006 - Can You Really Prevent Heart Disease? New Science On Cholesterol, Plaque And Stroke Risk

Hi, and welcome to Clear Cardio Prevention is Power podcast, where we help you take control of your health and protect your future. I'm your host, J.D. Enright, and today's episode is all about breaking the myths that keep people from taking action on their heart health. You know, for too long, people have been trapped in outdated false beliefs, believing they need to wait for insurance approval before getting checked. Trusting doctors who still rely on ineffective decades-old tests. Thinking Big Pharma has all the answers, or even waiting for others to validate their decision before taking control of their health. And the biggest myth of all, that heart disease is not preventable or predictable until it's too late. Well, that's a lie, guys, and today we're here to prove it. Joining me to bust these dangerous myths is Dr. John Osborne. He's a Harvard-trained cardiologist with nearly 30 years of experience in preventing and treating heart disease. Dr. Osborne, welcome back to Clear Cardio Podcast. How are you doing today?

I am smashing. Thank you, JD.

Oh, I'm excited about this conversation because I used to watch a show called MythBusters all the time, and I love to bust myths, and we're here to do that. And I know our audience here, our viewers, are excited to hear what these myths are. Like, you know, why are so many people been kept in the dark for so long? You know, it's time to set the record straight. Don't you agree?

We're going to do it today.

Yeah, let's do that. So what are some of these myths, Dr. Osborne?

Oh, so I'll tell you one in no particular order. This is data that's going to be coming out very soon.

Okay, so this is late breaking.

This is late breaking. This is actually before it's Even published.

You heard it here first, guys.

So everyone has been sworn to silence.

Yes.

Okay. We will be publishing data that shows using the most sensitive tool to detect and quantify plaque, which is the Cleer Cardio process.

I was going to say, what is it?

Which is the Cleer Cardio process.

Which I've gone through. Yep.

Which is basically we put you in our scanner, high-tech CAT scanner. We take and get these high-resolution, 3-dimensional pictures. We then take that data, upload to the cloud, do this incredible AI upon the data, and literally be able to see what we could not see before AI. And there's also the ability to quantify that plaque as well.

So how does this AI work? I'm just curious for those who are watching. So this AI, it analyzes all of the images. If I remember our conversation when I was in your office, right? The first time, a year and a half ago, almost 2 years ago now, whatever it was, when we looked at it, it was incredible. What does the AI do? Well, exactly. Yeah.

So first of all, we feed it this amazing, incredible, high-resolution, 3-dimensional imaging of the heart and the blood vessels and all that.

So it starts with these really cool images.

Yeah, really cool images. So have you ever seen that, like the pictures of the heart rotating?

Yeah, I remember that. The living autopsy, which is incredible.

The living autopsy. So that is cardiac CT.

Okay.

But now, and the major advance in the last few years, is now we can take that data, upload to the clouds. And basically what's happened behind the scenes, of the millions of pixels, technically voxels, but of the millions of pixels that are obtained when we do the scan, it will analyze every single one of those pixels. And every pixel is encoded As we call it, with over 2,000 shades of gray. So what I mean is, if you look at an X-ray, it's gray, right? Black to white and gray in the middle. Our eyes can see or differentiate about 50 to 100 shades from black to white. Electronically, in every pixel of the images we obtain, there are 2,000 shades of gray. So AI can see things that are invisible to us.

I had no idea that many shades of gray. Yeah, I just remember the book and the movie.

50 Shades of Grey.

Yeah. Okay, so they go through this incredible process. The AI is doing this incredible analysis, which is giving them a report. And so what are these myths that everybody's talking about that we're busting here?

So they took 250 people. They did this incredibly, well, incredibly accurate tool, the most accurate tool we have short of the autopsy. I don't know, it could be better than autopsy, but to be able to know exactly how much plaque there was and measure total whole heart plaque and all the blood vessels of the heart.

So if you were to— it's like, wait, you got 50 pounds of plaque versus 10 pounds of plaque. You can actually— Or no plaque. Good stuff.

Yeah, so you can really measure that down to a 10th of a cubic millimeter.

Wow, that's super accurate.

Yeah.

Yeah.

With a test that takes a few minutes.

Wow. Okay. So we should all do it. Yeah.

