The Lp(a) story continues to be one of the most exciting developments in preventive cardiology, and this week brought fresh pipeline context: • Muvalaplin (Eli Lilly) — oral Lp(a)-lowering agent, Phase 2 data complete, Phase 3 underway at UC Health and other centers • Lepodisiran (诺华/Novartis) — siRNA agent, single injection showing reductions of ~90%+ in Phase 1/2; ACCLAIM-Lp(a) trial active • Olpasiran (安进/Amgen) — siRNA, similar efficacy profile • Pelacarsen (Ionis/AstraZeneca) — ASO agent, earliest in development The HORIZON trial — first dedicated cardiovascular outcomes trial for an Lp(a)-lowering agent — is expected to report before end of 2026. This is the data that will tell us whether lowering Lp(a) actually reduces events the way LDL lowering does. If HORIZON is positive, Lp(a) screening moves from "interesting but untreatable" to "actionable cardiovascular risk factor" — a massive shift in preventive cardiology practice. Source: UCHealth Today, August 4 · [Family Heart Foundation / ACC/AHA 2026 Guideline]

https://calroy.com/education/2026-guide-to-supporting-vascular-health-by-targeting-the-endothelial-glycocalyx/

I met Mason at the Silverback Summit. Mason had excellent questions about management of cardiovascular risk factors. We discussed hormone replacement therapy as well

> Date Time: 2025-12-14 07:31:57 > Instructor: Dr. Deanna Minick ## 📝 Summary On 2025-12-14, Dr. Deanna Minick delivered a comprehensive lecture on circadian biology and its profound effects on endocrine, immune, metabolic systems, aging, women’s health, and practical strategies to optimize light exposure, nutrition, and timing. Emphasizing that time runs biology, she explained how specialized retinal cells, the suprachiasmatic nucleus (10,000–20,000 neurons), and peripheral clocks orchestrate daily rhythms, with peak gene expression oscillations at dawn and dusk. She highlighted personal chronotypes, genetic variants (e.g., MTNR1B), eye color sensitivity, and gut microbiome rhythms. Dr. Minick discussed circadian misalignment causes (shift work, artificial light at night, mistimed eating) and its link to “circadian syndrome,” chronic disease risk, and neurodegenerative processes. She focused on life stages—puberty and menopause—illustrating melatonin’s lifespan decline (about one-third by middle age, ~10% by the 50s) and its interplay with estrogen, cortisol noise, and sleep disruption. Seasonal rhythms affect immune parameters, vitamin D, and melatonin, with spring being a vulnerability period. She presented evidence that ultraviolet light exposure plus vitamin D supplementation improves bone density and muscle strength better than vitamin D alone in postmenopausal women. Practical takeaways included: align light and dark exposure; eat when it’s light; support melatonin and glymphatic clearance at night; consider plant melatonin with lutein and zeaxanthin; protect and nourish the eyes (lutein/zeaxanthin, omega-3 DHA); feed the gut microbiome with 30–50 plants/week and rotated fibers; leverage polyphenol chronobiotics; and time supplements appropriately (melatonin at night, vitamin D in daylight, polyphenols throughout the day). She concluded with actionable strategies to restore rhythm even in challenging environments like Las Vegas with abundant artificial light.

I know not to wear sunglasses when getting morning sunlight but wonder about using readers or even regular prescription glasses.