Not on cholesterol meds? New guidelines may change that
- Thread starter Steve Williams
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Steve, you're putting a lot of words in my mouth and I suggest rereading what I wrote: Prevention, exercise, nutrition and identification of sub populations that would benefit from using drugs when all else fails. But unfortunately I see this as the lazy way out and just encourages the pill popping environment.
You know this isn't unlike Jonathan Haider's argument that anti-depressants are under-utilized eg. If you haven't won the genetic synaptic lottery, then why not take an anti-depressant if it enhances one's ability to function.
And don't take it personally that I think in many ways our medical system has failed. We don't have a health care but a crisis care system. Doctors need to do a better job of practicing what they preach to their patients. That's not to say that we [those in the health care system] can't improve delivery. Indeed, that was the objective of a recent symposium I attended entitled Life Maximization; this was a first attempt to bring together multiple specialties docs, trainers, nutritionists, chiros, etc. to realize the landscape is changing and we need to work together rather than pissing on each other!
My wife, God bless her, has spent far too much time on diagnoseyourelfparanoid.com. She's convinced that statins are devastating my memory (please don't tell her I just wasn't listeing to her...), bringing on dimentia, making me drool...I"m not sure what all they're supposed to do to me, but it's bad. Very bad.
Incredulous, she asked, "Are you afraid that if you stop taking them you're going to have a heart attack?"
Bingo.
I get my bloodwork done regularly and all is well with, I believe, the help of a generic pill, the cost of which is negligible. When I was in the midst of the most rigorous exercise program of my life - lifting, running, biking, meditating - it didn't control my numbers as well.
I don't have a cardiologist; I've never needed one, thanyouverymuch, but my GP tells me I'm doing very well with the statins. What were the side effects again? Not to be the objectivist, but not the side effects worried over on internet discussion forums, but the measured, tested, peer reviewed verified side effects? Because the side effects of long-term elevated choleseral - the measured, tested, peer reviewed and verified side effects - are coronary heart disease.
And I don't think diagnoseyourselfparanoid.com has anything on that. Just sayin'...
Seriously. What are these side effects? Why should I not be taking a pill that keeps my good cholesteral up and my bad cholesteral down? Maybe I missed it, but I haven't seen that in this thread.
Tim
Incredulous, she asked, "Are you afraid that if you stop taking them you're going to have a heart attack?"
Bingo.
I get my bloodwork done regularly and all is well with, I believe, the help of a generic pill, the cost of which is negligible. When I was in the midst of the most rigorous exercise program of my life - lifting, running, biking, meditating - it didn't control my numbers as well.
I don't have a cardiologist; I've never needed one, thanyouverymuch, but my GP tells me I'm doing very well with the statins. What were the side effects again? Not to be the objectivist, but not the side effects worried over on internet discussion forums, but the measured, tested, peer reviewed verified side effects? Because the side effects of long-term elevated choleseral - the measured, tested, peer reviewed and verified side effects - are coronary heart disease.
And I don't think diagnoseyourselfparanoid.com has anything on that. Just sayin'...
Seriously. What are these side effects? Why should I not be taking a pill that keeps my good cholesteral up and my bad cholesteral down? Maybe I missed it, but I haven't seen that in this thread.
Tim
Again having high HDL levels was central to the CHD dogma based upon those individuals genetically endowed with high HDL. But recent clinical trials with drugs that raise HDL (I've posted this elsewhere on WBF) haven't panned out as expected. So is it the quantity or quality of HDL that's important? Next, other drugs in clinical trials have both raised HDL and lowered LDL, thus muddying the water as to which is important.
there are studies showing pre-existing plaque can be reduced via use of statins, diet and exercise. In any event, I am not going to argue the case. Everyone has to make the best decision for themselves. I will trust my cardiologist's advice over a hi-fi critic's any day...
Ummm Christian, hardly JUST an audio reviewer. My PHD degree is actually in Pathobiology. YMMV...
And with changes in our health care system over the last decade or two have made the patients participation in the decision making process important. The key is finding a physician that you feel comfortable with..
The question I would like some here to answer is the following : Is Cholesterol that bad? I am asking the question seriously. I am not a conspiracy theorist but am very aware of the power of lobies and what they can do in the name of profit. health policies are not immune to such. For proof of such he current debate some would say battle about what a nation as wealthy as the USA lack: Health insurance for all its citizen.
