Bill: To begin with, I consider you a friend. So I will speak frankly. I wonder if you are blind and deaf because you are certainly dumb being unaware of the current massive discrimination against Jewish students at Harvard. Jewish students there have long said that anti-Semitism is rampant. As for your article otherwise, and as usual, quite good. Since 1972 I have recommended a non-HDL cholesterol of 90 or less in the well and 75 or less in those with ASCVD, BP 110-115/60-70 or so-first published in Lancet in 1991. In 1983 I wrote the Wellness Protecting Numbers which are essentially unchanged to date: www.thepmc.org. Your publications support those values. Bob S (HRS, MD, FACC)
My main purpose was to bring some balance to the conversation. If Jews are 2% of the population and 20% of the student body, it is hard to think the university discriminates against Jewish students. Drs Libby and Lown have courageously promoted better care in the face of tremendous pushback
I agree with your comments here. Harvard’s overt anti-semitism and tolerance for it on campus is appalling as is it’s blatant anti-Asian discrimination. You can’t hide behind DEI and then blatantly discriminate against specific groups.
Is it the university itself, or are they turning away and allowing it to happen? There is a fine line. An observation from non-academia, but strong connections to the Jewish culture and religion.
Bill, thank you for lifting up the awful discrimination of Harvard by the current administration. Medical and scientific research will be set back decades of the cut in funding is real. Thank you, as always, for your dedication to telling the truth! Best regards, Jane
Thanks, Bill, for this insight into these pioneers and your comment about how misdirected current policies are regarding Harvard and other universities & research institutes as well as government agencies. Also an excellent summary of much of your message and a great story about how you came to this. Always learn a lot from you.
Great substack post, thank you Dr Bestermann. As a patient with multi vessel disease, and an extremely high calcium score along with 3 stents, you have validated my approach of medication (statins, despite all the misinformation on the Internet), along with the equally important lifestyle changes, in diet, exercise, and (an attempt at) stress management.
It souinds like you are on a great path. If you have high blood pressure or type 2 diabetes, best practice medications are important there as well. Let me know if you have any questions.
Thanks so much. There is one thing I’m wondering about…. Medications……My cholesterol, including LDL-C , which is currently at 50, has never been a problem, aside from low (32-25)HDL. I think my most important issue is Metabolic Syndrome. I’ve always had high triglycerides, low HDL, high BP, and a dexascan recently showed 4.4 pounds of visceral fat.. so while I’ve never been officially told I have metabolic syndrome, it’s pretty clear.
So I’m thinking I need to ask my Cardiologist, at next visit, to put me on Metformin. My fasting morning blood sugar is high at 125, but a1c is 4.9.
To get to the question….. Metformin? GLP-1 drugs? And with a calcium score of 1998 a/o 2 years ago, should I ask him to increase Crestor from 20 to 40 mg?
Wondering, if I get a “no” on any or all of these, how hard I should push back. Any guidance appreciated. TG was 175 last month, lowest it’s been in a while.
If you have coronary artery disease, you should be on a high intensity statin like atorvastatin (lipitor) or rosuvastatin (Crestor)regardless of cholesterol levels. Lowering cholesterol is one way these statins help but it is more important that statins are antioxidant, antiinflammatory, and they activate a master genetic survival switch called AMPK.
If your fasting sugar is 125, you are solidly prediabetic and that is the best argument to take metformin. Any fasting sugar over 100 merits that diagnosis. A fasting sugar of 126 is diabetic and those cut points are arbitrary. Higher sugar levels represent a coninuum of risk. Patients with a diagnosis of diabetes should be on metformin because it lowers their risk of cardiovascular events beyond its impact on the blood sugar. Metformin DIRECTLY inhibits mTOR and activates AMPK. Metformin directly blocks the effects of ADMA whilch is part of the cause of cardiovascular disease. There are a host of clinical trials that support these positions. I had a fasting sugar of 107. I have been taking metformin for twenty years. My last fasting sugar was 85.
Thanks for the links, and response. So regarding fasting glucose, being prediabetic, does this still apply if 1. my a1c is always between 4.9 and 5.3, and 2. By afternoon, even after no longer fasting, blood glucose is in the range of 85-90?
And would you agree that it’s present to up my rosoivastatin dosage from 20 mg to 40Mg?
