Healthy on the Outside: The Silent Risk Dr. Nancy Snyderman Never Saw Coming

10 min readAn unexpected changeNancy L. Snyderman, MD, began her career caring for one patient at a time. After medical school, Nancy became a board-certified surgeon, working at academic medical centers, and she kept running into the same gap: the distance between what doctors knew and what patients actually understood about their own health. Television, she realized, could help close it. “A big part of being a doctor, for me, was putting humanity back into medicine,” she says. So she traded caring for one patient at a time for caring for all Americans.For nearly three decades, Americans welcomed Nancy into their homes through their televisions. As a chief medical correspondent, she covered wide ranging medical topics and traveled the world extensively, reporting from many of the world’s most-troubled areas. Every day, she expertly translated complex medical news into easily digestible—and actionable—information for people across America.“I spent my whole career being the person who talked about health to help others,” she says. “I never thought I’d be the one in need of help.”It didn’t start with a symptom. It started with a friend.Nancy has always been active. Even now, she hikes, travels and keeps up with her young grandchildren. But being active and feeling good doesn’t always mean you’re healthy. No one knows this better than Nancy, who had no symptoms of heart disease before her diagnosis. It started when she was still a national medical correspondent, working on a story on CT angiograms and a then-new test that provided a coronary artery calcium (CAC) score. As part of her report, Nancy had the scan done herself and her score came back at 100. “I thought, ‘Oh my gosh, this is great, I aced this test’,” she says—only to learn that acing it means a score of zero.What is a CAC Scan?A coronary artery calcium (CAC) scan is an imaging test that measures the amount of calcified plaque built up in the heart's arteries.1 It can help doctors and patients understand cardiovascular risk—even before symptoms appear.1At the same time, she was struggling to keep her LDL-C, or low-density lipoprotein cholesterol, often called “bad” cholesterol, in check. High LDL-C is one of the leading risk factors for a heart attack or stroke, but also one of the most modifiable.2 To lower her LDL-C, Nancy had been taking statins—which are a commonly prescribed class of LDL-C lowering medication—for decades. “I knew what to do, and I thought I was doing the right things,” she says. “But I was never able to really get my bad cholesterol to my doctor-recommended level.”What finally changed everything was a conversation. After reconnecting with an old friend, who also happens to be a cardiac nurse, Nancy mentioned her CAC score and stubborn LDL-C. Her friend insisted that Nancy see a new cardiologist. After some additional testing, the results were nothing Nancy ever expected to hear: severe coronary artery disease, with significant blockages in the arteries feeding her heart.What is LDL-C?LDL-C stands for low-density lipoprotein cholesterol—often called “bad” cholesterol. When too much of it builds up in the blood, it can settle into artery walls, narrowing them and raising the risk of a heart attack or stroke over time.2“My diagnosis was a huge wake-up call,” she says. “I thought I was doing the right things, but even I, as a physician, needed an advocate.” She’s quick to point out why that mattered: “A lot of the risks women face with heart disease can be managed,” she adds, “but only if we understand them and speak up for ourselves.”High cholesterol in women needs timely attentionNancy’s experience is far more common than many women realize. Heart disease remains the leading cause of death for women in the United States3—yet only about half (56%) of women recognize it as their number one threat.3 “One of the most dangerous things about heart disease is how quietly it can develop,” says Sirisha Vadali, MD, a board-certified cardiologist in Scottsdale, Arizona. “It can progress silently, even when you feel completely healthy,4 and women in particular may not have the obvious warning signs we’ve all been taught to watch for.”So much of that hidden risk traces back to a single number: LDL-C. When there’s too much of this “bad” cholesterol circulating, it doesn’t just sit in the blood. It works its way into the artery walls and builds up as a sticky plaque, narrowing them and raising the risk of a heart attack or stroke over time.5,6 “It isn’t only how high your LDL-C is today,” Dr. Vadali says. “It’s how high it has been, and for how long. The longer it’s too high, the more cardiovascular risk accumulates.”