My Plaque Protocol, and Why I Started a PCSK9 Inhibitor | Simon Hill, MSc

A few weeks ago I published my own heart scans, and one number travelled further than the rest: a 48% drop in plaque over 16 and a half months. The question underneath that video was the obvious one. How? This episode is the answer, and it is also the part I could easily have left out.

Three companies analysed the same two scans. HeartFlow found a 48% reduction, Cleerly found a 20% increase, and QAngio found essentially no change at all. Same heart, same images, and a sixfold spread in the absolute amount of plaque they measured. I walk through my full protocol, explain which analysis I anchor to and why, and tell you why, despite that headline, I have started a PCSK9 inhibitor.

What We Cover:

Why cumulative ApoB exposure matters more than the cholesterol reading you have today

My nutrition, training, and sleep protocol, and the supplements I deliberately avoided

Why three platforms measuring the same heart came back with 11.5, 60, and 74 cubic millimetres

The published concern about AI overestimation of plaque, and which analysis Dr Matthew Budoff trusts

How my percentile swings 25 points depending on the reference database

Why I started a PCSK9 inhibitor, and how I chose it over a statin

Why you should be sceptical of dramatic short-interval scan results, including mine

All three analyses agreed on the thing that matters: the plaque burden is low, and it is not progressing rapidly. That agreement is worth far more than the headline.

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