Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile
Dr Rob 🫀🩺 🇦🇺

@drhungo

Primary Care Physician | Educator | ASCVD, 🫀Failure, Diabetes | Addicted to 🏃‍♂️ 🏏 &🏌🏼‍♂️ Follows Jesus, loves family, tweets≠medical advice @RACGP

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calendar_today30-09-2015 10:00:43

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Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

🛣️ HDL’s Road Trip: How Reverse Cholesterol Transport Works 🫀 RCT starts as HDL extracts cholesterol from arterial foam cells (macrophage & VSMC origins) 🚚 Cholesterol rides HDL → liver via SR-B1 or transfers to VLDL/LDL via CETP 💩 Ends with fecal excretion (bile or TICE

🛣️ HDL’s Road Trip: How Reverse Cholesterol Transport Works

🫀 RCT starts as HDL extracts cholesterol from arterial foam cells (macrophage & VSMC origins)

🚚 Cholesterol rides HDL → liver via SR-B1 or transfers to VLDL/LDL via CETP

💩 Ends with fecal excretion (bile or TICE
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

💊 Statins & T2DM: Risk Real, but Worth the Trade-Off? 📉 JUPITER & meta-analyses confirm: 🩺 Statins slightly ↑ new-onset T2DM (HR ~1.28) in 👥 at risk of diabetes ⚖️ But benefits far outweigh risks: ✅ 39% ↓ in major CV events 📊 NNT: 134 events prevented / 54 new T2DM

💊 Statins & T2DM: Risk Real, but Worth the Trade-Off?

📉 JUPITER & meta-analyses confirm:

🩺 Statins slightly ↑ new-onset T2DM (HR ~1.28) in 👥 at risk of diabetes 

⚖️ But benefits far outweigh risks:

✅ 39% ↓ in major CV events

📊 NNT: 134 events prevented / 54 new T2DM
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

🧠 Statins & Cognition: No Harm, Possible Help? 📚 ASPREE & 20+ studies show: ❌ No link between statins & cognitive decline or dementia 🧓 Statin users had no faster memory loss 🧠 Some data suggest slower decline or blunted memory loss 🧪 RCTs ongoing: STAREE & PREVENTABLE

🧠 Statins & Cognition: No Harm, Possible Help?

📚 ASPREE & 20+ studies show:

❌ No link between statins & cognitive decline or dementia

🧓 Statin users had no faster memory loss

🧠 Some data suggest slower decline or blunted memory loss

🧪 RCTs ongoing: STAREE & PREVENTABLE
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

🧓 LDL-C Still Predicts Risk at 80+: Age ≠ Immunity 📊 Copenhagen General Study (n=91,131): 🔺 LDL-C predicts MI & ASCVD across all ages — incl. 80–100 y/o 💡 NNT to prevent ASCVD over 5 yrs: • Age 80–100: 42 • Age 50–59: 345 📉 Lower LDL = lower risk, even in late life

🧓 LDL-C Still Predicts Risk at 80+: Age ≠ Immunity

📊 Copenhagen General Study (n=91,131):

🔺 LDL-C predicts MI & ASCVD across all ages — incl. 80–100 y/o

💡 NNT to prevent ASCVD over 5 yrs:
• Age 80–100: 42
• Age 50–59: 345

📉 Lower LDL = lower risk, even in late life
Pablo Corral MD (@drpablocorral) 's Twitter Profile Photo

☝️Effect of Lipid-lowering Therapies on Lp(a) Levels: A Comprehensive Meta-analysis of RCTs ☝️New evidence just published in Atherosclerosis ! 👉This comprehensive meta-analysis of 147 RCTs involving over 145,000 participants confirms that most currently available lipid-lowering

☝️Effect of Lipid-lowering Therapies on Lp(a) Levels: A Comprehensive Meta-analysis of RCTs

☝️New evidence just published in <a href="/ATHjournal/">Atherosclerosis</a> !

