Anurag Shrivastava 🏖️

I had a heart attack at 52 with LDL of 110 with no family history. Every doctor told me to lower my LDL further to under 50 Not one of them told me the wall of my artery could be healed. @PeterJAnderson_ one of the most important independent cardiovascular researchers alive, laid out the five ways nitric oxide protects the glycocalyx. The living shield on the inside of every artery. 1. It suppresses NADPH oxidases, the superoxide pathway that all risk factors share (S-nitrosylation of p47phox). 2. It inhibits the enzymes that shed the glycocalyx. 3. It prevents LDL from oxidizing. 4. It blocks AGE formation. 5. It is anti-inflammatory, anti-oxidative, and anti-thrombotic. Here is the finding that should change cardiology forever. Native LDL can only produce superoxide after it passes through a damaged glycocalyx and reaches the endothelial surface. The particle is not the threat. The wall letting it through is. Neamu et al. (University of Illinois, Microscopy and Microanalysis, 2006) proved it with electron microscopy. eNOS knockout mice showed glycocalyx with profound lack of continuity. Patchy. Thin. Full of gaps. Without nitric oxide, the shield falls apart. Ajayi et al. (Anatomy Journal of Africa, 2019) showed nitrate supplementation reversing atherosclerotic arterial thickening while subjects were still eating a high fat high fructose diet. Sugiura et al. (Universitas Airlangga, 2023) showed boosting eNOS function reversing atherosclerotic changes in a smoking model while still smoking. The wall was not just protected. It was repaired. While the risk factor was still present. Nobody told me this was possible. Nobody told me to look at the wall. They just told me to lower my LDL. The wall is rising.