Dr. Josh Wageman brings a rare blend of expertise to cardiovascular prevention. With credentials spanning physical therapy, biochemistry, and Yale PA training, he's transformed how we understand lipid science through brilliant, accessible metaphors that make complex medical concepts understandable to everyone.
At the heart of our conversation is Josh's innovative framework that reimagines cardiovascular health as a "home security system" and cholesterol management as living in a "safe lipid neighborhood." Rather than overwhelming listeners with biochemical pathways, he translates these concepts into vivid metaphors - LDL particles become mailmen delivering packages, HDL serves as the police force, and lipoprotein(a) represents potential felons threatening arterial walls. This approach fulfills what Josh describes as the true test of understanding: "If you can explain it to somebody who may not be familiar with the topic."
Josh challenges several persistent misconceptions about cholesterol. He explains why LDL isn't inherently "bad" (it's only problematic when depositing cholesterol in arterial walls) and why high HDL doesn't necessarily mean protection. "Just relying on your HDL cholesterol to tell you anything about its functionality is irresponsible," he notes, sharing examples where patients with impressive HDL numbers had extensive coronary disease.
Most powerfully, Josh advocates for shifting cardiovascular care from reactive to preventive approaches. He explains why standard risk calculators miss significant disease and why additional tools like coronary artery calcium scoring can be life-saving. Through a striking example of a physically fit friend whose 10-year risk was calculated at just 2.3%, yet required five-vessel bypass surgery, Josh demonstrates why we need to look beyond traditional metrics.
Beyond technical expertise, Josh emphasizes the human element in medicine: "No one cares how much you know until they know how much you care." His approach reminds us that effective healthcare requires not just knowledge, but the ability to communicate in ways patients understand and trust.
Want to prevent heart attacks, strokes and dementia? Find "The Home Security System in the Lipid Neighborhood" on Amazon and follow Josh on LinkedIn and Twitter for more insights that could save your life.
Amazon: https://www.amazon.com/Security-System-Lipid-Neighborhood-Complicating/dp/B0DTJ1HJ4Y

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