Episode 481: What's Coming Next for Lipoprotein(a) Treatments

This week on Heart Doc VIP, Dr. Joel Kahn takes a deep dive into one of the most influential research projects in cardiovascular history: the Framingham Heart Study. Launched in 1948 and still going strong, this landmark study helped identify many of the risk factors we now take for granted, including smoking, diabetes, high cholesterol, high blood pressure, obesity, and physical inactivity. Much of what modern cardiology considers "common knowledge" about prevention started in Framingham. Dr. Kahn also explores practical and emerging topics in heart health, including the role of magnesium and berberine supplementation, how to approach both low-carb and low-fat diets in a healthy way, and concerns about long-term proton pump inhibitor use. Additional discussion covers EECP therapy and strategies to improve coronary blood flow, along with the potential benefits of ezetimibe for cholesterol reduction and brain health. Thank you to this week's sponsor, Igennus. Visit igennus.com and use code DRKAHN for a special discount.

This week, Dr. Kahn breaks down a new paper examining the risks and reported side effects of statins—including the surprising finding that placebo alone is linked to many of the same symptoms. He also covers an oral PCSK9 inhibitor currently under study and what it could mean for cholesterol management. The episode then dives into the latest research on emerging therapies designed to lower lipoprotein(a), including a real-world case study that highlights where this rapidly evolving field is headed.  Shorter discussions include heart disease at a young age, why so many patients fail to reach blood pressure treatment goals, aspirin use one year after AFib ablation, skeletal muscle as an endothelial stabilizer, and why exercise variety may be one of the most powerful risk reducers we have.  Thanks to WellBean for sponsoring the show. Save on their delicious bean-based products at wellbean.life with code DrKahn15.  Dr. Kahn will also be leading a free online seminar on cholesterol on February 17, 2026 at 7 PM EST with Forks Over Knives. Register HERE.

This week, Dr. Kahn discussed a case study involving a 30-year-old man with newly discovered, very high cholesterol. The implications of heart disease in young adults—backed by a recent paper from the CARDIA study group—suggest that early intervention, beginning with lifestyle changes, should be offered, along with follow-up lab testing. The Portfolio Diet plan would be a strong starting point on the journey toward a more plant-based diet. Other topics covered include the risks of diet soda, the health impacts of being a night owl, coffee consumption for atrial fibrillation patients, the role of genetics in longevity, plant-based diets for kidney health, and red light therapy for brain illness and trauma.  Thanks to getfreshDRKAHN.com for the $1 offer on a bottle of fresh-pressed olive oil from some of the finest estates. EXTENDED SHOWNOTES:  Dr. Kahn also touched on several additional topics during the episode. He discussed olive oil tasting and shipping, encouraging listeners to sign up before the current shipment from Italy ends and explaining how tasting fresh olive oil helps assess quality. Red light therapy came up in the context of brain injury, including a study showing potential benefits from nasal exposure in college athletes with repeated head trauma. He also mentioned advocacy efforts to promote routine coronary calcium scoring starting at age 45. Several studies on diet and longevity were reviewed, including research showing that plant-forward diets are associated with better kidney health and that genetics may account for up to 50% of longevity—though lifestyle choices still matter greatly. Dr. Kahn also covered caffeine and heart rhythm, noting research where coffee consumption was linked to fewer episodes of atrial fibrillation, while diet soda was associated with a higher risk of dementia. Finally, he discussed sleep patterns, citing data suggesting that night owls face higher cardiovascular risks than early risers.

In this bonus episode, Dr. Kahn sits down with his longtime friend TJ Robinson, founder of the Fresh Pressed Olive Oil Club and self-described "olive oil hunter." TJ has made it his life's mission to track down the freshest, highest-quality extra virgin olive oils in the world — often straight from small producers in Europe and South America — and get them shipped to the U.S. as quickly as possible. The conversation dives into what most people don't realize about olive oil: how freshness impacts flavor, health benefits, and antioxidant levels, and why the oil sitting on a grocery store shelf may not be doing your heart any favors. TJ explains how he sources each harvest, what separates truly exceptional olive oil from the rest, and why timing is everything when it comes to preserving polyphenols and taste. Dr. Kahn and TJ also discuss why extra virgin olive oil remains one of the healthiest dietary staples available, especially for cardiovascular health, and how consumers can avoid misleading labels and outdated products.  Listeners can sample the latest Fresh Pressed Olive Oil Club release for just $1 shipping by visiting getfreshDRKAHN.com .  If you prefer to watch the conversation, the full video interview is available on YouTube: youtube.com/watch?v=AZP64Au_j5M

This week, Dr. Kahn discusses a new report from the American Heart Association on the causes of heart-related deaths in the U.S., and the sobering reality that cardiovascular disease remains the nation's leading cause of death. Despite this, prevention and early detection continue to be underemphasized at the national level—meaning much of the responsibility still falls on individuals. Dr. Kahn also covers several shorter topics, including a response to the CSPI food pyramid, water quality on airplanes, Apple Watch detection of atrial fibrillation, why earlier meal timing is better, the vascular benefits of extra-virgin olive oil, and the cholesterol-lowering power of oats. Thanks to the Fresh Pressed Olive Oil Club, you can sample a bottle of high-quality extra-virgin olive oil for just $1 at getfreshDRKAHN.com. Registration is now open for Dr. Kahn's lecture on January 29, 2026 at 7:00 PM EST. Sign up HERE.

