Evidence Library
Every article anchored to clinical trials and the 2026 ACC/AHA guideline. No opinions without data, no recommendations without evidence ratings.
Understanding your numbers
LDL, HDL, triglycerides, non-HDL — what each number means, why total cholesterol is the least useful figure on your panel, and the two markers (ApoB and Lp(a)) that most panels don't include but should.
Read the guide →More Medication Guides
The newest class of triglyceride-lowering drugs, how they work, and who they're actually for.
Read the guide →How ANGPTL3 inhibition lowers LDL-C independent of the LDL receptor — and why that matters for the most severe, treatment-resistant cases.
Read the guide →What the PROMINENT trial actually showed about fibrates, and what it changed about when they should be prescribed.
Read the guide →What the cardiovascular outcomes evidence for GLP-1 receptor agonists actually shows, beyond weight loss and glucose control.
Read the guide →When LDL-C or Lp(a) is so refractory that blood filtration becomes a treatment — how it works and who qualifies.
Read the guide →The cardiovascular and kidney-protective effects of SGLT2 inhibitors that have nothing to do with blood sugar.
Read the guide →Lipoprotein(a)
The genetically inherited risk factor most lipid panels don't include. Structure, genetics, how it drives disease, coronary calcium and CT angiography, emerging Lp(a)-lowering drugs, and a practical framework for what to do with your result.
Read the guide →What diet, exercise and supplements can and can't do to Lp(a) — and why the honest answer disappoints most people who ask.
Read the guide →Advanced Cardiac Diagnostics
How to choose the test that actually answers your question — coronary calcium scoring, CT angiography, high-risk plaque features, coronary inflammation imaging, and a sensible 2026 testing sequence.
Read the guide →What an incidental aortic valve calcium finding on a CT scan means, and when it warrants further cardiology evaluation.
Read the guide →How to reconcile an elevated LDL-C with a reassuring zero calcium score — and what it does and doesn't rule out.
Read the guide →How the AHA PREVENT equations work, what inputs they use, and how to interpret a 10-year versus 30-year risk estimate.
Read the guide →Lipids & Residual Cardiovascular Risk
What can remain after LDL-C is treated. ApoB and non-HDL-C targets by risk category, triglyceride-rich remnant particles, and inflammatory residual risk — and why lowering a number isn't automatically the same as lowering risk.
Read the guide →Why every drug that successfully raised HDL-C failed to reduce cardiovascular events — and what that taught the field about causality.
Read the guide →Whether LDL-P and ApoB actually measure different things, or whether ordering both is redundant.
Read the guide →Risk Factors & Comorbidities
Why diabetes produces more diffuse atherosclerosis, and why glucose is only one part of the risk — ApoB, remnant cholesterol, inflammation, and where GLP-1/SGLT2 therapy fits.
Read the guide →Why cardiovascular risk accelerates around menopause, what changes in the lipid profile, and what that does and doesn't mean for treatment.
Read the guide →How a family history of early heart disease should actually change your risk assessment and testing — and where it fits alongside PREVENT, CAC and Lp(a).
Read the guide →What a urine albumin-to-creatinine ratio actually measures, why it matters for cardiovascular risk beyond the kidneys, and when it should change your prevention plan.
Read the guide →What the evidence actually shows about alcohol and cardiovascular risk in 2026 — and why the "moderate drinking is protective" story doesn't hold up.
Read the guide →How elevated blood pressure directly accelerates plaque formation and instability, independent of cholesterol.
Read the guide →What changed after the FDA removed the blanket statin contraindication, which patients may still need treatment during pregnancy, and why most lipid-lowering drugs are paused for most pregnancies.
Read the guide →Who needs pediatric lipid screening, at what age, and what an abnormal result in a child should trigger.
Read the guide →Why CKD dramatically raises cardiovascular risk beyond what standard risk calculators capture, and how it changes lipid treatment targets.
Read the guide →What walking, cardio volume, and VO₂max actually do to coronary plaque — and how much exercise is enough to matter.
Read the guide →How to recognize inherited extremely high LDL-C, why it needs earlier and more aggressive treatment, and what cascade family screening means for relatives.
Read the guide →Why age changes the risk-benefit calculation for treatment, and what the 2026 guideline says about early intervention versus lifestyle-first.
Read the guide →Whether homocysteine testing actually adds anything to cardiovascular risk assessment, or whether it's a biomarker that outlived its evidence.
Read the guide →Why fatty liver disease and cardiovascular risk are metabolically linked, and what that means for how both should be managed together.
Read the guide →Why visceral fat specifically — not just BMI — drives cardiovascular risk, and how that changes what "successful weight management" should target.
Read the guide →How sleep duration and sleep apnea independently affect cardiovascular risk, and when sleep should be part of a prevention workup.
Read the guide →How smoking and vaping accelerate atherosclerosis through distinct mechanisms, and what the evidence says about vaping as a "safer" alternative.
Read the guide →What changes about the statin risk-benefit calculation in older adults, and how the 2026 guideline approaches treatment decisions past 75.
Read the guide →How hypothyroidism and hyperthyroidism directly change your lipid panel, and why thyroid function should be checked before starting lipid therapy.
Read the guide →Why cardiorespiratory fitness may be one of the strongest predictors of cardiovascular outcomes — and how to actually estimate yours.
Read the guide →Lowering LDL
What lifestyle changes actually accomplish, which supplements have real evidence behind them, and what the 2026 clinical guidelines say about when medication becomes the appropriate next step. Evidence-first, no bias in either direction.
Read the guide →The meta-analysis of 124 randomized trials, the dose-response curve, why timing matters (and is the most commonly missed instruction), and the one contraindication everyone should know before starting.
Read the guide →A blunt, evidence-graded rundown of every supplement commonly marketed for cholesterol and plaque — what has real data and what doesn't.
Read the guide →What the first randomized trial of vitamin K2 on coronary calcium progression actually found.
Read the guide →Diet & lifestyle
The four Portfolio Diet components, what each contributes to LDL reduction, and how the effects add up. The most evidence-supported dietary pattern for cholesterol — explained with clinical trial data and practical meal structure.
Read the guide →What the two landmark Mediterranean diet trials actually showed about cardiovascular outcomes — and how the results differ.
Read the guide →Complete weekly grocery list, 7 days of meals with per-meal fiber and protein stats, a daily Portfolio Diet tracker, and a saturated fat swap guide. Printable. Free.
View the plan →The quiz analyzes your LDL, risk factors, and treatment preferences — and routes you to the evidence-based plan that matches your actual situation.
Take the 2-minute quiz →