👉This comprehensive meta-analysis of 147 RCTs involving over 145,000 participants confirms that most currently available lipid-lowering
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

🔥 Atherosclerosis Starts Young: Time to Treat BP Like LDL New EHJ editorial: life-course blood pressure matters as much as cholesterol 🧠🫀 🧒 Even modest BP elevations in youth/adulthood = ↑ plaque later in life ⚠️ Calls for early, sustained prevention — not just midlife

🔥 Atherosclerosis Starts Young: Time to Treat BP Like LDL

New EHJ editorial: life-course blood pressure matters as much as cholesterol 🧠🫀

🧒 Even modest BP elevations in youth/adulthood = ↑ plaque later in life

⚠️ Calls for early, sustained prevention — not just midlife
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

☕️ Coffee O’Clock Could Shape Mortality Risk EHJ study of >170,000 US adults finds ⏰ timing of coffee matters: 🕗 Morning-only coffee = ⬇️ all-cause & CVD mortality ☕️ Afternoon/evening drinkers = ☝️ higher risk 🔍 Supports chrononutrition in CV prevention 🔗

☕️ Coffee O’Clock Could Shape Mortality Risk

EHJ study of &gt;170,000 US adults finds ⏰ timing of coffee matters:

🕗 Morning-only coffee = ⬇️ all-cause &amp; CVD mortality

☕️ Afternoon/evening drinkers = ☝️ higher risk

🔍 Supports chrononutrition in CV prevention

🔗
Ahmed Bennis (@drbennisahmed) 's Twitter Profile Photo

Finerenone Reduces New-Onset Atrial Fibrillation Across the Spectrum of Cardio-Kidney-Metabolic Syndrome: The FINE-HEART Pooled Analysis The nonsteroidal MRA finerenone reduced the risk of new-onset AF/AFL across the CKM spectrum. jacc.org/doi/10.1016/j.…

Finerenone Reduces New-Onset Atrial Fibrillation Across the Spectrum of Cardio-Kidney-Metabolic Syndrome: The FINE-HEART Pooled Analysis

The nonsteroidal MRA finerenone reduced the risk of new-onset AF/AFL across the CKM spectrum.

jacc.org/doi/10.1016/j.…
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

🕰️ Atherosclerosis isn’t random. It’s driven by: • Particle Count → ApoB particles 🧪 • Permeability → Endothelial dysfunction (obesity ⚖️, hypertension 💓, diabetes 🩸, genetics 🧬 ) • Passage of Time → Cumulative exposure ⏳ Plaque builds silently for decades. Know

🕰️ Atherosclerosis isn’t random.

It’s driven by:

• Particle Count → ApoB particles 🧪

• Permeability → Endothelial dysfunction (obesity ⚖️, hypertension 💓, diabetes 🩸, genetics 🧬 )

• Passage of Time → Cumulative exposure ⏳

Plaque builds silently for decades.

Know
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

🎤 GPCE Melbourne 2025 ✅ 6 hrs on Lipids & CV Prevention ✅ 1 hr on Heart Failure ✅ Dinner deep-dive: New ASCVD therapies Don’t miss it! 👉🏼 SPEAKER50EDU to get 50% off your Session Pass. #GPCEMelbourne invt.io/1txbx00qarv #MedTwitter #CardioTwitter #meded #FOAMed

🎤 GPCE Melbourne 2025

✅ 6 hrs on Lipids &amp; CV Prevention
✅ 1 hr on Heart Failure
✅ Dinner deep-dive: New ASCVD therapies

Don’t miss it!

👉🏼 SPEAKER50EDU to get 50% off your Session Pass. 

#GPCEMelbourne  invt.io/1txbx00qarv

#MedTwitter #CardioTwitter #meded #FOAMed
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

INTERHEART showed lipids cause the biggest share of MI risk 🫀(49% PAR). But the Global CV risk consortium finds quitting smoking 🚭 & controlling BP 💊 add the most years of life free of CVD or death. 🔑 Both true: lipids drive plaque, but BP & smoking hit broader diseases &

INTERHEART showed lipids cause the biggest share of MI risk 🫀(49% PAR).

But the Global CV risk consortium finds quitting smoking 🚭 &amp; controlling BP 💊 add the most years of life free of CVD or death.

🔑 Both true: lipids drive plaque, but BP &amp; smoking hit broader diseases &amp;
Alberto Cordero (@acorderofort) 's Twitter Profile Photo

Global Effect of Cardiovascular Risk Factors on Lifetime Estimates NEJM “The absence of 5 classic risk factors at 50 was associated with more than a decade greater life expectancy than the presence of risk factors” nejm.org/doi/full/10.10…

Global Effect of Cardiovascular Risk Factors on Lifetime Estimates
<a href="/NEJM/">NEJM</a> 
“The absence of 5 classic risk factors at 50 was associated with more than a decade greater life expectancy than the presence of risk factors”
 nejm.org/doi/full/10.10…
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

👶➡️🧠 Pregnancy complications predict future stroke risk. 🇸🇪 Swedish study: preeclampsia, gestational hypertension, preterm birth & more link to ⬆️ long-term stroke risk—even after adjusting for shared genetics/environment. 🔦 Pregnancy history = a window into cerebrovascular

👶➡️🧠 Pregnancy complications predict future stroke risk.

