"Высокий холестерин не болит, он просто тихо убивает". Профессор №1 Арутюнов

Key Wellness + Prevention Strategies (Cardiology / Professor Grigory Arutyunov)

1) Understand “biological aging” vs. passport age

• Compare your biological age to your passport age—many people are described as being ~12 years older biologically.
• Use simple indicators as prompts:
  • Pulse
  • Waist circumference
  • Symptoms, for example:
    • cold feet/legs
    • shiny skin
    • hair loss patterns

2) Don’t ignore cholesterol risk—especially because it “doesn’t hurt”

• High cholesterol is framed as silent: it can “quietly kill,” so you need measurement and follow-up rather than waiting for symptoms.
• Cholesterol risk is described as a long-term, cumulative “burden” with potential intergenerational influence:
  • Early-life cholesterol exposure (even through feeding practices) may contribute to later vascular changes.
  • Parents are encouraged to consider diet/weight patterns in children.

3) Use targeted self-checks for cardiovascular risk (simple, practical)

• Pulse
  • Count your pulse for 10 seconds, then multiply by 6.
• Blood pressure
  • Measure it and learn your real numbers.
• Waist circumference
  • Men: ~≤104 cm
  • Women: suggested cutoff varies by population, around ~≤94 cm.
• Watch for “hidden” belly-fat consequences:
  • Abdominal fat may contribute to:
    • increased abdominal pressure
    • constipation via microbiome disruption
    • systemic intoxication
    • kidney compression → higher BP
  • Pericardial/coronary fat may contribute to potential coronary spasm risk.

4) Lifestyle changes that repeatedly come up: “walk + reduce inactivity”

• Physical inactivity is described as dominant—“ate, lay down, sofa.”
• Practical action:
  • Track steps daily.
  • The professor emphasizes many people are far below typical targets (citing a study with an average ~1,800 steps).
• Mechanism mentioned:
  • Muscles act as endocrine organs; movement releases myokines, helping reduce systemic inflammation.

5) Sleep hygiene is a cardiovascular risk factor

• Screen for possible sleep apnea indicators:
  • snoring
  • daytime sleepiness
  • possible breathing pauses during sleep (often noticed by partners)
• Sleep duration guidance discussed from observational data:
  • Optimal ~7 hours
  • <6–7 hours increases risk
  • >7–10–12 hours increases risk again (the curve rises)

6) Reduce high-risk foods: fats, salt, sugary drinks; follow evidence-based diet patterns

Diet principles emphasized:

• Limit fatty foods, especially excess animal fats and fried foods.
• Avoid/limit sweet fizzy drinks (called particularly harmful).
• Avoid excess salt
  • Ideal target stated: ~5 g salt/day (about two teaspoons)
  • Typical intake cited: 12.5–15 g/day in Muscovites (up to ~3× norm)
  • Major sources: industrial/semi-finished foods and preserved meats/sausages.
• Mediterranean diet model:
  • Main fat: cold-pressed olive oil
  • Reduce red fatty meat; prefer poultry/white meat
  • Fruits/vegetables: at least 1 time/day, up to “until 5 times/day” mentioned
  • Desserts: minimize; prefer nuts and fruit, avoid sugary items
  • Alcohol: if at all, small amount with meals (emphasis on dose limits—“more harm than benefit”)

Second diet mentioned:

• DASH diet
  • Strong emphasis on fruit/vegetables and strict salt control.

7) Pharmacology perspective: early risk correction and lipid-lowering targets

• Core principle: early identification + early correction.
• Statins
  • Strongly defended as highly evidence-based for reducing cardiovascular events.
  • Side effects are discussed but framed as rare; if muscle symptoms occur, therapy can be adjusted and alternatives exist.
  • Criticism of claims such as “statins are poison,” especially those promoted online.
• Other lipid-lowering options mentioned:
  • Bempedoic acid (for statin intolerance)
  • Monoclonal antibodies (injections at intervals such as every 14–28 days and about every ~180 days)

8) Statins as “lifelong control,” not occasional breaks

• Lipid control is treated as long-term, since lipid profile drives plaque formation.
• Opposition to:
  • “statin holidays”
  • dose halving/suspension
• Rationale: pausing therapy worsens prognosis by losing target lipid control.

9) Additional risk-factor control beyond cholesterol

• Smoking: described as one of the most powerful risk factors for inflammation and vascular spasm.
• Glucose levels and other cardiometabolic factors are included as part of overall risk—not just cholesterol.

10) Blood pressure guidance: no “working pressure”

• Emphasis:
  • There is no truly safe “working pressure.”
  • If BP is >140, it should be treated with medication (individualized decisions).
• General trend discussed:
  • Modern evidence supports lowering toward ~120–130 if tolerated.
• Exceptions highlighted:
  • severe carotid stenosis (stroke risk if BP lowered too much)
  • very elderly/frail patients (fall + fracture risk)

11) Measure BP correctly (and keep a diary)

Technique and routine:

• Use a rest period (3–4 minutes).
• Sit properly; relax; consider leg position.
• Take averages over readings.
• Key details:
  • Measure on both arms
  • Consider sitting vs. standing (orthostatic changes)
  • Keep a home BP diary and bring it to doctors
  • Watch BP variability across the week

12) Salt + hydration + “thick blood” concept and thrombosis risk

• “Thick blood” is presented as a lay term; clinicians look at hematocrit (blood viscosity context).
• Thrombosis prevention points:
  • Avoid dehydration / maintain fluid intake (especially hot weather and sweating).
• Risk increases with factors like:
  • excess weight
  • pregnancy
  • reduced mobility / long sitting (noted as a smaller contribution)
  • high heels and long flights discussed as smaller contributors
• If clot symptoms occur:
  • one-leg swelling, blue color, dense swelling → seek urgent medical care (possible thrombosis)
  • immediate attention needed for pulmonary embolism risk if severe sudden symptoms appear.

13) Aspirin (“acetylsalicylic acid”)—risk-based, not automatic

• Message:
  • Don’t prescribe aspirin automatically based on age.
  • Consider it only when cardiovascular risk is high, ideally after discussing with a cardiologist.
• Balance:
  • Benefits: reduced thrombosis risk
  • Risks: bleeding and GI irritation

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Presenters / Sources

Presenter / Source

• Grigory Pavlovich Arutyunov
  • Professor, cardiologist
  • Mentioned as head of the Institute of Clinical Medicine of Pirogov University
  • Corresponding member of the Russian Academy of Sciences
  • Doctor of Medical Sciences

Video / Context sources referenced by name

• Framingham Heart Study (“Fremingham” / “Fomingham” mentioned)
• DPP study (Diet/Prevention Program)
• Mars-520 experiment (salt metabolism in a simulated Mars mission)
• Charles Dickens (referenced via Pickwick Papers; “Pickwick” syndrome)
• American Heart Association (AHA) (statin side-effect data referenced)
• Jules Verne (referenced via The Mysterious Island in an aspirin origin story)
• Anichkov and Khalatov (Russian/Soviet figures; cholesterol atherosclerosis theory)
• World Health Organization (WHO) (BP measurement method referenced)
• Korotkov (blood pressure measurement method)
• Revorotchi (mentioned in cuff history)