Welcome back to the trenches! In our final breakdown of the 2026 ACC/AHA lipid guidelines, we are unpacking the pharmacology toolbox. From statins and ezetimibe to PCSK9 inhibitors and the nuances of side effects like SAMS, I want to give you the practical, evidence-informed strategies we need for our patients. We are all just trying to navigate this together.

Stop stressing over every health detail & start living! My FREE 'Necessary Nine' PDF cuts through the noise, giving you the essential things you need for a healthy life.

➡️ Download Here: https://www.jrennickemd.com/necessaryninepdf

CHAPTERS:
00:00 - Intro
00:01:00 - Statin Mechanism of Action
00:01:34 - Types of Statins and Intensities
00:03:04 - Hydrophobic vs Hydrophilic Statins
00:05:15 - Statins and Glycemic Control
00:06:14 - Pleiotropic Effects of Statins
00:07:12 - Statin Side Effects Overview
00:08:36 - Ezetimibe as First-Line Add-On
00:09:54 - Bempedoic Acid
00:11:18 - PCSK9 Inhibitors
00:13:16 - Inclisiran and siRNA Therapy
00:14:26 - Bile Acid Sequestrants
00:15:47 - The Rule of 6 and Combination Therapy
00:17:16 - Statin-Associated Muscle Symptoms
00:19:04 - CoQ10 Supplementation
00:20:07 - Special Populations: Older Adults and Pregnancy
00:21:20 - Liver Safety and Drug Interactions
00:23:15 - Statins, Dementia, and Brain Fog
00:24:23 - Statins and Diabetes Risk
00:25:21 - Managing High Triglycerides
00:27:06 - Conclusion and Summer Sabbatical

SELECTED REFERENCES:

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423

*Disclaimer*
This podcast is for entertainment, education, and informational purposes only.
The topics discussed should not solely be used to diagnose, treat , or prevent any condition.
The information presented here was created with an evidence based approach, but you please keep in mind that science is always changing and at the time of listening to this there may some new data that makes this information incomplete or inaccurate.
Always seek the advice of your personal physician or qualified health care provider for questions regarding any medical condition.

In this episode, I'm breaking down sections 4.2.3 through 4.2.10 of the dense ACC/AHA dyslipidemia guidelines so you don't have to. We'll cut through the noise on the new PREVENT equations, risk enhancers, imaging, and algorithms for primary and secondary prevention. Let's get you equipped to handle these complex lipid management decisions in the clinic.

Stop stressing over every health detail & start living! My FREE 'Necessary Nine' PDF cuts through the noise, giving you the essential things you need for a healthy life.

➡️ Download Here: https://www.jrennickemd.com/necessaryninepdf

CHAPTERS:
00:00 - Intro
00:25 - Individualized Risk-Benefit Discussions
02:24 - The New PREVENT ASCVD Equations Explained
04:29 - Understanding New Risk Thresholds
05:32 - The Math Behind the 3% Treatment Threshold
09:28 - Risk Enhancers and Personalizing Risk
11:21 - Reproductive Age Risk Markers
12:15 - Polygenic Risk Scores
13:12 - Selective Imaging: CAC and Coronary CT
15:16 - Treating Incidental Plaque
15:58 - The Core Primary Prevention Algorithm
19:26 - Severe Hypercholesterolemia (LDL > 190)
21:58 - Diabetes and Lipid Management
23:15 - Residual Risk and Omega-3s
23:37 - Secondary Prevention Targets
26:46 - Special Populations: Children and Young Adults
28:04 - Older Adults and Deprescribing
28:54 - Pregnancy and Lactation
29:55 - HIV, CKD, and Inflammatory Diseases
31:14 - Heart Failure and Cancer Survivors
32:05 - Managing Hypertriglyceridemia 
34:18 - Lipoprotein(a) as a Risk Enhancer

SELECTED REFERENCES:
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423

*Disclaimer*
This podcast is for entertainment, education, and informational purposes only.
The topics discussed should not solely be used to diagnose, treat , or prevent any condition.
The information presented here was created with an evidence based approach, but you please keep in mind that science is always changing and at the time of listening to this there may some new data that makes this information incomplete or inaccurate.
Always seek the advice of your personal physician or qualified health care provider for questions regarding any medical condition.