Well, yeah, exactly. So that's the Cleer Cardio imaging part. We also provide the solutions as well. But here's the key thing. Here's the myth you have to understand. And I've been telling this for years. Now there's great science that shows it's true. So get ready, sit down.

Okay, I'm ready to go.

250 patients. We know exactly how much plaque each one has. We then, having all of their lipid or cholesterol data, we looked at, does your LDL, your bad cholesterol that probably many of you heard of, does that predict who has plaque? No. Does total cholesterol predict who has plaque and how much?

No.

Does HDL, the good happy cholesterol, the, the— I call it the heavenly happy cholesterol.

Everybody says this is good cholesterol. You want that high.

Had no predictive ability.

Oh my goodness.

Of understanding who had plaque and how much they had. We also have other cholesterol parameters, triglycerides. We have some, some stuff that we use routinely. I use routinely as a certified, board-certified lipidologist as well, some other biochemical tools. One is called Lp, which is very important. You're going to see more about that in the next few weeks.

That's associated with genetics, right? It is.

It is not picked up with a standard cholesterol profile. You got to check it.

It's very expensive. And that's what we do at ClearCut.

Yeah, but we do that too, because again, you will never ever detect it unless you order the test. It's called Lp. And then the other tool that actually has been shown to be a better predictor of cardiovascular events, strokes, heart attacks, balloon stents, sudden cardiac death, than even LDL cholesterol, right, is something called ApoB. Again, you've never heard of it. But we lipid dweebs and nerds, that's going to always be part of our assessment when we look to see what's happening on the lipids side of things. So here's the paradox. Any of those lipid parameters, any of those cholesterol parameters I outlined, had no predictive ability to understand, does this person have plaque or how much?

So the correlation to LDL, to cholesterol, total cholesterol, And if you're lucky, even Lp, even obscure markers, things like that, don't directly correlate to the amount of plaque you have built up in your arteries.

Exactly.

Okay, hold on. That's a massive mythbuster because I can tell you personally, having gone to some of the best clinics in the world to get health checkups for insurance purposes and all this other stuff, life insurance, and, and just, and they, one of the major things was, you know, You know, you're on insurance, right?

Yes.

When I had keyman insurance as an executive, yeah. You know, I had to go to these places, and you know, I was spending fifteen twenty thousand dollars, and I'd go in there, and they walk away, and they'd say, "Hey, you passed your stress test," and your your your good cholesterol is really high, but your bad cholesterol is high too. But because you got good cholesterol high, it offsets that. And I'm thinking to myself, okay, and they never put me on any drugs or any medications or anything to try to lower that.

They never did anything about it. Yeah, well, because they you know there was No discussion about plaque.

I've never heard about it until I met you. Thank goodness I did, because you literally saved my life. I never heard about plaque. When I thought plaque, I thought in your teeth, like you get plaque in your teeth, brush it out, good to go. But plaque in your arteries being the number one cause, is the cause of heart attacks and strokes, 90% of them at least, right? From ischemia, I guess. Yeah. That's a massive myth that there's no correlation.

Right.

Right. That's crazy.

Yeah. So HDL cholesterol, right?

Yeah.

That whole concept, it's the garbage truck. It takes cholesterol out of the vessels. All that kind of stuff is absolutely 100% wrong.

High density.

High density lipoprotein.

Okay.

HDL.

Very good. Yeah.

Very good.

I'm learning.

You're a good student, Grasshopper.

Yes. Thank you, sir.

But yeah, I mean, people still go on about that, and that was disproven 20 years ago. Yeah, right. So it just struck me, you know, people have swear jars. Yeah, right. Yes, I need an HDL jar. Yeah, every time someone says, but my HDL is great, 25 cents. Yes, right.

You'll be rich in a day.

Well, and, and well, hopefully I'll disabuse people of that and save lives. Yes, HDL, forget about it. In fact, High, very high levels of HDL can actually be pro-plaque, can be pro-atherogenic, can actually cause plaque to form. So there's a fantastic myth. But the other thing is historically, you go to the doc, they look at your cholesterol, they look at yours and say, you're fine. Well, yeah, we put you in the scanner and you weren't, right? Or conversely, I'll see the opposite. People who have high cholesterol, We put them in the scanner and they're fine. So let me rectify this paradox, because you go, but cholesterol is really critical. It's essential. It's got to be in— it's in the plaque. It's always there at the scene of the crime.

