Do you have evidence of this? I’ve heard the speculation that lipoproteins may have been beneficial in wound healing and fighting viral infections, but I haven’t seen any good evidence of that.
To my knowledge, I’m also not aware of any evidence that people who are aggressively lowering circulating LDL-C have worse wound healing. But I’ll be happy to be corrected. I did ask GPT-5, and it said there’s no evidence, aside from in people who have low lipoprotein levels due to malnutrition or severe systemic diseases, which would obviously massively impact wound healing.
Not really correct, if we’re being picky. The blood vessels form part of the BBB, because the endothelial cells are linked by tight junctions to prevent passage of molecules. They also contain receptors to allow selective transport of molecules between the blood and the brain. However, the whole BBB is formed from a cooperation of endothelial cells, pericytes, glial cells, astrocytes and even neurones - the new word is “neurovascular unit”. The BBB isn’t some wall - it’s a dynamic system which controls what enters and what leaves.
You’re absolutely correct about hypertension being a major risk factor though, and I would assume/hope that anybody taking Rapamycin for health has already covered the absolute basics like controlling their BP.
Is that right? It’s correct that we do build atherosclerotic plaque in multiple arteries. The coronary artery is particularly vulnerable because it is under super high pressure (being basically the first branch off the aorta). Also, I’ve seen some presentations modelling this, and the places where plaque accumulates tend to be where you have branches and the blood needs to change direction, which applies shear forces. You of course can build plaque in other places, such as the carotid, or the middle cerebral artery which supply the brain. However, in brain capillaries (where the BBB is “located”) the flow is low pressure and very slow. I don’t think you’d build plaque or accumulate lipoproteins there.
Nothing. Let’s take a few things as facts:
-
Her current ApoB/Lp(a) level is still enough to build soft plaque. The CTA proves it.
-
You said she already has a great diet and exercises. So we’d assume there’s not much additional room to reduce risk by cutting saturated fat, lowering her BP etc.
The only thing left is lowering her ApoB, from wherever it is now, down to something low enough that she stops building more plaque. Tinkering with an already good diet, or adding supplements isn’t going to make a big difference. The only thing that will significantly move the needle is medication. (I’m aware that you already know this, haha. But some people just need to push to finally start taking the damn pills).
May also be worth her doing a Lp(a) test, just to see whether that might also be involved?
A researcher I know that me that she thinks it’s diffusion. If cholesterols are lower in the blood than in the artery wall, some will leave down the concentration gradient. (Of course some will be trapped, don’t have a diffusion pathway etc)