⁵For Nancy, the lesson was humbling: expertise is not immunity. “You can be the most informed person in the room and still miss a health warning in yourself,” she says. It sometimes takes a push from a loved one to take the necessary action.When lower wasn’t low enoughAfter her diagnosis, Nancy did exactly what she had spent years urging her viewers to do: she partnered with her cardiologist and built a plan. Together, they assessed her individual risk factors and set a clear target for her LDL-C to help lower her cardiovascular risk.Getting there was more challenging than Nancy realized. “Despite standard treatment, diet, and exercise, my LDL-C was still too high, and we needed to lower it to my doctor-recommended LDL-C goal,” she says.That gap—between lower and a guideline-recommended target—is one Dr. Vadali sees constantly. “When it comes to LDL-C, lower is better, but ‘lower’ isn’t the same as reaching the guideline-recommended goal for your unique risk factors,” she says.What are the Guideline-Recommended Goals?The 2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia recommends specific LDL-C goals based on individual risk. For example, below 70 mg/dL for people with diabetes and multiple cardiovascular risk factors, and below 55 mg/dL for those with cardiovascular disease at very high risk.7,*“Knowing your LDL-C number—and talking with your doctor about what’s right for you—is one of the first steps toward understanding your risk level,” Dr. Vadali adds.She’s also quick to retire a persistent myth. “For a lot of people, especially those already at increased cardiovascular risk, diet and exercise alone may not be enough to get LDL-C to the guideline-recommended goal,” Dr. Vadali says. “That’s not a personal failing. It’s biology. Sometimes the body needs additional help, and that’s worth a conversation with your doctor.”For Nancy, that additional help became part of her plan. Working with her cardiologist, she started treatment with REPATHA® (evolocumab) to help lower her LDL-C and reduce her risk of a major cardiovascular event.INDICATIONSWhat is Repatha®?Repatha® is an injectable prescription medicine used:to reduce the risk of major adverse cardiovascular (CV) events, such as death from cardiovascular disease, heart attack, stroke, certain types of chest pain conditions (unstable angina) requiring hospitalization, or certain types of surgery or procedures to restore arterial blood flow to the heart and other parts of the body, in adults at increased risk for these events.Along with diet and exercise to reduce low-density lipoprotein (LDL) or bad cholesterol in adults with high blood cholesterol levels called hypercholesterolemia and in adults with a type of high cholesterol called heterozygous familial hypercholesterolemia (HeFH).Please see additional Important Safety Information below and full Prescribing Information.These days, treatment is a welcome part of Nancy’s routine. “Every two weeks, I give myself an injection and have built a small ritual around it as part of my treatment plan to help keep my LDL-C at the goal my doctor recommended,” she says. “I can take it in the comfort of my own home or on the go† which is a treatment that can fit into my routine.”Nancy is careful to say her path is her own. “I’m sharing my experience as a patient, but everyone’s situation is different,” she says. “What mattered was working with my doctor to figure out what was right for me. That’s what I want for every woman reading this to consider.”Dr. Vadali says REPATHA is a treatment she has consistently recommended for appropriate patients. “I prescribe REPATHA because we know it starts working quickly,” she says. “For high-risk patients, keeping LDL-C lower will help reduce their risk of a life-altering event like a heart attack or stroke.”The question every woman should askIf one thread runs through Nancy’s story, it’s the one so many women will recognize: the tendency to take care of everyone else first. “Women wear a lot of hats, and most of them involve caring for other people,” she says. “We don’t always stop to care for ourselves.”That’s the habit she’s determined to break—in herself, and in the women who’ve heard important health messages from her for years. Her message today isn’t fear; it’s agency. “I want women to proactively understand their cardiovascular risk before something forces them to,” she says. “Ask the question: What’s my risk, and what can I do about it?”Nancy’s ask is simple: Talk to your healthcare provider about your LDL-C and your personal cardiovascular risk factors. Get your LDL-C tested, know your doctor-recommended LDL-C goal and—if needed—make a plan with your doctor to help you reach it.