Knife Down

Is lower LDL cholesterol actually better for your heart? In this video, I break down the brand-new results from the EZ-Pave study to answer the question that keeps my patients up at night: How low should your cholesterol really go? As a vascular surgeon, I see the end-stage results of heart disease every day. We’ve heard the "lower is better" mantra for decades, but new research is finally providing the hard evidence we need to settle the debate. Study link: https://www.nejm.org/doi/full/10.1056/NEJMoa2600283 We’re looking at how LDL cholesterol levels impact actual cardiovascular events and whether adding medications like ezetimibe truly changes the outcome for your heart health.If you’ve been skeptical about statins or confused by conflicting health trends, this breakdown of the latest science is for you. My mission is to put myself out of business by giving you the truth about prevention before you ever need to see me in the operating room. For educational purposes only. Not medical advice. Always consult your healthcare provider before changing any treatment plan. Sign up for more information on my own practice here: https://corsighthealth.com/High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-startOther tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

I've seen daily aspirin save lives from heart attack — and cause fatal bleeds. As a vascular surgeon, here's my honest take on heart health.The answer isn't yes or no — it depends entirely on who you are.In this video I break down the three groups you need to know:✅ Who SHOULD take daily aspirin — if you've already had a heart attack, stroke, or stent, aspirin for secondary prevention of heart disease is still one of the most evidence-backed interventions we have.❌ Who SHOULD NOT — the 2022 USPSTF guidelines quietly changed the recommendations for primary prevention. If you haven't had a cardiovascular event, daily aspirin may be doing more harm than good.⚠️ The gray zone — two situations where the answer gets complicated: elevated coronary artery calcium (CAC) scores and high Lp(a) (lipoprotein a). Both raise your cardiovascular risk in ways the standard guidelines don't fully account for.This is the conversation your doctor should be having with you — but often doesn't have time for. I'm a vascular surgeon teaching the prevention side of medicine — the part most doctors don't have time to cover. Subscribe for more evidence-based answers on heart disease, metabolic health, and longevity. Sign up for more information on my own practice here: https://corsighthealth.com/High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-startOther tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

We hit all the high points today! Nutrition, exercise, lipids, dental health, hormones, and more. We had amazing participation and it was wonderful to have a chance to interact with everyone in real time. Thanks SO much for taking some of your precious weekend to talk cardiovascular health, heart scans, CAC scores, and all the other nerdy prevention things with me. Hope you enjoyed it! If you want me to do more of these in the future, please say so in the comments!Water filters that remove microplastics:Clearly Filtered Pitcher: https://a.co/d/0e2GGJ1cLifeStraw 18-cup Water Filter Dispenser: https://a.co/d/0a7rPQKMOther Ways To Minimize Plastics and Air Pollutants:Glass Meal Prep Containers: https://amzn.to/4ocEPJ2Air Purifier: https://amzn.to/4puzTQZDental Hygiene Tools I Use:Sonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-startOther tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhApple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwSleep Mask: https://amzn.to/48fSJV5___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

Plaque reversal is one of the most debated topics in preventive cardiology, so in this video I react to Dr. Kevin Ham’s CAST protocol for plaque reversal: Causes, Adding Cures, Strengthening the Body, and Training the Mind and Body.Overall, I think this is a thoughtful framework and I agree with much of it. But as a vascular surgeon who treats advanced atherosclerosis, I also add some nuance around what “plaque reversal” really means, what may be missing from this conversation, and where I’d want more granularity in a real-world cardiovascular prevention plan.We talk about the causes of plaque buildup, metabolic health, lifestyle change, cardiovascular risk reduction, and the difference between improving risk factors versus actually changing plaque biology. I also share where I think protocols like this can be helpful—and where they risk oversimplifying atherosclerosis.If you’re trying to understand plaque reversal, atherosclerosis, heart disease prevention, metabolic health, LDL, ApoB, inflammation, insulin resistance, and cardiovascular risk, this video will help you think more clearly about the problem.Let me know in the comments: Do you think “plaque reversal” is a useful term, or does it create more confusion than clarity?#PlaqueReversal #Atherosclerosis #HeartDisease #CardiovascularHealth #MetabolicHealth #PreventionHigh Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-startOther tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

If you’ve had a positive calcium score (CAC score), you’ve probably asked the obvious next question: when should I repeat it?In this video, I explain why I generally do not order another calcium score if the first one is positive—and what I prefer to use instead to follow atherosclerosis over time.We walk through what a coronary artery calcium score actually measures, why it’s really just the tip of the iceberg, and why a higher repeat score does not necessarily mean your treatment failed. I also explain the difference between calcified plaque and soft, lipid-rich plaque, why that distinction matters for heart attack and stroke risk, and why serial CAC testing often adds less useful information than people think.I also cover: • why calcium scores can be helpful as a one-time risk assessment tool • why I’m more cautious about relying on CAC in younger patients • when I will repeat a calcium score • why I prefer more informative tools like CCTA and CIMT for tracking disease over timeIf you’re trying to understand calcium score progression, plaque stabilization, soft plaque, coronary artery disease, heart disease prevention, stroke prevention, ApoB, Lp(a), statins, and cardiovascular risk, this video is for you.Let me know in the comments: If your first calcium score was positive, would you want to repeat it—or would you rather use a different test to follow your risk?#CalciumScore #CACScore #HeartDiseasePrevention #Atherosclerosis #CardiovascularHealth #CIMT #CCTASign up for more information on my own practice here: https://corsighthealth.com/High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-startOther tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

