(Created with assistance of Grok AI and human editing)
If you’ve read pop media stories about heart disease, you likely think if you do not smoke, exercise, have a reasonably normal weight, normal cholesterol, and do not have diabetes, do not drink excessively, and “eat right”, your chances of heart disease are low or non-existent.
But that is not true. Unfortunately, pop media – and to a large extent, the cardiology field itself – has promoted a core group of risk factors that may mislead the public.
A side effect is many of us – including the field of cardiology – often act oblivious to these other risk factors. Recently, while meeting with a cardiology physician’s assistant (very knowledgeable), I asked a question about the vitamin B link to heart risk, and her reply was that she needed to look into that. My interpretation is that this had not crossed her radar.
A side effect is the seeming focus – still – on cholesterol levels even among those with normal range cholesterol – and today’s further refinement to primarily focus on the subset of LDL-C.
Other risk factors for heart disease, like inflammation, homocysteine levels, vitamin deficiencies (e.g., B vitamins), and even dental health, deserve more attention. While smoking, diabetes, high blood pressure, and LDL cholesterol are well-established contributors, the focus on them—especially LDL—often overshadows emerging evidence on other factors.
- Inflammation is a common thread, with markers like C-reactive protein (CRP) strongly linked to cardiovascular risk.
- Elevated homocysteine, often tied to B-vitamin deficiencies (B6, B12, folate), can damage arteries, and studies suggest addressing this could reduce risk.
- Poor dental health, particularly periodontal disease, introduces bacteria that may trigger systemic inflammation, with research showing a correlation to heart disease.
The heavy emphasis on LDL cholesterol stems from decades of research and pharmaceutical influence (e.g., statins), but it’s not the whole story. For example, recent studies question the simplistic “LDL = bad” narrative, pointing out that particle size and density matter more than total LDL, and that low HDL or high triglycerides can be equally significant. Other factors like stress, poor sleep, gut dysbiosis, and environmental toxins also play roles but are understudied or ignored in mainstream discourse.
Cardiology’s focus on a few risk factors is partly due to ease of measurement and treatment (e.g., statins for LDL, meds for blood pressure), while factors like inflammation or homocysteine require more complex interventions. Pop media simplifies this further, prioritizing catchy narratives over nuance. Giving more attention to these other factors could lead to better prevention strategies, like dietary interventions for B-vitamin status or dental health campaigns, but it requires shifting research funding and public health messaging away from the current cholesterol-centric model. Until then, a broader, integrative approach—focusing on inflammation and lifestyle—remains underutilized.
Why this post?
I had a blocked artery treated in 2025. They threw a ship load of medicines at me, some of which caused severe side effects – yet may have little to no benefit for me. (In 2026, many of the medications may be discontinued, per what they tell me.)
We know that I had been vitamin B deficient for years, causing serious health problems including heart arrhythmia – all of the problems cleared up when the B deficiency was corrected. Today it is documented that vitamin B deficiency raises homocysteine levels which causes arterial inflammation. Even though this is a known risk factor and I had B deficiency health problems – the cardiology team had not shown an interest in this until I asked about it. Instead, they put me on LDL lowering medications. My normal LDL level is in the 80 range, well below the upper bound of 129 (or 99 – one hospital says 99 and the other says 99!). That’s because the new guidelines say that someone with my condition should have an LDL number less than 55. But what if LDL was never the culprit?
During the past 5 and 1/2 years, I had numerous causes of inflammation – two untreated broken feet, two cracked ribs, 3 torn tendons – and between 2008 and 2022 I had what turned out to be an inflamed (infected) cracked wisdom tooth that had cause serious tinnitus problems for a long time. Once this was discovered in 2022 and the tooth was pulled, within days all of the tinnitus that had been present for years went away. (An audiologist told me this was nearly impossible – almost no one gets rid of tinnitus!) The endodontist said that the inflammation from this went up inside my head through the left ear.
I had multiple sources of chronic inflammation underway for years.
But the primary focus is pushing a mid-range normal LDL level even lower by giving drugs. Statins caused MASSIVE PAIN – muscle damage, weakness, pain, joint pain, muscle cramps. One of the worst experiences of my life.
Heart disease is – obviously – more complex than is presented to the public. For decades, the focus was on a narrow set of issues:
- Smoking
- Blood pressure
- Diabetes
- Cholesterol, including dietary cholesterol
- Fat consumption, especially saturated fats, and later trans-fats
There are potentially many causes of heart disease. Unfortunately, the public messaging around heart disease seems to have been oversimplified – and leaves out other now-known risk factors such as inflammation and vitamin B deficiency, and over consumption of sugar and easily digested carbohydrates.