“This is the health story I never expected to tell,” Nancy says. “But if telling it means one more woman picks up the phone and calls her doctor, then it’s the most important one I’ve ever shared.”To learn more, talk to your doctor about your recommended LDL-C goals and whether REPATHA is right for you. You can visit Repatha.com to learn more and to see the full Prescribing Information including the Patient Information.Sponsored by Amgen. Nancy Snyderman is partnering with Amgen to share her personal story. Dr. Vadali has been compensated by Amgen for participation in this project.*≥2 major cardiovascular events (including heart attack or stroke) OR 1 major event + ≥2 high-risk conditions (including diabetes, age ≥65, and smoker).†Make room in the refrigerator (36°F to 46°F) to store Repatha®. Storing Repatha® in its original carton protects the medicine from light. Before injecting Repatha®, you’ll need to take the device out of the refrigerator and let it sit to warm up to room temperature (30 minutes for SureClick® Autoinjector and Prefilled Syringe). Repatha® can also be stored at room temperature at 68°F to 77°F (20°C to 25°C) for up to 30 days. Please see appropriate administration steps, storage, and handling guidance in the Instructions for Use.IMPORTANT SAFETY INFORMATIONDo not use Repatha® if you are allergic to evolocumab or to any of the ingredients in Repatha®. Before you start using Repatha®, tell your healthcare provider about all your medical conditions, including if you are allergic to rubber or latex, are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed. Repatha® is available as prefilled single-dose SureClick® autoinjectors and prefilled single-dose syringes that either contain dry natural rubber (a derivative of latex) in the needle cover or are not made with natural rubber latex. The carton and “Instructions for Use" in the carton will state if your prefilled single-dose SureClick® autoinjector or prefilled single-dose syringe contains dry natural rubber. The pre-filled single-dose pen is not made with natural rubber latex.Tell your healthcare provider or pharmacist about any prescription and over-the-counter medicines, vitamins, or herbal supplements you take.What are the possible side effects of Repatha®? Repatha® can cause serious side effects including serious allergic reactions. Stop taking Repatha® and call your healthcare provider or seek emergency help right away if you have any of these symptoms: trouble breathing or swallowing, raised bumps (hives), rash or itching, swelling of the face, lips, tongue, throat or arms.The most common side effects of Repatha® include: runny nose, sore throat, symptoms of the common cold, flu or flu-like symptoms, back pain, high blood sugar levels (diabetes) and redness, pain, or bruising at the injection site.Tell your healthcare provider if you have any side effects that bother you or that do not go away.These are not all the possible side effects of Repatha®. Ask your healthcare provider or pharmacist for more information. Call your healthcare provider for medical advice about side effects.You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. INDICATIONSWhat is Repatha®?Repatha® is an injectable prescription medicine used:to reduce the risk of major adverse cardiovascular (CV) events, such as death from cardiovascular disease, heart attack, stroke, certain types of chest pain conditions (unstable angina) requiring hospitalization, or certain types of surgery or procedures to restore arterial blood flow to the heart and other parts of the body, in adults at increased risk for these events.Along with diet and exercise to reduce low-density lipoprotein (LDL) or bad cholesterol in adults with high blood cholesterol levels called hypercholesterolemia and in adults with a type of high cholesterol called heterozygous familial hypercholesterolemia (HeFH). Please see full Prescribing Information, including Patient Product Information. References1. Family Heart Foundation. Cardiac CT calcium score: your guide to understanding results & risk. https://familyheart.org/cardiac-ct-calcium-score. Published October 23, 2025. Accessed October 28, 2026.2. Repatha® (evolocumab). What is bad cholesterol (LDL-C)? Amgen. https://www.repatha.com/why-lower-ldl. Accessed October 28, 2026.3. Centers for Disease Control and Prevention. Women and Heart Disease. https://www.cdc.gov/heart-disease/about/women-and-heart-disease.html. Published May 15, 2024. Accessed October 28, 2026.4. Yusuf S, Hawken S, Ôunpuu S, et al; INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937–952. doi:10.1016/S0140-6736(04)17018-95. Domanski MJ, Tian X, Wu CO, et al. Time Course of LDL Cholesterol Exposure and Cardiovascular Disease Event Risk. J Am Coll Cardiol. 2020;76(13):1507–1516. doi:10.1016/j.jacc.2020.07.0596. American Heart Association. My Cholesterol Guide. https://www.heart.org/LDL. Accessed October 28, 2026.7. Blumenthal RS, Morris PB, Gaudino M, et al. 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2026. doi:10.1016/j.jacc.2025.11.016USA-CCF-84687