Joe Rogan got half a million people talking about what's happening inside their blood vessels. As a vascular surgeon, I've spent my career trying to do exactly that. So when a celebrity does it for me, I pay attention (and thank my lucky stars ;).In the clip, Dr. Shauna Swan joins Joe Rogan to discuss the surprising hazards linked to everyday household products. In my reaction, I go through the actual studies behind the microplastics- and forever chemicals-cardiovascular disease conversation: what the data show, where the evidence is genuinely alarming, and where the certainty online is running about three years ahead of the science. Because both things are true.What we cover:— Microplastics found inside arterial plaques — and what that study actually says— PFAS (forever chemicals), phthalates, and other endocrine disruptors— Why association isn't causation and why that matters for your next doctor's appointment— What to actually do with genuine scientific uncertaintyThe signal is real. The panic is premature. You deserve to know the difference.If this video has you wondering whether you already have plaque — that's exactly the right question. Here's where to go next: https://youtu.be/-lt_2swYFhY?si=bRiZyDVY5QAxVvu8📚 Studies referenced:    1. Marfella R, Prattichizzo F, Sardu C, Fulgenzi G, Graciotti L, Spadoni T, et al. Microplastics and Nanoplastics in Atheromas and Cardiovascular Events. N Engl J Med. 2024;390(10):900–10. doi:10.1056/nejmoa2309822   2. Dunder L, Salihovic S, Varotsis G, Lind PM, Elmståhl S, Lind L. Plasma levels of per- and polyfluoroalkyl substances (PFAS) and cardiovascular disease - Results from two independent population-based cohorts and a meta-analysis. Environ Int. 2023 Nov;181:108250. doi: 10.1016/j.envint.2023.108250. PMID: 37832261.Sign up for more information on my own practice here: https://corsighthealth.com/High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-startOther tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #minnesota

SELECT trial explained: does semaglutide reduce cardiovascular risk because of weight loss, or is something else going on? In this video, I break down the SELECT trial and the follow-up analysis examining whether the cardiovascular benefit of semaglutide was directly mediated by weight loss. The answer matters, because the data suggest the reduction in major adverse cardiovascular events was not simply a function of people losing more weight.I’m a board-certified vascular surgeon focused on cardiometabolic prevention, and in this video I walk through what the SELECT trial actually showed, what the subsequent analysis adds, and why this changes how we think about GLP-1 receptor agonists, obesity, heart disease, and prevention. If you’ve been wondering whether semaglutide’s heart protection is just about the number on the scale, this is where we separate mechanism from marketing.In this video, I cover: • The SELECT trial design and main cardiovascular outcomes • How semaglutide affected heart attack, stroke, and cardiovascular death risk • The follow-up mediation analysis on weight loss • Why the cardiovascular benefit does not appear to be explained by weight loss alone • What this may mean for inflammation, metabolism, and vascular protection • How I think about semaglutide clinically in the bigger picture of cardiometabolic healthIf you care about semaglutide, GLP-1 drugs, cardiovascular disease prevention, obesity medicine, insulin resistance, plaque, and the real mechanisms behind cardiometabolic risk reduction, you’re in the right place.Question for you: when you think about semaglutide, do you mainly think “weight loss drug,” or has the cardiovascular data changed your view?Sign up for more information on my own practice here: https://corsighthealth.com/High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-startOther tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #minnesota

When people hear “poor circulation,” they often assume the answer is a procedure. Not so fast. In this episode of Knife Down, Dr. Jacqueline Majors and I talk about when opening a blocked artery helps, when it backfires, and why the real work of saving legs often starts long before the operating room.We get into what patients with poor circulation, blocked leg arteries, leg pain with walking, smoking-related vascular disease, and diabetes actually need to know. We talk about when a procedure helps, when it can make things worse, why not every blockage should be opened, and how lifestyle change, medical therapy, and careful decision-making can sometimes save a limb better than another stent.We also talk about what vascular surgery training gets right and what it misses, how Dr. Majors built a limb salvage-focused private practice, why strength training matters for vascular patients, and how to help people make meaningful changes without shame, perfectionism, or all-or-nothing thinking.Dr. Jacqueline Majors, MD is a board-certified vascular surgeon, Co-Owner, and Director of Limb Salvage at Zenith Vascular & Fibroid Center in Memphis, Tennessee. She is CEO of Vascular Excellence, PLLC, a consulting firm spanning expert witness work and locum tenens. She is also Founder and CEO of AnatomyPad, a patient education and operative planning product. She has performed multiple first-in-state procedures in Tennessee, including absorbable stents, retrievable BTK stents, advanced thrombectomy, and intravascular lithotripsy.Dr. Majors is a two-time Castle Connolly Top Doctor and multiple Top Doctor in Tennessee award recipient. She serves as an industry KOL, speaking nationally on drug-coated balloon therapy, intravascular lithotripsy, carotid disease, and limb salvage. She hosts Center of Excellence courses in Memphis, is the Vice Chair of the Young Physicians Association for the Tennessee Medical Association, and serves on the Board of the Memphis Medical Society.A former Division I athlete and nationally licensed soccer coach, she brings that same discipline to medicine, business, and patient care. Her philosophy: excellence is not an outcome. It is a discipline.Find Dr. Majors here:https://www.instagram.com/zenithmemphis/https://www.linkedin.com/company/zenith-memphis/https://www.facebook.com/zenithmemphisThis episode is for education only and is not personal medical advice. If you have symptoms of poor circulation, a nonhealing wound, rest pain, or concern for blocked arteries, please talk with your own physician.Chapters00:00 Introduction00:18 Why prevention matters in vascular surgery04:07 Nutrition, sleep, stress, and the athlete mindset08:07 Why she chose vascular surgery10:57 Talking to patients about new procedures14:13 What vascular training misses about lifestyle16:43 Nutrition philosophy: from “eat healthy” to low-carb Mediterranean22:38 Patient stories: saving limbs without rushing to procedure27:12 Why not every blocked leg artery should be fixed31:24 Why poor circulation is underrecognized34:35 Building a limb salvage-focused private practice43:24 Social media, physician education, and the modern doctor49:59 How Dr. Majors approaches food, exercise, and habit change57:05 Walking, strength training, and insulin resistance01:01:00 Helping patients who aren’t ready to change01:05:44 Smoking, diabetes, and whether all plaque is the same01:08:05 What medical management vascular surgeons should own01:11:34 How to get screened for poor circulation01:13:53 The top 3 ways to prevent blocked leg arteries01:15:15 Favorite procedures, resources, and AnatomyPad01:19:30 Where to find Dr. Jacqueline MajorsSign up for more information on my own practice here: https://corsighthealth.com/High Quality 3rd-party tested suppl