In this video, we break down the 2026 guidelines for lipid-lowering lifestyle treatments. From the minimalist vs. optimizer diet approach to exercise dosing and managing supplements, let's equip you with actionable tools for the primary care trenches.

Stop stressing over every health detail & start living! My FREE 'Necessary Nine' PDF cuts through the noise, giving you the essential things you need for a healthy life.

➡️ Download Here: https://www.jrennickemd.com/necessaryninepdf

CHAPTERS:
00:00 - Intro
01:36 - The Strategy of Primordial Prevention
02:45 - The Dietary Shift: Minimalist vs. Optimizer
04:56 - Titrating for Elevated Triglycerides
06:23 - Weight Loss and Sick Fat
07:31 - Physical Activity as the 5th Vital Sign
08:27 - The Truth About Dietary Supplements
10:15 - When to Consult a Registered Dietitian
10:48 - The Comprehensive Impact & Takeaways

SELECTED REFERENCES:
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423

*Disclaimer*
This podcast is for entertainment, education, and informational purposes only. The topics discussed should not solely be used to diagnose, treat , or prevent any condition. The information presented here was created with an evidence based approach, but you please keep in mind that science is always changing and at the time of listening to this there may some new data that makes this information incomplete or inaccurate.
Always seek the advice of your personal physician or qualified health care provider for questions regarding any medical condition.

In this video we'll talk about the Evaluation and Diagnosis Section from the 2026 ACC/AHA Lipid Guidelines. 

Stop stressing over every health detail & start living! My FREE 'Necessary Nine' PDF cuts through the noise, giving you the essential things you need for a healthy life.

➡️ Download Here: https://www.jrennickemd.com/necessaryninepdf

CHAPTERS:
00:00 - Intro
00:32 - The Shift in ACC/AHA Guidelines
01:44 - Universal Pediatric Screening
05:47 - Why Non-Fasting Lipid Panels Are Now Standard
07:42 - Changing the LDL Equation
09:48 - Why Advanced Lipid Testing (NMR) is Not Recommended
12:05 - The Rise of ApoB: Counting the Trucks
13:14 - CKM Syndrome and High Discordance
17:28 - Lipoprotein(a): The Once-In-A-Lifetime Test
21:29 - New Monitoring & Follow-Up Goals
23:07 - Rapid Fire Summary

SELECTED REFERENCES:
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423

Disclaimer
This podcast is for entertainment, education, and informational purposes only.
The topics discussed should not solely be used to diagnose, treat , or prevent any condition.
The information presented here was created with an evidence based approach, but you please keep in mind that science is always changing and at the time of listening to this there may some new data that makes this information incomplete or inaccurate.
Always seek the advice of your personal physician or qualified health care provider for questions regarding any medical condition.

As front-line clinicians, we constantly face confusion around exercise advice. Today, we are cutting through the noise with the massive 2026 ACSM Position Stand on resistance training. We unpack the practical, evidence-informed frameworks for strength, hypertrophy, and power, debunk gym myths, and give you the exact 30-second script to confidently prescribe safe, effective exercise to your patients tomorrow morning.

Stop stressing over every health detail & start living! My FREE 'Necessary Nine' PDF cuts through the noise, giving you the essential things you need for a healthy life.

