You can crush workouts, hit great HRV numbers, and still have arteries aging faster than you are. That’s the uncomfortable gap we dig into with Dr. Craig Backs, a 40+ year physician who calls himself a “recovering allopath” and now focuses on proactive cardiometabolic care. We talk about why atherosclerosis is an inflammatory process in the artery wall, how plaque rupture can turn a “fine” day into an ambulance ride, and why better measurement beats reassurance based on the usual checkup script. 

We also get into the hidden drivers most people never think to test. Dr. Backs explains how carotid ultrasound can reveal plaque and estimate arterial age, why “normal” lab ranges can still be suboptimal for longevity, and why insulin resistance and chronic inflammation deserve more attention than a single cholesterol number. One of the most surprising threads is the dentistry connection: gum disease, infected root canals, and oral bacteria can contribute to systemic inflammation that raises cardiovascular risk, which is why he collaborates with progressive dentists and remote “scanners.” 

From there, we make it practical. Dr. Backs shares his “badasses” checklist, why resistance training is often the missing exercise lever, and how to avoid getting distracted by expensive “entertainment medicine” when simple habits could move the needle faster. If you care about heart health, stroke prevention, dementia risk, metabolic health, and extending healthspan, this conversation gives you a clearer map and a stronger reason to act. 

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