EP373: Coffee CACs and Questions

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Coffee, CAC and Questions Podcast Summary Introduction Dr. Warrick Bishop hosts this podcast and videocast station, welcoming listener questions and feedback on health and cardiovascular topics. In this episode, Dr. Bishop addresses questions from listeners about atrial fibrillation treatment options, cholesterol-lowering medications and their metabolic effects, coronary artery calcium scoring, and the cardiovascular effects of coffee consumption. Key Takeaways: Drugs are generally preferred over AV nodal ablation for atrial fibrillation rate control, with ablation reserved as a last resort when medications fail to adequately slow the ventricle. Recent muscle biopsy studies suggest that statin use does not significantly alter coenzyme Q10 levels in muscles, contrary to some previous assumptions about statin side effects. The relationship between statins and vitamin K2 levels remains unclear and requires further research, though Dr. Bishop raised it as a theoretical concern rather than established fact. Bembedoic acid works upstream in the same metabolic pathway as statins, meaning it would have similar potential pleiotropic effects, though these effects are not yet well-studied. Coronary artery calcium scores of 1-10, while still low-risk, represent a three-fold increase in cardiovascular event risk compared to a score of zero, demonstrating that plaque accumulation begins affecting risk even at minimal levels. Coffee consumption shows a J-curve (or U-shaped) relationship with cardiovascular risk, with an optimal sweet spot at approximately three cups per day or 250 milligrams of caffeine. A comprehensive study of over a million participants found that regular coffee consumption is associated with reduced cardiovascular disease risk, supporting multiple previous meta-analyses on this topic. Dr. Bishop encourages listeners to submit questions and topic suggestions via email at [email protected] or through his webpage to help guide future podcast content.