LDL (“bad” cholesterol) and HDL (“good” cholesterol). Blocking CETP raises HDL and lowers LDL—but whether that actually helps reduce heart disease has been a big question.

While this study shows that CETP inhibitors can slightly lower the risk of heart attack and cardiovascular death, not all CETP inhibitors are created equal:

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Apolipoprotein B: A Better Predictor of Heart Disease Risk Than LDL Cholesterol?

Dr. Kumar’s Take:

A study published in the Journal of the American College of Cardiology found that apolipoprotein B (apoB) and non-HDL cholesterol are better markers of cardiovascular risk than LDL cholesterol in patients taking statins. If you’re on cholesterol-lowering medication, relying solely on LDL cholesterol may not give you the full picture of your heart health. Instead, measuring apoB could provide a clearer assessment of your risk for heart disease.

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PCSK9 Inhibitors and Cardiovascular Risk: Do They Really Reduce Heart Attacks and Strokes?

Dr. Kumar’s Take:

A recent meta-analysis reviewed the effects of PCSK9 inhibitors, a class of cholesterol-lowering drugs, on cardiovascular risk. The study included over 76,000 patients and found that while these drugs do lower LDL cholesterol, their ability to prevent heart attacks and strokes appears modest at best. The study suggests alirocumab may slightly lower the risk of death, but the overall benefits on mortality and cardiovascular events are small and limited to very high-risk patients.

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