➡️ Download Here: https://www.jrennickemd.com/necessaryninepdf

CHAPTERS:
00:00 - Intro
01:54 - The 2026 ACSM Position Stand Update
04:20 - Strength Training Essentials
06:29 - The Neurologic Spillover Effect
07:51 - Hypertrophy and Cellular Metabolic Stress
10:26 - Clinical Scenario: Lifting with Knee Arthritis
11:46 - Power Training and Fall Prevention
15:19 - Myth 1: Training to Failure
16:55 - Myth 2: Unstable Surfaces and Balance Training
18:59 - Myth 3: Complex Periodization and Spreadsheets
21:49 - Practical Application: Bands and Bodyweight
24:48 - The Cardiovascular Safety of Resistance Training
27:38 - The 30-Second Patient Prescription Script

SELECTED REFERENCES:
https://pubmed.ncbi.nlm.nih.gov/41843416/

Disclaimer
This podcast is for entertainment, education, and informational purposes only.
The topics discussed should not solely be used to diagnose, treat , or prevent any condition.
The information presented here was created with an evidence based approach, but you please keep in mind that science is always changing and at the time of listening to this there may some new data that makes this information incomplete or inaccurate.
Always seek the advice of your personal physician or qualified health care provider for questions regarding any medical condition.

Feeling overwhelmed by the "perfect diet" wars? From carnivore to raw vegan, social media is a chaotic mess of conflicting advice. In this episode, we'll break down the common denominators of healthy eating and why your lifestyle, culture, and personal joy are just as important as your macros.

Stop stressing over every health detail & start living! My FREE 'Necessary Nine' PDF cuts through the noise, giving you the essential things you need for a healthy life.

➡️ Download Here: https://www.jrennickemd.com/necessaryninepdf

CHAPTERS:
00:00 - Intro
00:04 - The Chaos of Online Diet Culture
00:39 - Paralysis by Analysis and the Default Environment
01:11 - Clinical Reality: Confused Patients and Guru Marketing
02:30 - Why Complexity Sells (and Simplicity Doesn't)
03:10 - Is There a Universal "Perfect" Diet?
04:16 - The Common Denominators of Successful Diets
05:57 - Sustainability vs. Intensity: Why Adherence is King
06:50 - The Best Diet for You: Practical Criteria
08:21 - Minimalists vs. Optimizers
09:07 - Final Thoughts: Food as Culture and Connection

*Disclaimer*
This podcast is for entertainment, education, and informational purposes only. The topics discussed should not solely be used to diagnose, treat , or prevent any condition. The information presented here was created with an evidence based approach, but you please keep in mind that science is always changing and at the time of listening to this there may some new data that makes this information incomplete or inaccurate. Always seek the advice of your personal physician or qualified health care provider for questions regarding any medical condition.

The ACC and AHA just dropped a massive 123-page clinical practice guideline on the management of dyslipidemia, fundamentally shifting how we approach cardiovascular risk in primary care. From retiring the pooled cohort equations in favor of the PREVENT calculator to introducing the CPR framework and establishing hard numerical targets for LDL and ApoB, there is a lot to unpack. I went through the entire document so you don't have to.

Stop stressing over every health detail & start living! My FREE 'Necessary Nine' PDF cuts through the noise, giving you the essential things you need for a healthy life.

➡️ Download Here: https://www.jrennickemd.com/necessaryninepdf

CHAPTERS:
00:00 - Intro
01:39 - The Four Main Steps of the Guidelines
02:16 - Retiring the Pooled Cohort Equations
02:28 - The PREVENT Calculator & Risk Thresholds
04:52 - Net Clinical Benefit: NNT vs. NNH
07:46 - The CPR Framework for Personalized Care
09:23 - Moving Beyond LDL to ApoB
11:22 - Understanding Lp(a)
13:52 - Coronary Artery Calcium (CAC) Scores
15:31 - The Return of Hard Treatment Targets
17:44 - The Expanded Lipid-Lowering Toolkit
20:04 - Lifestyle and Diet Recommendations
20:51 - The Primary Care Algorithm

SELECTED REFERENCES:
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001423

*Disclaimer*
This podcast is for entertainment, education, and informational purposes only.
The topics discussed should not solely be used to diagnose, treat , or prevent any condition.
The information presented here was created with an evidence based approach, but you please keep in mind that science is always changing and at the time of listening to this there may some new data that makes this information incomplete or inaccurate.
Always seek the advice of your personal physician or qualified health care provider for questions regarding any medical condition.