Because I've heard you say that cholesterol, without cholesterol running through your blood, you won't have plaque buildup.

Yeah, it's impossible. So it has to be there. It's mandatory, necessary, may not be sufficient, but it is always there at the scene of the crime. So let me rectify this conundrum, this mystery, riddle, enigma. Okay, okay. So cholesterol absolutely is 100% part of plaque, right? It gets into your vessel wall, it sticks, blah blah blah, right? So part of that can be too much cholesterol, right? It overwhelms the the body's defenses to cholesterol, and it sneaks into your blood vessel. Not good. Okay. However, if you look at people who are admitted to the hospital with CAD coronary artery disease, right? This is from a study of 142,000 people.

That's a lot of people.

Yeah. Those patients admitted to the hospital for CAD had lower LDL than the rest of the population.

Wow.

Okay? So here's what's happening. So remember, when you measure— when we measure cholesterol in the blood, we are literally just measuring cholesterol in the bloodstream, just floating around in the arteries and veins, right? Tells me nothing about is it sticking. I only care about cholesterol if it's sticking.

So you can have really high cholesterol and Teflon for arteries.

You got it. It doesn't stick at all. Precisely.

And you just— how does it get out of your system?

Our liver gets rid of it.

So through our liver?

Yeah.

Okay. So liver's just, goodbye. Don't care. Yep. Yep. It's all good. I'm going to eat all that stuff. Don't care.

No worries.

But if your arteries aren't like Teflon—

Right. You got Velcro.

Like Clinton in the '90s, Teflon Man, right? Everything just kind of slipped off. Nothing stuck.

Yeah. Well, yeah, he didn't have Teflon arteries.

No, he got got.

Well, no, sorry.

Yeah, I know, fair enough. He had it, exactly. So if it's sticky, then what happens?

So you could have high cholesterol, and I've seen this with our scans, right? High cholesterol, and yet your vessels are like Teflon. The cholesterol bounces off, if you will, and you don't form plaque. You could have average or even well below average cholesterol, and I've seen this too, but you have vessels like Velcro that are super sticky, so it doesn't take much cholesterol at all to float around these super sticky vessels, and that cholesterol is going to stick.

Got it.

That's why knowing your cholesterol tells me nothing about, do you have the disease? Although cholesterol is central and critical to that. You could have no heart disease at high cholesterol, Lots of heart disease at low cholesterol. So measuring your cholesterol tells me nothing about do you have the disease.

So there's a myth absolutely busted.

100%.

I also— there's also a myth that you have to wait to have your health insurance company approve you to go get a heart— like a Cleer Cardio program scan, things like what we do. Is that— that's not true, is it?

No.

That's absolutely not true?

No.

Okay, so anybody can literally say, I just want one.

Do not beg your your health insurance carrier to save your life, because they won't.

Okay. Got it. So there's 2 myths busted. And so still right now, people are doing stress tests and EKGs, and they're doing all of these— these are widely used tests, right?

Where's the swear jar again?

Right. So these are outdated, right? They're ineffective. I've learned that, right? So, so it actually— I mean, dangerous, right?

Yeah, because you can have a normal EKG and have significant heart disease, right? Tells you nothing. Lots of people do stress tests, looks perfect, and then keel over dead the next day, next week, next month, next year, right?

Yeah.

So those tests, you know, EKGs are tests that go back literally to the end Of the 19th century. End of 19th century.

Well, that's a long time.

Yeah. Again, are useful. EKGs are useful for heart arrhythmias.

But that's just electrical, right?

Purely electrical.

That's not going to tell you if you have plaque, right?

They tell me nothing about the plumbing.

Yeah.

Right?

Or the plaque, right?

Or the plaque.

Doesn't tell you.

Yeah. Right? Stress tests. Again, we've been doing those for 60, 70 years. They've evolved. We've added Other high-tech parts of that, but basically they're all the same. They will not become abnormal till you have at least a 70% blockage in the vessel. They do not pick up early disease. They can't pick up— it's impossible for them to pick up early disease. They only pick up late disease. And even then, because we're assessing basically blood flow, right? Not plaque, but blood flow.

Yeah.

