I've seen daily aspirin save lives from heart attack — and cause fatal bleeds. As a vascular surgeon, here's my honest take on heart health.

The answer isn't yes or no — it depends entirely on who you are.

In this video I break down the three groups you need to know:

✅ Who SHOULD take daily aspirin — if you've already had a heart attack, stroke, or stent, aspirin for secondary prevention of heart disease is still one of the most evidence-backed interventions we have.

❌ Who SHOULD NOT — the 2022 USPSTF guidelines quietly changed the recommendations for primary prevention. If you haven't had a cardiovascular event, daily aspirin may be doing more harm than good.

⚠️ The gray zone — two situations where the answer gets complicated: elevated coronary artery calcium (CAC) scores and high Lp(a) (lipoprotein a). Both raise your cardiovascular risk in ways the standard guidelines don't fully account for.

This is the conversation your doctor should be having with you — but often doesn't have time for.

I'm a vascular surgeon teaching the prevention side of medicine — the part most doctors don't have time to cover. Subscribe for more evidence-based answers on heart disease, metabolic health, and longevity.

Sign up for more information on my own practice here: https://corsighthealth.com/

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___________________________
🧬 About Dr. Lily Johnston

Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

#MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota

We hit all the high points today! Nutrition, exercise, lipids, dental health, hormones, and more. We had amazing participation and it was wonderful to have a chance to interact with everyone in real time. Thanks SO much for taking some of your precious weekend to talk cardiovascular health, heart scans, CAC scores, and all the other nerdy prevention things with me. Hope you enjoyed it! If you want me to do more of these in the future, please say so in the comments!

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Home BP Cuff: https://amzn.to/49Cq7rh
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___________________________
🧬 About Dr. Lily Johnston

Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

Plaque reversal is one of the most debated topics in preventive cardiology, so in this video I react to Dr. Kevin Ham’s CAST protocol for plaque reversal: Causes, Adding Cures, Strengthening the Body, and Training the Mind and Body.

Overall, I think this is a thoughtful framework and I agree with much of it. But as a vascular surgeon who treats advanced atherosclerosis, I also add some nuance around what “plaque reversal” really means, what may be missing from this conversation, and where I’d want more granularity in a real-world cardiovascular prevention plan.

We talk about the causes of plaque buildup, metabolic health, lifestyle change, cardiovascular risk reduction, and the difference between improving risk factors versus actually changing plaque biology. I also share where I think protocols like this can be helpful—and where they risk oversimplifying atherosclerosis.

If you’re trying to understand plaque reversal, atherosclerosis, heart disease prevention, metabolic health, LDL, ApoB, inflammation, insulin resistance, and cardiovascular risk, this video will help you think more clearly about the problem.

Let me know in the comments: Do you think “plaque reversal” is a useful term, or does it create more confusion than clarity?

#PlaqueReversal #Atherosclerosis #HeartDisease #CardiovascularHealth #MetabolicHealth #Prevention

High Quality 3rd-party tested supplements at Fullscript (10% discount): https://us.fullscript.com/welcome/ljohnstonmd/store-start

Other tools for optimal health (note these are affiliate links):
Home BP Cuff: https://amzn.to/49Cq7rh
Sonicare Toothbrush: https://amzn.to/3KllfMS
WaterPik: https://amzn.to/4894Xi8
Apple Watch with sleep & HR monitoring: https://amzn.to/3XaUn5d
Oura Ring with sleep, cycle, and recovery monitoring: https://amzn.to/4riyhLS
Intake Breathing Nasal Support: https://amzn.to/48dfQQ1
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Glass Meal Prep Containers: https://amzn.to/4ocEPJ2
Sleep Mask: https://amzn.to/48fSJV5
Air Purifier: https://amzn.to/4puzTQZ

___________________________
🧬 About Dr. Lily Johnston

Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.