Something that has been on my mind recently is the preventableness of cardiovascular disease. It’s a scientific miracle that we can essentially prevent most cardiovascular disease with lipid lowering drugs, it puts us in a bit of a weird position.
We’re preventing the one single disease of aging that has the possibility of killing you quickly (with a heart attack). Since we have not done much of anything to counteract any of the other diseases of aging (or aging itself) we are essentially condemning everyone to die of much slower diseases that cause drawn-out suffering like cancer and neurodegeneration.
To me, this highlights the importance of treating aging itself as a target, not just a disease at a time. I’m not entirely sure that the place we find ourselves in currently is even an ethical way to practice medicine. We have removed the only “humane” disease of aging and have redirected everyone to the most tragic ones.
ASCVD prevention primarily affects healthspan without extending max lifespan much because of other diseases for most. That’s the non-fatal strokes that puts someone in a retirement home, and there’s maiming heart attacks. There’s vascular dementia and all-cause dementia. We’re talking about of lots of cases of dementia here btw based on some early MR data. Better awareness and treatment in hospitals and after-care presumably decreased mortality. But ASCVD will be a significant bottleneck on max lifespan for most if it’s not prevented in its current forms.
Most cases are actually not from primary aging – it’s from secondary, e.g lipids, bp, t2d, so targeting aging on the prevention side and not reversal might not really change things that much, depending on your definition and what you’re targeting. There are young people with ASCVD from high lipids → quicker high cumulative apoB exposure.
So no, not really IMO, but target diseases of lifestyle and exposures, and aging, and individual diseases, all at the same time.
I agree with you in principle. I had horrible lipids (genetics) that probably would have killed me in my 70s from a heart attack. Since my lipids are now absolutely amazing, I have to assume I will have a later death from something else, most likely due to cancer. Not a great thought.
What’s inhumane is that we can basically prevent the vast majority of heart attacks if we drugged everyone up in their 20s. This is considered “unethical” by the safetyist crowd. They want us to wait until arteries are partially clogged, or even until we’ve had one heart attack already.