Are supplements safe? Not automatically. In this video, I explain why supplements are really drugs, why the industry has so little oversight, which products worry me most, and how I think about using supplements more safely in real life.I’m a board-certified vascular surgeon specializing in cardiometabolic prevention, and I do use supplements in practice — but in a targeted, evidence-informed way. Here I walk through the biggest myths about supplements, the real risks people ignore, the categories I side-eye hardest, and the framework I use to help patients choose products that are actually worth taking.If you’ve ever assumed that “natural” means safe, that a big retailer means quality, or that more supplements must mean better health… this one’s for you.Disclosure: Some links in this description may be affiliate links, which means I may earn a small commission at no extra cost to you. I only recommend sources I trust.➡️ Search for NSF sport certification here: https://www.nsfsport.com/certified-products/➡️ Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-startIf this video helped you, please subscribe and share it with somebody whose supplement cabinet is starting to look a little wild.Chapters0:00 Supplements are drugs1:22 What makes a supplement different from a prescription drug4:21 Myth #1: Supplements are more noble than Big Pharma6:24 Myth #2: Over-the-counter means safe9:01 Myth #3: Big retailers mean high quality10:38 Why I still use supplements in practice13:56 The right way to use supplements16:17 Who should not self-prescribe supplements17:23 How I choose safer, better-tested supplements19:17 The highest-risk supplement categories19:57 How to verify a supplement is actually helping21:06 Why I use FullscriptOther tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

• Feeling “healthy” is not a screening test. In this episode, Dr. Ford Brewer ( @DrFordBrewer ) tells the origin story: an ER doc who believed he was doing the right things—until he actually checked and found plaque. That discovery didn’t just change his health plan. It changed his entire job. He walked away from the adrenaline economy of emergency medicine and moved into cardiovascular prevention and teaching, because patching crises is not the same as stopping them. We talk about:• The moment “I’m fine” stopped being believable• Why coronary heart (vessel!) disease continues to go undetected in millions of people• How statins fit into prevention (and why the decision isn’t one-size-fits-all)• Low-carb vs low-fat diets for cardiometabolic health—what Ford has learned over time• Lifestyle vs medication: what actually moves risk in the real world• How Dr. Brewer built a prevention mission and a YouTube channel to teach at scale• What he wants you to understand before you become “a patient”Timestamps:00:00 Knife Down interview debut + double feature with @DrFordBrewer01:00 ER → prevention: the case that changed everything02:30 “Never a teacher… never a bean counter” (then: Johns Hopkins)05:10 Ford’s wake-up call: finding his own plaque07:15 “I walked the walk”: low-fat + endurance era (and why it didn’t protect him)12:16 The CIMT moment: expected a clean slate… found plaque anyway15:40 Metabolic disease hiding in plain sight (the real driver)16:50 A1C misses a lot + “prediabetes but nothing to do” myth22:50 Statins: fear vs intolerance + why he uses low doses (pleiotropic effects)28:40 Plaque vs calcium score: CAC=0 ≠ “no plaque”32:30 “It’s not heart disease — it’s vascular disease”34:10 Nutrition: low-fat history → insulin resistance reality38:10 Hyperinsulinemia: normal glucose, high insulin (why HOMA-IR can miss people)45:00 Visceral fat, DEXA targets, and why “just walking” often isn’t enough57:25 Low-carb vs low-fat + diet spectrum (his rule: if carbs hurt you, reduce them) Follow Dr. Brewer here: @DrFordBrewerDisclaimer: Educational only, not medical advice. #heartdisease #preventivemedicine #cardiovascularhealth #metabolichealthOther tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZSign up for more information on my own practice here: https://corsighthealth.com/___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