There still is at least a 25% False negative rate. That is, you have a severe blockage, the stress test looks great, cardiologist pats you on the back, says you have the heart of an 18-year-old, and then you have a heart attack the next week.

And half of the time you'll die from it.

Yeah.

Wow. Wow.

And then another 25% of the time, it'll look funky, abnormal. In the old days, we'd take those poor people to the cath lab, do a heart catheterization, $20,000, invasive, risk of complications, including strokes, heart attacks, kidney damage. Bleeding, et cetera. And then find out, oh, you look fine.

Yeah. So false positive.

Yeah. And by the way, even with a normal heart cath, because we're only seeing the channel, the lumen, I call it the donut hole, plaque always begins to form in the donut first. You'll never see that in a heart cath. It goes outwards. You'll never ever see it.

Yeah. And if they do see an obstruction, they'll never see the plaque, but they'll see maybe an obstruction. And only, if I understand, only 60% Or 70% or more, then they'll go in and actually do something about it.

Perhaps, yeah.

But then they're only treating the symptom and not the cause, because they don't really know where the plaque is and how big it is.

Right, you're not treating the disease. A blockage is a complication of a disease that's been there for decades.

That you can't see unless you look under the hood.

Exactly.

Okay, very good. That's 3 myths busted. And what about pharma companies? There's this— I, like a lot of our listeners, I'm sure, We look to pharma companies to know, do they have the answers? They have the answers. They know how to fix things. Is that accurate or?

I'm going to say, I think the tools that I use on a daily basis when a medication is required, they continue to get better. They continue to advance. They become more effective. Some are very good, I understand. Yeah. Work to reduce side effects and make them better tolerated and all that. They do charge a good amount of money for all of that.

Yeah.

So, but I will say that pharma has given me, via the research that they have done and developing these tools, tools that I didn't have, depending upon what we're looking at, 10 years ago, 20 years ago, 30 years ago.

Yeah. So—

But it doesn't tell you if you have plaque in your arteries or not. But it tells me, no. I mean, all they're doing is telling me, giving me a tool, which is great, to treat plaque. The problem is we are not picking up plaque early.

Yeah.

Right? That's our big, big failure. We have great tools to treat plaque. It's only getting better. But we wait until we're seriously ill. We're having chest pain. We flunk a stress test. We already have 70-plus percent blockages. We probably need stents, balloons, or surgery, perhaps Well, because we caught the disease so late in the game, but the disease has been there for 30 years. We had 30 years to detect it, check it, treat it, prevent it. We missed that 30-year window. And then we have to end up, if you live, because remember, in people who have no symptoms, first symptom in about half of them is you die.

Yeah.

Right? I call that the bottom half of the class. Only the top half of the class Gets the balloons, the stents, and the bypass surgery because they lived. The bottom half just dies. And that's a pretty terrible way of dealing with the leading cause of death in the US and globally, 20 million globally every year.

Yeah. Those are some big myths you just busted right there. One myth that I busted was because of you. And that was that I needed my general doctor's permission, or they needed to recommend me or refer me to a doctor like you, a preventive cardiologist, which you're like a unicorn. You're like the rare Bigfoot that—

I saw it today.

Yeah. The unicorn's here.

Yeah.

Because there aren't very many preventive cardiologists out there. They're very reactive. And they're, you know, I get that, but that's old school news.

Right.

Um, and we're myth— we're busting those myths. Uh, but I, I thought that like in the rare occasion I would go to a doctor. Okay. So for our listeners out there, um, primarily who are listeners who are men, because women in general, like my wife, uh, is very worried well, right? So she's very proactive. She doesn't want to become sick or ill or die. So she takes proactive mem—

uh, They don't call it a widowmaker for nothing.

That's right. Well, so whereas I, like a lot of my colleagues and friends and buddies, we like to play golf and whatever, we lose a limb and we just put a tourniquet on it.

Just put a scratch.

And we go back to work. Right? And so us going proactively to see a doctor, it's usually because our wives are pushing us or we are having symptoms. And what we are learning is that those symptoms mean you're far along.

Yeah.

Right. And so it's never too late. It's never too late. And that's why you got to get into an organization, meet a doctor like yourself and Clear Cardio to find out yes or no, definitively. However, the ones of us who do go into the doctor, and in that rare event, I always thought that I had to have the doctor's permission or they had to recommend me because my insurance company, to go see a cardiologist.