🇸🇪 Swedish study: preeclampsia, gestational hypertension, preterm birth &amp; more link to ⬆️ long-term stroke risk—even after adjusting for shared genetics/environment. 

🔦 Pregnancy history = a window into cerebrovascular
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

HDL: More Than Just ‘Good’ Cholesterol? New EHJ editorial revisits reverse cholesterol transport (RCT): 🫀 HDL removes cholesterol from plaques → liver → excretion ⚠️ RCT dysfunction may fuel atherosclerosis despite normal HDL levels 🔬 Future therapies may target HDL

HDL: More Than Just ‘Good’ Cholesterol?

New EHJ editorial revisits reverse cholesterol transport (RCT):

🫀 HDL removes cholesterol from plaques → liver → excretion

⚠️ RCT dysfunction may fuel atherosclerosis despite normal HDL levels

🔬 Future therapies may target HDL
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

🧬 ApoB & Lp(a): the core duo for cardiovascular risk 🔍 Sniderman, Pencina & Thanassoulis argue in @EuroHeartJ that these markers should be routine in risk assessment—beyond LDL alone. Precision prevention starts here. 🔗 doi.org/10.1093/eurhea… #CardioTwitter #MedTwitter

🧬 ApoB &amp; Lp(a): the core duo for cardiovascular risk 🔍

Sniderman, Pencina &amp; Thanassoulis argue in @EuroHeartJ that these markers should be routine in risk assessment—beyond LDL alone.

Precision prevention starts here.

🔗 doi.org/10.1093/eurhea…

#CardioTwitter #MedTwitter
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

📊 Not all apoB particles are created equal! New @EuroHeartJ study shows CAD risk rises with apoB count, but particle type & size matter too 🧬 A more nuanced view of atherogenic lipoproteins could refine risk stratification. 🔗 doi.org/10.1093/eurhea… #CardioTwitter

📊 Not all apoB particles are created equal!

New @EuroHeartJ study shows CAD risk rises with apoB count, but particle type &amp; size matter too 🧬

A more nuanced view of atherogenic lipoproteins could refine risk stratification.

🔗 doi.org/10.1093/eurhea…

#CardioTwitter
Dr Rob 🫀🩺 🇦🇺 (@drhungo) 's Twitter Profile Photo

💓 Heart rate lowering: friend or foe? Slowing heart rate can reduce myocardial oxygen demand—but go too far, and you risk impairing coronary perfusion, worsening heart failure, or increasing mortality in select groups. A double-edged sword: benefit depends on baseline risk,

💓 Heart rate lowering: friend or foe?

Slowing heart rate can reduce myocardial oxygen demand—but go too far, and you risk impairing coronary perfusion, worsening heart failure, or increasing mortality in select groups.

A double-edged sword: benefit depends on baseline risk,
Pablo Corral MD (@drpablocorral) 's Twitter Profile Photo

👉  New Evidence: Lifetime Risk Starts Early 👆 A 22-year follow-up of young adults from the CARDIA study shows that cumulative exposure to apoB, LDL-P, and TRL-P between ages 18–40 significantly increases the risk of ASCVD events later in life. 📈 Each 1 SD increase in these

👉  New Evidence: Lifetime Risk Starts Early 

👆 A 22-year follow-up of young adults from the CARDIA study shows that cumulative exposure to apoB, LDL-P, and TRL-P between ages 18–40 significantly increases the risk of ASCVD events later in life.

📈 Each 1 SD increase in these
Pablo Corral MD (@drpablocorral) 's Twitter Profile Photo

🎯 Precision Lipidology Enters the RNA Era Small interfering RNAs (siRNAs) and antisense oligonucleotides (ASOs) are reshaping lipid management by targeting mRNA degradation at the source. 👉Inclisiran targets PCSK9 → ↓LDL-C 👉Volanesorsen, Olezarsen, Plozasiran target