Encore: Why Normal Cholesterol Doesn't Always Mean Low Heart Disease Risk

Encore: Why Normal Cholesterol Doesn't Always Mean Low Heart Disease Risk

June 29, 2026 · 29 min

About this episode

Dr. Mark Hyman discusses the complexities of heart disease beyond cholesterol, emphasizing the roles of inflammation and metabolic health.

High cholesterol has been treated as the main cause of heart disease for decades. But over the years, I've changed my mind. Today, I believe cholesterol is only part of the story, and that inflammation, insulin resistance, and metabolic health are often the real drivers of cardiovascular disease. In this encore episode, I'm revisiting one of my most talked-about Office Hours conversations to share how my thinking has evolved and why understanding the root cause of heart disease can completely change the way you approach prevention. In today's episode, I discuss: Why cholesterol alone is a poor predictor of heart disease—and the biomarkers I believe matter even more, including ApoB, lipoprotein(a), inflammation, and insulin resistance The surprising role sugar, refined carbohydrates, and metabolic dysfunction play in driving cardiovascular disease Why two people with the same cholesterol can have dramatically different heart disease risk—and how a personalized approach changes the conversation The nutrition, lifestyle, and testing strategies I use to help reduce inflammation, improve metabolic health, and lower cardiovascular risk at its source Heart disease isn't simply a…

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Host: Dr. Mark Hyman

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Mentioned in this episode

Organizations: ApoB, lipoprotein(a), sugar, refined carbohydrates

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