We call them gatekeepers.

Gatekeepers. And that's not true.

And they kept slamming the door.

I found out that's not true. So those of you who want to take proactiveness, you absolutely can. I know, I'm proof, and I've got lots of friends and colleagues, and all the patients that Dr. Osborne sees through Clear Cardio, they— a lot of them decided that they weren't going to wait. Unfortunately, most of them had symptoms, and that's why they came, because it's still a learning process. We're still going through that process of education.

Right.

Do you find that the same way?

Oh, absolutely.

Yeah.

The good news is we're seeing the healthy people, no symptoms, I feel fine, who go, I got to know. I want to know. And if we find that you do not have anything, yahoo. I will slap you on the back, just like the old cardiologist that said, oh, your stress test looks great. You got the heart, 18-year-old. Well, no, I look at your heart. I look at your blood vessels. There's nothing there. There's just nothing there. 100%.

Keep doing what you're doing, baby. Yeah.

Or we take the marathon runner, the CEO, the guy or woman that looks to be peak health, and we look under the hood. We do clear cardio and we find out we got some opportunities for improvement.

Like me. Like me. You saved my life. And as I mentioned earlier, I'd gone to the The best clinics out there.

Well, you thought they were.

I thought they were. I thought they were the state of the art. I thought I was stepping into Star Wars, Star Trek land. And it turns out that most of it was pretty useless, including the myth we busted today about my cholesterol being a direct— indirectly or directly or whatever. So, wow, eye-opening. So any other myths that you're aware of that you want to bring up? At this point, you know, let me call this Mythbusters 1.0.

Okay, uh, we'll bring— but we'll, we'll come back to this. Okay, there's still a lot of myths out there.

There are.

But again, we can't overload you with too much myth-busting.

Fair enough. We busted a lot of myths. We did. Yeah.

And, and many more.

Yeah, many more. Yeah. And I bet you people are gonna go out and they're gonna Google and they're gonna see all this information. It's gonna be— some of it's gonna be like, that's completely not true, or the other doctors who are just like, they have agendas or whatever. I promise you, folks, Dr. Osborne, Harvard-trained, 30-year-old, 30-year in the industry, preventive cardiologist, lipidologist, and my doctor, and a lot of my colleagues and friends' doctors, and a lot of very well-known people's doctor. And the proof is in the seeing. It's not— we're not looking at risk factors. We're not looking at I mean, we are doing that, but that isn't how Cleer Cardio diagnoses, detects the disease, right? It's the seeing. It's, you know, because you see it. And when you see it, there's nothing like seeing it. And then knowing that you can solve it.

Whoever you go to, right? Or whoever you are going to, primary care doctor, cardiologist, whatever, unless they're showing you your heart, Yeah. Taking your heart apart, flying up and down your vessels, doing an AI analysis to see plaque that we cannot see with our eyes, and then quantifying that plaque.

Yeah. And what kind of plaque it is, because that's really important.

And what kind of plaque it is. You're a good student. You're getting inadequate care. I mean, honestly, I'm just going to call it out.

Subpar.

You're getting subpar care. Again, a quote I've quoted before, but I think it's so relevant to this discussion, as always, is the future's already here. It's just not equally distributed. Okay?

Yeah.

So our goal, we have all the solutions to eliminate heart disease. We don't have to wait. Other people may, but all you have to do is reach out, go to clearcardio.com, check it out. And we're just here to save your life. That's all. Nothing more, nothing less.

One life at a time. You got it. Yeah. I think the motto at Clear Cardio is 100,000 lives in 10 years. I think it's what it is, right? Something like that, but 10,000 lives a year.

Yeah.

So let's roll on that one. Well, thank you, Dr. Osborne, again. Wonderful having you here on the Clear Cardio Podcast. It's always enlightening, and we've had some great feedback from all of our listeners and those who tune in to our podcast. So for all of you that joined us and stuck in there with us, thank you very much. I know it's a lot of information. We can answer more questions. We highly recommend that you come in And meet with us, meet with the Clear Cardio team, have a discussion with Dr. Osborne. Go to clearcardio.com, that's C-L-E-A-R-cardio.com, and set up an appointment. Come in. It's, uh, it can only save your life.