This week, Dr. Kahn dives into four new research papers on omega-3 fatty acids and their impact on heart and brain health. The discussion highlights several eye-opening findings, including reduced atrial fibrillation risk and improved cardiovascular outcomes in patients undergoing hemodialysis. Dr. Kahn also explains how omega-3 intake supports brain health and why the "right" dose depends on the specific condition being addressed. Food sources, fish oil, algae-based supplements, and ahiflower are compared as practical ways to reach optimal omega-3 levels.  Additional topics in this episode include newly approved AI software for early detection of heart disease, the role of statins in patients with type 2 diabetes, the science—and hype—around NAD+ boosters, and emerging data on Prolon fasting for Crohn's disease. Dr. Kahn also reviews concerning research on heart rhythm risks associated with high-intensity endurance exercise in athletes over the age of 50. As always, the episode blends cutting-edge research with real-world clinical insight to help clarify what actually matters for long-term heart health. Thanks to The Fresh Pressed Olive Oil Club — get a bottle for $1 at getfreshDRKAHN.com.  More About This Episode This episode takes a deeper look at why omega-3 blood levels matter more than simply taking a supplement. Dr. Kahn reviews large population studies linking higher omega-3 levels to lower risks of atrial fibrillation, early-onset dementia, and major cardiovascular events, including in high-risk groups such as patients on hemodialysis. The key takeaway: testing omega-3 status and personalizing intake may be far more effective than a one-size-fits-all approach.  Beyond omega-3s, Dr. Kahn explores several timely and surprising topics, including AI-enhanced CT scan technology designed to detect silent heart disease without additional radiation, real-world data on statin benefits in patients with type 2 diabetes, and why costly NAD+ supplements may ultimately function as a form of vitamin B3. The episode also examines new evidence on fasting-mimicking diets for Crohn's disease and potential heart rhythm risks in high-level endurance athletes over 50. Throughout the discussion, Dr. Kahn emphasizes practical, evidence-based steps patients can review with their physicians, including omega-3 blood testing, coronary calcium scoring, and tailoring lifestyle and supplement strategies to individual risk factors.

This week, Dr. Kahn breaks down the newly released USDA 2025–2030 Dietary Guidelines and the surprising upside-down food pyramid they present. He explains how the final report differs from last year's Advisory Committee recommendations, including changes in committee membership and the influence of advisors with financial ties to the meat and dairy industries. Looking back at the original 1980 dietary guidelines, Dr. Kahn asks an important question: how much has really changed? His takeaway remains refreshingly simple—eat food, mostly plants, not too much. Short topics this week include urinary measurements of protein intake, optimal timing for surgery in dilated aortic roots, the cardiovascular risk of lipoprotein(a), and whether the science behind the Blue Zones truly holds up. You can order a bottle of olive oil for just $1 at getfreshDRKAHN.com. To join the next group ProLon fast, order your kit as soon as possible at prolonlife.com/DRKAHN. If you want it a touch shorter or more punchy for Apple Podcasts specifically, I can trim it another 10–15%.

Dr. Kahn kicks off 2026 by reviewing recent media reports on aspirin use and dosing for the prevention of cardiovascular events in the President of the United States. Much of the coverage overlooks an important factor: the relationship between aspirin dose and body weight. Dr. Kahn examines data from multiple studies suggesting that, in some cases, only higher-dose aspirin was effective in preventing cardiovascular events. As always, listeners are encouraged to discuss aspirin use and dosing with their own medical team. Additional topics this week include the health impact of carryout meals, kidney function and cystatin C, statin use in patients with diabetes, the risks associated with tramadol, cold drink–induced atrial fibrillation, and recent health reports involving Chevy Chase and Jelly Roll. Dr. Kahn also invites listeners to join an upcoming group 5-day PROLON Fasting Mimicking Diet, supported by dietitians and health educators. Order your PROLON kit now at prolonlife.com/drkahn to be ready to participate.

Tim Kaufman's journey is nothing short of remarkable. Diagnosed with Ehlers-Danlos Syndrome—an inherited condition affecting collagen that impacts the heart, joints, and tendons—Tim found himself in a dark place by 2011, struggling with food, alcohol, and painkiller addiction, compounded by morbid obesity. His inspiring recovery through a plant-based diet led him to complete the Lake Placid Ironman in 2024 while sustaining an incredible 200 lb weight loss. Tim shares his transformative story in his book Escape. Learn more about his journey at fatmanrants.com.

This week, Dr. Kahn shares his curated list of the top advances in heart research from 2025. He highlights key insights and perspectives from Drs. Kim Williams and Noel Merz, along with important updates from the American Heart Association. Dr. Kahn also reviews a newly published research paper on the 5-day Fasting Mimicking Diet (PROLON), including the first human evidence showing activation of autophagy. Learn what this could mean for metabolic and cardiovascular health. PROLON is available at prolonlife.com/drkahn. Thanks to tokuhealth.com/KAHN20 and their nattokinase product, Flow, for supporting the show.  Wishing everyone a healthy and happy holiday season and all the best in 2026.