The Silent Damage of Blood Pressure and Cholesterol — And Why Waiting 10 Years Is Too Late

The Silent Damage of Blood Pressure and Cholesterol — And Why Waiting 10 Years Is Too Late

Dr. Jeff Kindred, DO

Most people think of heart disease, stroke, and vascular disease as problems that show up suddenly later in life.

But the truth is far quieter — and far more important.

Conditions like high blood pressure and atherosclerosis don’t usually cause symptoms early. They cause damage slowly, silently, and progressively over decades. By the time someone “feels” something is wrong, the process has often been underway for 20–30 years.

Traditional medicine does a good job at managing disease once it’s obvious.
Medicine 3.0 asks a different question:

What can we do today to change where your health will be 20 or 30 years from now?

Why blood pressure and cholesterol matter long before they cause symptoms

Blood pressure and cholesterol don’t just affect numbers on a chart — they affect the health of your blood vessels.

Over time:

  • Elevated blood pressure damages vessel walls

  • Cholesterol particles penetrate those damaged areas

  • Plaque slowly builds

  • Blood flow becomes compromised

  • Risk accumulates quietly

This process — atherosclerosis — doesn’t announce itself early.
It doesn’t hurt.
It doesn’t slow you down… until it does.

This is why someone can feel “healthy” in their 40s or 50s and still develop significant cardiovascular disease later on.

The limitation of 5–10 year risk models

Most traditional risk calculators estimate 5- or 10-year cardiovascular risk.

That’s helpful — but it misses a critical group of people:

  • Younger or middle-aged adults

  • Active individuals

  • People with “borderline” labs

  • Those with strong family history

Many of these patients show:

  • “Acceptable” cholesterol

  • Mildly elevated blood pressure

  • No symptoms

  • Low short-term risk

But short-term risk does not equal low lifetime risk.

Medicine 3.0 extends the timeline:

  • What happens over 20–30 years?

  • What patterns are already forming?

  • What levers can we pull before disease becomes established?

Why ApoB matters (and may be the most important cholesterol marker)

When most people think of cholesterol, they think of LDL (“bad cholesterol”).

But LDL cholesterol is a measurement of cholesterol content, not the number of particles doing damage.

ApoB (Apolipoprotein B) measures the number of atherogenic particles — the particles that actually penetrate vessel walls and drive plaque formation.

Why this matters:

  • You can have “normal” LDL but high ApoB

  • Risk correlates more closely with particle number, not cholesterol mass

  • ApoB is strongly associated with atherosclerotic risk across decades

In many cases, ApoB gives us a clearer signal earlier — before traditional markers look alarming.

Genetics matter — but they are not destiny

Family history plays a major role in cardiovascular risk.

If heart disease, stroke, or high cholesterol runs in your family, your baseline risk may be higher — even if you’re doing many things right.

But genetics do not mean inevitability.

What Medicine 3.0 focuses on is:

  • Identifying inherited risk early

  • Monitoring the right markers

  • Acting sooner, not later

We have powerful levers:

  • Nutrition and lifestyle strategies

  • Exercise prescriptions

  • Lipid-lowering therapies (when appropriate)

  • Ongoing monitoring and adjustment

The earlier these are applied, the more impact they have.

The danger of “waiting until it’s bad enough”

One of the biggest misconceptions in medicine is:

“Let’s just watch it for now.”

While that can be appropriate in some cases, silent vascular damage doesn’t pause while we wait.

You don’t feel plaque building.
You don’t feel arteries stiffening.
You don’t feel decades of exposure adding up.

Medicine 3.0 isn’t about aggressive treatment for everyone — it’s about informed, timely intervention when the trajectory is heading the wrong way.

How we approach this at Hi, Finch Health

At Hi, Finch Health, we take a long-term, prevention-first approach.

That means:

  • Careful assessment of family history

  • Comprehensive labs (including ApoB when appropriate)

  • Accurate blood pressure measurement and education

  • Tracking trends over time — not just single data points

  • Discussing risk, not fear

  • Using lifestyle strategies and medications when needed

  • Building a plan that fits your life and your goals

This isn’t about chasing perfect numbers.
It’s about protecting your future healthspan.

The big picture

Heart disease remains the leading cause of death — but much of it is preventable when risk is identified early and managed thoughtfully.

The real question isn’t:

“Is this lab abnormal today?”

It’s:

“Where is this heading — and what can we do now to change that?”

That’s the heart of Medicine 3.0 and what we practice here at Hi,Finch Health. If you'd like to learn more about our concierge medicine membership you can click the link below. 

BOOK YOUR INTRODUCTORY CONSULTATION WITH DR. KINDRED HERE

References

  1. Libby, P., Buring, J.E., Badimon, L. et al. Atherosclerosis. Nat Rev Dis Primers 5, 56 (2019).
    https://www.nature.com/articles/s41572-019-0106-z#citeas

  2. Federica Galimberti, et al. Apolipoprotein B compared with low-density lipoprotein cholesterol in the atherosclerotic cardiovascular diseases risk assessment,
    Pharmacological Research, Volume 195, 2023, 106873,
    https://www.sciencedirect.com/science/article/pii/S1043661823002293

  3. Ference BA, et al. Low-density lipoproteins and cardiovascular disease.
    https://pubmed.ncbi.nlm.nih.gov/28444290/

  4. American Heart Association. High Blood Pressure and Heart Disease.
    https://www.heart.org/en/health-topics/high-blood-pressure

  5. Nordestgaard BG, et al. ApoB and atherosclerotic risk.
    https://pubmed.ncbi.nlm.nih.gov/31417638/

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