Is fruit actually evil? Today, we're taking a step back to look at a viral claim that eating grapes will destroy your brain and cause dementia. As per usual... some nuance is required.

Stop stressing over every health detail & start living! My FREE 'Necessary Nine' PDF cuts through the noise, giving you the essential things you need for a healthy life.

➡️ Download Here: https://www.jrennickemd.com/necessaryninepdf

CHAPTERS:
00:00 - Intro
00:18 - The Viral Claim: Grapes Are the Worst Fruit
01:18 - Breaking Down the Video & Dr. Boz's Background
03:22 - The Problem with Black and White Nutrition
04:54 - Analyzing a 225 Blood Sugar Spike
06:00 - Ketosis, Fasting, and Cotton Candy Grapes
07:02 - Glycemic Index vs. Glycemic Load
07:44 - Understanding Physiological Insulin Resistance
10:09 - Do Blood Sugar Spikes Cause Dementia?
11:09 - The Truth About Tau Proteins
13:51 - The Fructose Survival Hypothesis
15:39 - Why Fruit is NOT Evil
18:43 - The Minimalist vs. Optimizer Approach
19:41 - Outro & Final Thoughts

SELECTED REFERENCES:
https://academic.oup.com/endo/article-abstract/151/7/3105/2456757
https://lpi.oregonstate.edu/mic/food-beverages/glycemic-index-glycemic-load
https://pmc.ncbi.nlm.nih.gov/articles/PMC12018107/
https://pmc.ncbi.nlm.nih.gov/articles/PMC10363705/
https://drrichardjohnson.com/wp-content/uploads/2023/11/Newsweek-Dr-Richard-Johnson-Fructose-and-Weight-Gain-8-14-2023.pdf
https://pmc.ncbi.nlm.nih.gov/articles/PMC3978819/

Disclaimer
This podcast is for entertainment, education, and informational purposes only. The topics discussed should not solely be used to diagnose, treat , or prevent any condition. The information presented here was created with an evidence based approach, but you please keep in mind that science is always changing and at the time of listening to this there may some new data that makes this information incomplete or inaccurate.
Always seek the advice of your personal physician or qualified health care provider for questions regarding any medical condition.

Today, we're diving into a massive topic we see in clinic all the time: managing comorbid depression in patients with chronic illnesses. We'll take a 20,000-foot view of a recent meta-analysis to see how aerobic exercise can be used judiciously as medicine. I'll break down MET minutes, dose-response curves , and why movement is one of our big rocks for mental health.  

Stop stressing over every health detail & start living! My FREE 'Necessary Nine' PDF cuts through the noise, giving you the essential things you need for a healthy life.

➡️ Download Here: https://www.jrennickemd.com/necessaryninepdf

CHAPTERS:

00:00 - Intro
00:11 - The Stakes: Chronic Illness & Depression Risk 

00:48 - What is a MET? Breaking Down the Guidelines 

02:22 - The Systematic Review & Meta-Analysis 

03:49 - Does Aerobic Exercise Work? (Forest Plot) 

05:01 - Understanding Effect Size and Variance 

06:36 - How Much Exercise Do We Need? (Dose-Response) 

07:56 - The Minimally Important Difference (405 MET Minutes)

09:40 - Secondary Outcomes: Adherence & Dropout Rates 

10:34 - How to Implement This in Clinic 

12:04 - The Big Rocks & Main Takeaways 

SELECTED REFERENCES:

https://bjsm.bmj.com/content/60/4/258?rss=1

*Disclaimer*
This podcast is for entertainment, education, and informational purposes only.
The topics discussed should not solely be used to diagnose, treat , or prevent any condition.
The information presented here was created with an evidence based approach, but you please keep in mind that science is always changing and at the time of listening to this there may some new data that makes this information incomplete or inaccurate.
Always seek the advice of your personal physician or qualified health care provider for questions regarding any medical condition.