Bill: To begin with, I consider you a friend. So I will speak frankly. I wonder if you are blind and deaf because you are certainly dumb being unaware of the current massive discrimination against Jewish students at Harvard. Jewish students there have long said that anti-Semitism is rampant. As for your article otherwise, and as usual, quite good. Since 1972 I have recommended a non-HDL cholesterol of 90 or less in the well and 75 or less in those with ASCVD, BP 110-115/60-70 or so-first published in Lancet in 1991. In 1983 I wrote the Wellness Protecting Numbers which are essentially unchanged to date: www.thepmc.org. Your publications support those values. Bob S (HRS, MD, FACC)
My main purpose was to bring some balance to the conversation. If Jews are 2% of the population and 20% of the student body, it is hard to think the university discriminates against Jewish students. Drs Libby and Lown have courageously promoted better care in the face of tremendous pushback
You stats are true but UNRELATED to the CURRENT level of anti-Semitism at Harvard--that you are ignoring. Your response is NOT "some balance."
I agree with your comments here. Harvard’s overt anti-semitism and tolerance for it on campus is appalling as is it’s blatant anti-Asian discrimination. You can’t hide behind DEI and then blatantly discriminate against specific groups.
https://www.ivycoach.com/the-ivy-coach-blog/ivy-league/the-decline-in-jewish-students-on-ivy-league-campuses/. “For the past three years, The Harvard Crimson has reported that about 10 percent of incoming first-year students identified as Jewish, according to their own survey. For the incoming Harvard class of 2020, that number has dropped to 6 percent.”
Is it the university itself, or are they turning away and allowing it to happen? There is a fine line. An observation from non-academia, but strong connections to the Jewish culture and religion.
Bill, thank you for lifting up the awful discrimination of Harvard by the current administration. Medical and scientific research will be set back decades of the cut in funding is real. Thank you, as always, for your dedication to telling the truth! Best regards, Jane
Great to hear from you. You are a university leader and your affirmation means so much to me.
Thanks, Bill, for this insight into these pioneers and your comment about how misdirected current policies are regarding Harvard and other universities & research institutes as well as government agencies. Also an excellent summary of much of your message and a great story about how you came to this. Always learn a lot from you.
Well said, Dr. Bestermann
Great substack post, thank you Dr Bestermann. As a patient with multi vessel disease, and an extremely high calcium score along with 3 stents, you have validated my approach of medication (statins, despite all the misinformation on the Internet), along with the equally important lifestyle changes, in diet, exercise, and (an attempt at) stress management.
So thanks for writing.
It souinds like you are on a great path. If you have high blood pressure or type 2 diabetes, best practice medications are important there as well. Let me know if you have any questions.
Thanks so much. There is one thing I’m wondering about…. Medications……My cholesterol, including LDL-C , which is currently at 50, has never been a problem, aside from low (32-25)HDL. I think my most important issue is Metabolic Syndrome. I’ve always had high triglycerides, low HDL, high BP, and a dexascan recently showed 4.4 pounds of visceral fat.. so while I’ve never been officially told I have metabolic syndrome, it’s pretty clear.
So I’m thinking I need to ask my Cardiologist, at next visit, to put me on Metformin. My fasting morning blood sugar is high at 125, but a1c is 4.9.
To get to the question….. Metformin? GLP-1 drugs? And with a calcium score of 1998 a/o 2 years ago, should I ask him to increase Crestor from 20 to 40 mg?
Wondering, if I get a “no” on any or all of these, how hard I should push back. Any guidance appreciated. TG was 175 last month, lowest it’s been in a while.
If you have coronary artery disease, you should be on a high intensity statin like atorvastatin (lipitor) or rosuvastatin (Crestor)regardless of cholesterol levels. Lowering cholesterol is one way these statins help but it is more important that statins are antioxidant, antiinflammatory, and they activate a master genetic survival switch called AMPK.
If your fasting sugar is 125, you are solidly prediabetic and that is the best argument to take metformin. Any fasting sugar over 100 merits that diagnosis. A fasting sugar of 126 is diabetic and those cut points are arbitrary. Higher sugar levels represent a coninuum of risk. Patients with a diagnosis of diabetes should be on metformin because it lowers their risk of cardiovascular events beyond its impact on the blood sugar. Metformin DIRECTLY inhibits mTOR and activates AMPK. Metformin directly blocks the effects of ADMA whilch is part of the cause of cardiovascular disease. There are a host of clinical trials that support these positions. I had a fasting sugar of 107. I have been taking metformin for twenty years. My last fasting sugar was 85.
https://www.niddk.nih.gov/about-niddk/research-areas/diabetes/diabetes-prevention-program-dpp
https://pmc.ncbi.nlm.nih.gov/articles/PMC3081779/
https://pubmed.ncbi.nlm.nih.gov/27732831/
https://pubmed.ncbi.nlm.nih.gov/22135630/
Thanks for the links, and response. So regarding fasting glucose, being prediabetic, does this still apply if 1. my a1c is always between 4.9 and 5.3, and 2. By afternoon, even after no longer fasting, blood glucose is in the range of 85-90?
And would you agree that it’s present to up my rosoivastatin dosage from 20 mg to 40Mg?
Excellent