Hypertension isn’t a mystery. It’s physics. And it’s quietly remodeling your arteries while you’re out here arguing with your salt shaker.In this reaction to @DrAlexWibberly, I’m mostly nodding along—because he nails the big idea: blood pressure is a mechanical force + a hormonal system problem, not just “too much sodium.” We talk through the three levers that create blood pressure (cardiac output, blood volume, vascular resistance) and why the “salt is the villain” storyline is incomplete for a huge chunk of adults—especially anyone with insulin resistance / metabolic syndrome.Then I add the vascular-surgeon angle: high blood pressure isn’t just a number on a chart. It’s endothelial injury, arterial stiffness, plaque progression, and the reason your brain/kidneys/heart don’t age gracefully. I also get into why processed food is the real trap: it hits you with salt + refined carbs in the same bite, so pressure rises… and then the kidneys stay locked in retention mode.Bottom line: meds work and save lives. But the long game is fixing the system—insulin down, nitric oxide up, whole foods in, ultraprocessed foods out—so your body can regulate pressure the way it was designed to.Watch Dr. Alex’s original video here: https://youtu.be/KwkG5Gh0M6k?si=DL6G_5JnHxbAt8O2 Watch next: https://youtu.be/-lt_2swYFhY?si=yek6DjdRv6HEB5JhNot medical advice. Educational only. Talk with your clinician—especially if you’re already on blood pressure meds (because lifestyle changes can move the needle fast and your doses may need adjusting).Question for you: Have you ever cut salt “religiously” and your BP didn’t budge—until you cleaned up the carbs/processed food? Drop your story below.#bloodpressure #hypertension #insulinresistance #metabolichealth #hearthealth #vascularhealth #nitricoxide #endothelium #kidneyhealth #stroke #cardiovascularhealthSign up for more information on my own practice here: https://corsighthealth.com/Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

In this research report deep dive, I walk through a randomized trial that asked a very specific, very modern question: can high-intensity interval training (HIIT) measurably change coronary atherosclerotic plaque—not just your VO₂ max?We go line-by-line through the paper: who they enrolled, what the HIIT protocol actually was, how they measured plaque (and plaque type), what outcomes moved, what didn’t, and the limitations that matter before you turn “exercise is medicine” into a personality.Also: this is ~40 minutes of dense research nerdery. So if you’re here for quick answers, you took a wrong turn. If you’re here for receipts, welcome.Citation: Vesterbekkmo EK, Aksetøy I-LA, Follestad T, Nilsen HO, Hegbom K, Wisløff U, Wiseth R, Madssen E. High-intensity interval training induces beneficial effects on coronary atheromatous plaques: a randomized trial. European Journal of Preventive Cardiology. 2023;30:384–392. doi:10.1093/eurjpc/zwac309Link: https://academic.oup.com/eurjpc/article/30/5/384/6958432(Not medical advice. Educational only. Don’t watch this and decide to “fix your plaque” by running a marathon tomorrow—talk to your clinician first. I’d like you alive for the follow-up.)Sign up for more information on my own practice here: https://corsighthealth.com/Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

Sign up for more information on my own practice here: https://corsighthealth.com/Wondering what a CIMT (carotid intima-media thickness) exam is actually like? In this quick “what to expect” walkthrough, I show you how the test works, what it feels like, how long it takes, and what the images can tell us about early plaque and cardiovascular risk.Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

A subscriber asked about statins—so I made ChatGPT answer first… and then I fact-checked it as a vascular surgeon. We’re talking cholesterol, LDL, ApoB, plaque growth and plaque rupture, and what “prevention” actually means when the goal is avoiding the first heart attack (or the next one). We’ll cover when statins make sense, when they’re oversold, and why “my numbers are fine” doesn’t always mean your arteries are fine. This is AI in healthcare with a reality check.For my more complete philosophy on the role of lipoproteins in plaque, please watch THIS video: https://youtu.be/ZR1tI0egcmISign up for more information on my own practice here: https://corsighthealth.com/Need labs? Order your own here (affiliate link):https://www.ultalabtests.com/partners/lilyjohnstonmd/Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

In this video, we explore the exciting pipeline of drugs targeting lipoprotein a and its implications for cardiovascular disease prevention. We'll examine how these cholesterol drugs are designed to work, including those utilizing sirna technology, and discuss the reasons for both enthusiasm and caution regarding this medical breakthrough. This discussion aims to clarify the current landscape of new treatments and what questions still need answers.Here’s what I cover:- The strategy for lowering Lp(a): stop production vs block assembly (it’s basically all in the liver)- The late-stage / headline agents and trials:    - Pelacarsen (ASO) — Lp(a)HORIZON    - Olpasiran (siRNA) — OCEAN(a)    - Lepodisiran (siRNA)— ACCLAIM-Lp(a) (enrolling)    - Zerlasiran / SLN360 (siRNA) — development in flux    - Muvalaplin (oral assembly inhibitor)— KRAKEN (phase 2)- Why I’m genuinely hopeful: plasmapheresis is a “proof-of-concept” that lowering Lp(a) *might* reduce events (with important confounders)- Why I’m still skeptical until outcomes data lands: the graveyard of “should-have-worked” drugs (CETP inhibitors, canakinumab—great biomarker/endpoint signals, messy real-world tradeoffs)- My 5-question framework for evaluating any new cardiometabolic drug the moment it hits the market:    1. What problem does it actually solve—and how big is the benefit?    2. How strong/unbiased is the evidence (and do we have outcomes)?    3. Who is the right target (and who wasn’t in the trial)?    4. What are the tradeoffs (side effects, cost, duration, unknowns)?    5. Would I take it? Would I give it to my mom—under what conditions?References:Lp(a) HORIZON Phase 2 - DOI: 10.1056/NEJMoa1905239OCEAN(a) Phase 2: DOI: 10.1056/NEJMoa2211023ALPACA Phase 2: DOI: 10.1056/NEJMoa2415818Zerlasiran Phase 2: doi:10.1001/jama.2024.21957KRAKEN Phase 2: doi:10.1001/jama.2024.24017___________________________Sign up for more information on my own practice here: https://corsighthealth.com/Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZBuy me a coffee: https://buymeacoffee.com/lilyjohnstonmd___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #minnesota

