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Attia believes APOB is an unambiguous causal driver of atherosclerosis and must be treated even in metabolically healthy individuals, using an APOB of 150 as an example to treat down to a goal of 60 in a clean-artery patient.
Attia compares treating high APOB in a patient with pristine arteries to convincing a new smoker to quit before lung damage appears, arguing causality not certainty guides the intervention.
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