TN50#111, The 4 Horsemen Are Coming for You, 10 April 2023

Hi Team,

Happy Monday and welcome to The Next 50 #111.  I like to think of personal performance in 3 buckets: physical, mental and emotional.  This blog is my playground or sandbox for sharing little tidbits of information that you might find useful regarding those 3 domains.

We all know a few people who have been visited by the 4 Horsemen: Heart Disease, Cancer, Dementia and Metabolic Disease and if you aren’t already dealing with one of the horsemen yourself or regarding someone very close to you, you most likely don’t spend to much time focused on their arrival and I’m here to tell you, you should.

We’ll start with the John Wick of the 4 Horsemen, Heart Disease.  I call it the “John Wick” of the 4 Horsemen because John Wick has killed more people than cancer and so does heart disease – every year.  “So what?” you say, “we all have to die of something” and I completely agree; but oddly enough a lot of professionals in this space say heart disease, as a whole, is very avoidable.  Dr. Peter Attia believes that heart disease, he actually calls it ASCVD (atherosclerotic cardiovascular disease) shouldn’t even be in the top 10.  Crazy right?  The John Wick of the 4 Horsemen shouldn’t get a horse; it shouldn’t even make the top 10 killers list!

You can read all about the how’s and the why’s in Peter Attia’s new book, Outlive.  Chapter 7, The Ticker.  This chapter is all about heart disease and how to prevent it.  Don’t have the book yet?  I’ll give you a hint on 4 things to focus on while you’re waiting on Amazon.

  1. Don’t smoke.
  2. Manage high blood pressure.
  3. Reduce your measurable levels of apoB particles, to very, very low.
  4. Check to see if you are genetically predisposed to having an elevated amount of Lp(a) 20 – 30% of the US population has levels high enough to be at increased risk.  If you are at risk talk to your doctor about ways to manage this.

OBVIOUSLY, eating better, sleeping better and moving better are all useful in keeping heart disease at bay and if you need help with that just give me a shout!

There is also a handy overview of lipid-lowering medications that Attia has included at the end of the chapter.  Statins are the workhorse of this space and have been around for decades; some people think statins are the devil and others think statins should be in the drinking water.  Here is what I can tell you personally:

  • I work with clients who have been on statins forever, they are very healthy and very active and have good blood work. They also have very healthy-looking hearts when higher end scans are available.
  • I work with a client who tried statins and had to discontinue use because of negative side effects, specifically really sore muscles. Apparently about 5% of the population have this issue, these side effects go away once you stop taking the drug.

If you are on statins, you should also be on the supplement CoQ10, unless you are eating 5 servings of fruit and veggies a day, fish 2 or 3 times a week and nuts 2 or 3 times a week.  Uh, ok, like I said take the supplements.

To repeat from last week.  In my opinion, the chapters on the 4 horsemen are worth the price of the book, Outlive.

As always share the post with your team or anyone who might find it useful and let me know what you think!

Have a good one, Alex

PS. If you would like me to write an entry on the other 3 Horsemen, email and let me know.