Original video:https://www.youtube.com/watch?v=mJLKTyKy-14&list=WL&index=31We’ve been obsessed with this cholesterol number for decades — but what if we’ve been chasing the wrong thing this whole time?In this video, I’m reacting to Physionic’s powerful “We Were Wrong” episode on cholesterol, where he argues that one widely celebrated marker has never actually been shown to be a therapeutic target in major trials.We break down: • Why we’ve overvalued this marker, despite never having RCTs proving that raising it prevents heart disease • What the guidelines and trials actually say (spoiler: less impressive than we were taught) • The concept of function vs. quantity — and why that’s where the real action is, even if we’re still figuring it outThis is a must‑watch if you’re tired of the same oversimplified cholesterol spiel and want to know what actually matters for cardiovascular risk.Sign up for more information on my own practice here: https://corsighthealth.com/Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  This video is for general education and discussion only and does not establish a doctor‑patient relationship. None of this content should be interpreted as personal medical advice, diagnosis, or treatment recommendations. Always consult your own physician or qualified healthcare provider before making any decisions about your health, medications, or lab values. Guidelines and evidence evolve, and what I say here reflects my understanding at the time, not a substitute for your own clinical judgment (or your doctor’s).#MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

High Lp(a) cholesterol is common—and frustrating—because there’s no single drug that fixes it (yet).In this video, I walk through how I manage elevated lipoprotein(a) today, using the tools we actually have: metabolic health optimization, LDL/ApoB lowering, statins, PCSK9 inhibitors, aspirin (in select patients), and menopausal hormone therapy where appropriate.If you’ve been told your Lp(a) is high and then… nothing else, this video is about what does matter right now—and what doesn’t.This is Part 2 of my Lp(a) series.▶️ Part 1: What Lp(a) is, how to test it, and how to interpret your number▶️ Part 3: The Lp(a) drug pipeline—what’s coming and what we still don’t knowKey Studies:Statins & Lp(a)--Khera AV, et al. Circulation. 2014.Lipoprotein(a) concentrations, rosuvastatin therapy, and residual vascular risk: an analysis from the JUPITER trialPubMed: https://pubmed.ncbi.nlm.nih.gov/24243886/-Berg K, et al. Clin Genet. 1997.Lp(a) lipoprotein level predicts survival and major coronary events in the Scandinavian Simvastatin Survival StudyPubMed: https://pubmed.ncbi.nlm.nih.gov/9520115/-MacDougall DE, Tybjærg-Hansen A, Knowles JW, Stern TP, Hartsuff BK, McGowan MP, Baum SJ, Wilemon KA, Nordestgaard BG. Lipoprotein(a) and recurrent atherosclerotic cardiovascular events: the US Family Heart Database. Eur Heart J. 2025 Nov 21;46(44):4762-4775. doi: 10.1093/eurheartj/ehaf297. PMID: 40331569; PMCID: PMC12634116.PubMed: https://pubmed.ncbi.nlm.nih.gov/40331569/Menopausal Hormone Therapy & Lp(a)--Kim CJ, et al.Effects of hormone therapy on lipoprotein(a) and lipids in postmenopausal women.Atherosclerosis. 2001.https://pubmed.ncbi.nlm.nih.gov/8305420/-Anagnostis P, et al. The effect of hormone replacement therapy and tibolone on lipoprotein(a): a systematic review and meta-analysis.PubMed: https://pubmed.ncbi.nlm.nih.gov/28364865/-Shlipak MG, et al. Estrogen and progestin, lipoprotein(a), and the risk of recurrent coronary heart disease. PubMed: https://pubmed.ncbi.nlm.nih.gov/10770146/--------------------------------------Sign up for more information on my own practice here: https://corsighthealth.com/Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

In this video, I react to a recent post from Dr  @LeonidKimMD   a physician who shares evidence-based nutrition and lifestyle medicine content here on YouTube. His channel focuses on strategies for health, and this video discusses a meal pattern proposed to support cardiovascular health.In this reaction, I walk through: • What claims like “unclogging arteries” usually mean in physiologic terms • Where diet and lifestyle can meaningfully improve vascular health • Where expectations sometimes drift beyond what the data can supportMy goal here isn’t to criticize or sensationalize, but to add clinical context and nuance—especially for viewers trying to translate online health advice into real-world decisions.Link to more information on plant sterols:Dayspring TD. Understanding Sterols. LipidCenter, Inc. Available at: https://www.lipidcenter.com/pdf/Understanding_Sterols.pdf Key quote: “Unesterified sterols, should they get into an arterial wall macrophage or foam cell are more atherogenic than cholesterol (an esterified sterol) as in their unesterified state, they are very prone to oxidative forces.” _______________Sign up for more information on my own practice here: https://corsighthealth.com/Disclaimer: This video is for education only and is not medical advice. Always talk to your clinician about your individual risk and treatment options.Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

