In short: no, it’s impossible to give an absolute lifelong guarantee of cardiovascular health — but nature has produced people who come remarkably close to this ideal, Professor Mikhail Koryakin, Doctor of Medical Sciences, told aif.ru.
A lucky few carry what’s known as a “beneficial mutation” in the PCSK9 gene. From birth, their lipid metabolism functions flawlessly: levels of “bad” cholesterol (LDL) remain at 1.5–2.0 mmol/L — similar to the levels seen in people who take potent statins or PCSK9 inhibitors throughout their lives.
Due to the mutation, the PCSK9 protein is barely active, which keeps the receptors responsible for clearing cholesterol from the blood highly active for decades. As a result, these individuals’ risk of heart attack and coronary artery disease is reduced by nearly 90 %. This isn’t a theoretical figure: it’s backed by long‑term observational studies.
Importantly, they don’t suffer the side effects often associated with aggressive cholesterol‑lowering treatments — there’s no increased risk of cancer, infections, or memory problems. The only notable trade‑off is a slightly elevated risk of type 2 diabetes, but this is far outweighed by the massive protection their cardiovascular system enjoys.
This mutation isn’t vanishingly rare: it occurs in about 2–2.5 % of African Americans and 2–3 % of Europeans. It’s a rare but real natural “advantage.” Still, it doesn’t make a person immortal: the brain ages normally, and other risk factors — such as high blood pressure, smoking, or chronic inflammation — still matter. However, their hearts and arteries remain virtually resistant to atherosclerosis.
This discovery directly inspired the development of PCSK9 inhibitor drugs (alirocumab, evolocumab, inclisiran). These medications artificially mimic the same effect. Yet even they can’t offer a lifelong guarantee: they’re typically started later in life, require regular injections, and don’t eliminate other health risks.
So, while 100 % lifelong protection isn’t possible, nature has shown us an almost‑ideal blueprint. Modern medicine can now approach that same level of protection — though not from birth, but through targeted therapy.
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