What Is the Optimal Number For ApoB? | Dr. Thomas Dayspring | The Proof Clips Ep 251

Episode Overview

• Dr. Thomas Dayspring discusses the specific levels of Apolipoprotein B (ApoB) that are associated with the development of atherosclerosis (plaque buildup in arteries).
• He explains that the "tipping point" for disease is not a single number but is heavily influenced by the presence of other cardiovascular risk factors like smoking, diabetes, and hypertension.
• The conversation frames optimal and high-risk ApoB levels using population percentiles, providing clear targets for cardiovascular disease prevention.

Key Concepts

• ApoB Thresholds: The discussion explores the specific concentration of ApoB at which it begins to cause atherogenesis, moving from a benign state to a pathological one.
• Compounding Risk Factors: The timeline for developing atherosclerotic plaque is accelerated by the presence of other health issues. A given ApoB level is more dangerous in a person who also smokes, has diabetes, or has high blood pressure.
• Population Percentiles as a Guide: Dr. Dayspring uses population percentiles to define risk. The ideal target is the bottom 20th percentile, while the top 20th percentile (above the 80th percentile) is considered a high-risk zone.
• Long-Term Exposure: Atherosclerosis is a disease of cumulative exposure over decades. A high ApoB level in a young, otherwise healthy person should not be ignored, as the risk compounds over their lifetime.

Quotes

• At 00:13 - "A lot depends on what other risk factors is present in you... it would take longer than if you were a smoker who was a diabetic, who was a hypertensive... it'd be a much shorter time before you've got atherosclerotic plaque in your arteries." - explaining that the speed of disease progression depends on one's total risk profile.
• At 00:53 - "And that would be 80 milligrams per deciliter. So in general, unless you do have a multitude of other factors, if you're running around with an ApoB of 80, that's probably fine." - identifying the ApoB level that corresponds to the low-risk 20th percentile.
• At 02:16 - "But if you're 30 and 40 and you want to see 90, I wouldn't go 50 years with an ApoB that's sky-high, 'cause there would be zero data supporting that that is safe." - warning against complacency and emphasizing the long-term, cumulative danger of elevated ApoB.

Takeaways

• Target an ApoB level of 80 mg/dL or lower for optimal cardiovascular health. This level, representing the bottom 20th percentile of the population, is associated with a very low risk of developing atherosclerosis over a lifetime.
• Assess your total cardiovascular risk, not just one number. The danger of an elevated ApoB level is significantly magnified by other factors like smoking, high blood pressure, and diabetes. Managing all risk factors is crucial.
• Address high ApoB levels early in life. Don't assume that feeling healthy or having a clean calcium scan negates the long-term risk. Atherosclerosis is a slow, cumulative process, and early intervention provides the greatest chance for prevention.