Lp(a) Explained: The Genetic Cholesterol Most Doctors Don’t Check (And Why It Matters)You can be fit, lift heavy, eat “clean,” and still have a hidden cardiovascular risk most standard cholesterol tests miss.In this video, I break down lipoprotein(a), or Lp(a) — a genetically determined cholesterol particle that quietly raises the risk of heart attack, stroke, peripheral artery disease, and calcific aortic valve stenosis, even in people who look metabolically healthy.You’ll learn: • What Lp(a) actually is (and why it’s different from LDL) • Why 1 in 5 people have elevated Lp(a) and don’t know it • How to read your own Lp(a) lab result (mg/dL vs nmol/L) • The green / yellow / red risk zones most guidelines now agree on • How much Lp(a) really increases cardiovascular risk (with real numbers) • Who should absolutely get tested — and why this is usually a once-in-a-lifetime lab • Why Lp(a) is linked to early plaque and aortic stenosisWe start with the story of Bob Harper (The Biggest Loser trainer) — lean, athletic, doing everything “right” — who suffered a sudden cardiac arrest caused in part by undiagnosed high Lp(a). His story highlights why this particle matters even when everything else looks fine.This is Part 1 of a series.In Part 2 (dropping next week) we’ll cover: • How metabolic health and fat distribution change Lp(a) risk • Why statins can still be lifesaving even if Lp(a) nudges up • How hormone therapy affects Lp(a) in post-menopausal women • The new Lp(a)-lowering drugs in trials that reduce levels by 80–95%⚠️ Important disclaimer:This video is for education only and is not personal medical advice. Always review results and decisions with your own medical team.👇 Your homework after this video: • Check whether you’ve ever had Lp(a) measured • If you have, see which risk zone you’re in. If you're high, talk to your family and get them screened too! • If you haven’t — and you have family history, plaque, or unexplained risk — ask about it_____________________Want to get your labs checked without going through your doctor's office? Check out the options below where you can order your own tests, including everything we discussed in the video above! Just order your labs, checkout online, then go to a collection center (Ulta uses Quest, Own Your Labs uses LabCorp). If you have limited time or transportation, several companies including Ulta offer MOBILE phlebotomy where the lab comes to you in your home or office! https://www.ultalabtests.com/partners/lilyjohnstonmdhttps://ownyourlabs.com/Sign up for more information on my own practice here: https://corsighthealth.com/Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZBuy me a coffee: https://buymeacoffee.com/lilyjohnstonmd___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResista

Is it possible to fix a blocked artery without major open surgery? In this video, I explain the Detour procedure (Percutaneous Transmural Arterial Bypass)—a new, minimally invasive technique that routes blood flow around blockages to restore circulation. For patients with advanced peripheral artery disease (PAD), this innovation offers a powerful alternative to traditional leg bypass surgery.DETOUR2 trial results: https://www.jvascsurg.org/article/S0741-5214(24)00307-0/fulltextSign up for more information on my own practice here: https://corsighthealth.com/Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZ___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

What Is It Really Like Being On Call as a Surgeon? | Life, Death, Burnout & Decisions at 2AMWhat does being on call as a surgeon actually mean—beyond the pager, the scrubs, and the stereotypes?In this video, a board-certified vascular surgeon pulls back the curtain on life on call: the anxiety, the ethical decisions made at 2 a.m., the mistakes you never forget, and the rules that keep patients safe when you’re exhausted and human.This isn’t a highlight reel. It’s an honest look at surgical call, decision-making under pressure, work-life balance in medicine, and how to build a career that doesn’t hollow you out.Whether you’re a medical student, resident, attending, nurse, or someone curious about how hospitals really work—this one’s for you.⸻⏱️ Chapters / Timestamps0:00 Life or death: what surgery actually demands1:47 Call anxiety & living with uncertainty2:09 The mindset shift that makes call survivable2:40 Why slowing down saves lives (and mistakes)3:32 A case I rushed—and what it cost5:37 “Load the boat”: why asking for help matters7:38 Multidisciplinary care & better outcomes8:38 The hospital survival guide (scrubs, socks, sanity)10:13 Work-life balance in surgery (and why I went part-time)11:51 Residency hours vs real life as an attending13:47 The real cost of mastering surgery15:46 Different career models in medicine (locums, part-time, full-time)17:06 Being tired, being human, and making the right call19:21 Two rules every surgeon should live by20:14 Why your team determines your quality of life22:42 Choosing jobs based on people, not prestige23:53 When it’s time to change your career—or how you do it25:00 Final reflections & advice for future surgeons⸻🔍 Topics Covered • What being on call as a surgeon is really like • Surgical decision-making under fatigue • Mistakes, humility, and ethics in medicine • Burnout, part-time practice, and alternative career models • Team dynamics in hospitals • Advice for medical students and residents • How surgeons think when everything is urgent⸻If you want more honest conversations about medicine, surgery, prevention, and building a career that actually works—subscribe and let me know what you want to see next.Knife down. Take good care.⸻Sign up for more information on my own practice here: https://corsighthealth.com/Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZhttps://buymeacoffee.com/lilyjohnstonmd___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a triple board-certified vascular and general surgeon and obesity medicine physician in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

Cholesterol isn’t the villain you were taught to fear — it’s the fuel. And in this video, I’m breaking down why fuel isn’t the same thing as fire, and why most people are fighting the wrong battle when it comes to heart disease.If you’ve ever stared at your LDL number and wondered, “Is this actually going to kill me?” — this one’s for you.Most people obsess over cutting down a few trees… while ignoring the raging sparks flying everywhere.In this episode, we cover:✔️ Why LDL/ApoB matters — but why it’s only one piece of the risk puzzle✔️ The metabolic “weather conditions” that turn plaque from slow embers into a wildfire✔️ Why early detection (CAC, CIMT, CCTA) is the missing link in prevention✔️ How to think like a surgeon when interpreting risk✔️ And how to stop managing numbers and start managing dangerIf you’re trying to understand your risk — not the average person’s — hit play.Sign up for more information on my own practice here: https://corsighthealth.com/Things I personally use and recommend for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZhttps://buymeacoffee.com/lilyjohnstonmd___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

Dr. Lily Johnston is back to discuss why women are often underdiagnosed and undertreated for heart disease, highlighting often-overlooked risks in standard assessments. She addresses common menopause myths surrounding menopausal hormone therapy (HRT) and its impact on cardiovascular health. This discussion seeks to inform and reassure viewers about the latest research and recommendations for women's health and heart health, including a thorough cardiovascular risk assessment.⸻Find a menopause provider near you: https://www.directory.worldlinkmedical.com/https://portal.menopause.org/NAMS/NAMS/Directory/Menopause-Practitioner.aspxSign up for more information on my own practice here: https://corsighthealth.com/Insurance Based Women's Health Telemedicine, available in 50 states (disclosure: I'm an advisor to this company): https://www.visanahealth.com/Other tools for optimal health (note these are affiliate links):Home BP Cuff: https://amzn.to/49Cq7rhSonicare Toothbrush: https://amzn.to/3KllfMSWaterPik: https://amzn.to/4894Xi8Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5dOura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLSIntake Breathing Nasal Support: https://amzn.to/48dfQQ1Personal Blender: https://amzn.to/4pyNGGlTrue Nutrition Protein: https://oken.do/q2xzqeqwGlass Meal Prep Containers: https://amzn.to/4ocEPJ2Sleep Mask: https://amzn.to/48fSJV5Air Purifier: https://amzn.to/4puzTQZhttps://buymeacoffee.com/lilyjohnstonmd___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

Most women have been taught to fear menopausal hormone therapy.Blood clots. Heart attacks. Strokes.A generation of headlines convinced millions that estrogen was dangerous—even when the science didn’t actually say that.As a vascular surgeon and metabolic health specialist, I spend my days treating the consequences of cardiovascular disease. And I can tell you this: women deserve far better information than they’ve been given.I break down the three biggest myths about menopausal hormone therapy (MHT) and what the evidence actually shows when you look at timing, dose, delivery route, and individual risk factors—not outdated interpretations of the WHI.⸻MYTH #1: “MHT causes blood clots.”We look at: • how oral estrogen impacts clot risk and why transdermal estrogen is different • what matters more than estrogen itself (hint: metabolic health, smoking, and genetics) • who actually needs to be cautiousMost women have never been told that route of delivery is one of the biggest variables in clot risk. That matters.⸻MYTH #2: “MHT causes heart attacks and strokes.”We walk through: • how the WHI initially misled the public • what the re-analyses revealed • the “timing hypothesis” and why starting therapy early mattersThis isn’t about selling hormones.It’s about recognizing when estrogen is harmful, when it’s neutral, and when it’s deeply protective.⸻MYTH #3: “MHT doesn’t impact heart health anyway.”This one might be the most harmful of all.We unpack how estrogen affects: • Vascular aging        • Risk for heart attacks        • All cause mortalityCardiovascular disease is the #1 killer of women. Pretending estrogen is irrelevant is not neutral—it’s dangerous.⸻Who this video is for:-Women in perimenopause or menopause-Women deciding whether MHT is right for them-Clinicians hungry for more nuance-Anyone overwhelmed by conflicting medical adviceI’m not here to push therapy.I’m here to clarify risk, translate the data, and help you make decisions based on evidence—not fear.If you’ve ever felt confused or dismissed when asking about menopause, you’re not alone.You deserve information that respects your intelligence, your autonomy, and your future health.___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

In this video, I break down CAC (coronary artery calcium score), CIMT (carotid intima–media thickness), and CCTA (coronary CT angiography) — the three imaging tests that reveal your real cardiovascular risk. If you’ve ever been told your cholesterol is “fine” or “high” and you still don’t know what that means for you, this is the missing link.Most people think cholesterol numbers (LDL, HDL, triglycerides) can predict heart attacks and strokes. They can’t — not on their own. What actually matters is whether you’re building plaque in your arteries. And the only way to know that is through imaging.What we cover: • What a CAC score really measures and why a calcium score of zero isn't always reassuring • How CIMT ultrasound detects early soft plaque long before calcification • Why CCTA (coronary CT angiography) is the gold-standard for spotting dangerous non-calcified plaque, and why I don't recommend it for everyone • CAC vs CIMT vs CCTA: which test is right for you, and how much they cost • Why some people with “normal cholesterol” still develop plaque • How we currently assess cardiovascular disease risk and why it's not enough • Why detecting disease early saves livesIf you want to understand your true heart attack and stroke risk — not just a lab number — these scans are the roadmap.I’m Dr. Lily Johnston, a vascular surgeon who treats the end stage of this debate every week. My goal is to help you prevent the heart attacks, strokes, and amputations I see in the OR. You deserve clarity, not confusion.Take good care — and if this helped, share it with someone who needs to know their real risk.___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

Most standard lab panels miss the early warning signs of heart disease, metabolic dysfunction, thyroid trouble, and chronic inflammation. In Part 2 of this series, I break down 5 more essential tests every patient should understand before symptoms show up.In this video, we cover:✅ Ferritin — why low or high iron can signal hidden disease✅ ApoB — the most important cholesterol number (and why your doctor may not order it)✅ Thyroid function tests — TSH, Free T4, and Free T3 (critical for energy, metabolism, and mood)✅ STOP-BANG screening — the simplest way to detect sleep apnea, a massive and overlooked risk factor✅ Vascular imaging — CAC, CIMT, and CCTA (the tests that predict heart attack and stroke before they happen)I’ll explain what each test measures, when it’s useful, and how it fits into a bigger strategy for preventing heart disease, metabolic syndrome, and other chronic illness.⚠️ Vascular imaging gets its own deep-dive video next — stay tuned.If you want to stay ahead of heart attack, stroke, diabetes, and premature aging, these labs are worth knowing!___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

What does a vascular surgeon really do?Most people think it’s all about legs. It’s not. Your vascular system reaches every organ — your heart, brain, kidneys, gut...and even lower 🍆... — and when blood flow goes wrong, everything goes wrong with it.In this video, I break down:✅ What vascular surgeons actually treat (PAD, aneurysms, carotid disease, clots, strokes, ulcers, amputations)✅ Why these problems are often preventable✅ The common risk factors: diabetes, smoking, high blood pressure, high cholesterol✅ The overlooked risk factors: inflammation, insulin resistance, hormones, genetics, lifestyle patterns✅ How to lower your risk and protect your arteries long-termIf you want to avoid heart attacks, strokes, amputations, kidney failure — and aging into disability — your arteries are where it starts. Prevention isn’t flashy, but it saves lives, limbs, and independence.As a vascular surgeon turned prevention specialist, I’ll show you how to think about your risk, what tests matter, and how to take control before disease takes control of you. Because it's never a good day if you urgently need my surgical services.___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #PreventiveMedicine #PADPrevention #HeartAttackRisks #stroke #erectiledysfunction #HealthPortfolio #surgeon #vascularsurgery  #California #SanDiego #Arizona #Virginia #Minnesota

My first job felt like cleaning up 20 years of bad decisions that looked like normal life. Metabolic disease doesn't announce itself—it compounds quietly while you're "fine" until your heart gives out or your brain shorts or you lose a limb. I was the last stop, and by then, I was just damage control with a scalpel.It took me 2 years to realize I was fighting downstream from the actual war. So I pivoted to meet people where prevention still matters.⚕️ What you'll learn:The real timeline of metabolic disease (it starts way earlier than diagnosis)How cardiovascular damage compounds silently for decadesWhy "managing" disease isn't the same as preventing itThe moment I realized surgery was the wrong battlefieldWhat actually moves the needle before you're on my tableIf you've been told your numbers are "fine for now" or you're "pre-" anything—this is for you. The window to act is bigger than you think, but it doesn't stay open forever.___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #WomenInMedicine #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota #diabetes

Which blood tests should you get? Most people get “standard labs” every year—but those basic tests often miss the early signs of heart disease, insulin resistance, kidney damage, and metabolic dysfunction.In this video, vascular surgeon and metabolic health specialist Dr. Lily Johnston breaks down the essential lab tests every patient should know—PLUS the advanced labs she orders in her prevention-focused practice to detect problems before they lead to heart attack, stroke, dementia, kidney failure, or amputations.Standard Labs You Already Get:✅ Complete Blood Count (CBC)✅ Basic Metabolic Panel (BMP)✅ Lipid Panel (cholesterol, triglycerides, HDL, LDL)Advanced Labs That Actually Move the Needle:✅ Fasting insulin – early marker of insulin resistance✅ Lipoprotein(a) / Lp(a) – genetic cardiovascular risk✅ hs-CRP – inflammation and plaque formation✅ Homocysteine – B-vitamin metabolism & stroke risk✅ Microalbumin/creatinine ratio – kidney damage from diabetes or hypertension✅ Vitamin D ✅ Uric acid – gout, blood pressure, vascular inflammationIf you haven’t seen your primary care doctor in a while, it’s a great time to get updated labs—and ask about these tests if you’re concerned about metabolic health, family history, or cardiovascular disease. Get empowered with health information to understand your lab results and overall wellness, guided by a medical expert. Want deeper videos on cholesterol testing, metabolic syndrome, fasting insulin, or Lp(a)?Comment below with what you want next and subscribe so you don’t miss future episodes.📍 Like the video (it helps more people see this)📍 Subscribe for real science and real-world prevention📍 Share with someone who needs to understand their metabolic risk___________________________🧬 About Dr. Lily Johnston  Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.  #MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #womeninmedicine #PreventiveMedicine #HealthPortfolio