I do not have all the answers but there has been some people and serious people at that that have been the dissenting voice about Cholesterol and the present debacle is their voice being heard more and more. Those interested can have a look at this website. Those that are not and/or feel great using statins, should not take removing themselves from the drug lightly it is a life and death issue. I know not enough to recommend anything. I choose the alternative of not using statins and will keep doing it. That is a personal choice that engages only me. it is not one of those audio debate. it is a life and death issue and I believe that people should make their choices based on knowledge.I also believe that the truth is not always a popular or widely accepted notion so i am pointing people toward this as an alternative voice. You will make your own decision on the validity of these people researches and views . Again I decline all responsibility on the matter.
The website is thincs.org
I do not have all the answers but there has been some people and serious people at that that have been the dissenting voice about Cholesterol and the present debacle is their voice being heard more and more. Those interested can have a look at this website. Those that are not and/or feel great using statins, should not take removing themselves from the drug lightly it is a life and death issue. I know not enough to recommend anything. I choose the alternative of not using statins and will keep doing it. That is a personal choice that engages only me. it is not one of those audio debate. it is a life and death issue and I believe that people should make their choices based on knowledge.I also believe that the truth is not always a popular or widely accepted notion so i am pointing people toward this as an alternative voice. You will make your own decision on the validity of these people researches and views . Again I decline all responsibility on the matter.
The website is thincs.org
LDL cholesterol is clearly implicated in plaque formation. Is LDL cholesterol the only thing involved in plaque formation? Definitely not, but without enough of it plaque will not form.
Myles, there are a number of studies showing plaque reversal (on cardiac angiograms) will lowered LDL and (especially) raised HDL cholesterol. Interestingly enough in some of the early studies showing this the cholesterol changes were accomplished primarily with diet and exercise. In some of the more recent ones cholesterol lowering medications have been more prominently involved.
Actually regular aerobic exercise is almost the only thing which has consistently been shown to raise HDL cholesterol, although the quantitative effects vary quite a bit.
In addition to the fact that many of the new recommendations are not evidence based, this is my other big problem with them; the decreased emphasis on the importance of diet, exercise and general life style changes (not profitable, of course
). Treating the patient rather than the disease should involve giving fewer medications, not more. There are far too many people on far too many medications in this country presently
Actually regular aerobic exercise is almost the only thing which has consistently been shown to raise HDL cholesterol, although the quantitative effects vary quite a bit.
In addition to the fact that many of the new recommendations are not evidence based, this is my other big problem with them; the decreased emphasis on the importance of diet, exercise and general life style changes (not profitable, of course
+1
The side-effects occur in only a minority of patients. They are primarily development of Type II diabetes (~10%), reversible elevations of liver enzymes (perhaps 5-10% depending on the specific drug) muscle pain and weakness (similar incidence to liver problems) and memory loss (same). Overall, fewer than 20% of patients started on statins stop taking them for one or more of these reasons.
Just the fact that you have a cardiologist at your age suggests your risk profile (for cardiovascular disease) is quite high.
I went to a cardiologist 2 years ago solely for the reason my Mother had a heart attack that she recovered well from. I wanted a baseline. Carotids clear, LDL 135, HDL 55. I passed my stress test. The calcium chest scan score was zero. While viewing the picture, it was determined I have an aneurism of the ascending aorta and the root. It is larger than it should be and as a result they treated my mild high blood pressure with atenolol and put me on a statin. 1 year later without changing my meat loving diet and still not exercising enough, LDL is 87 and HDL is 56, so that statin really didn't do much for my HDL but sure helped my LDL. I am still working on the better diet exercise regime. The aneurism has reduced by a few mm. Hopefully it will remain stable and I can avoid surgery down the road.
It almost seems to me that we are all saying the same thing but in different ways.
Frantz.... There are indeed some good from fat and cholesterol. However LDL is the bane along with elevated triglycerides. Both of these can and do improve with diet and exercise BUT again you are making comments based on you and your health. You forget those patients who have acquired things genetically. In a case such as those who fail to achieve normal levels then IMO statins are necessary regardless
Thank you. These are well-known. And let me see, on the bloodwork that I had done a couple of months ago, good cholesteral was up, bad was down, liver enzymes were normal as was blood sugar...what were the other two?
Seriously, my memory is fine. Muscle pain? At my age who would know? Pain is what gets me out of bed in the morning. Pain is the great motivator. But I have a rhumatologist, not a cardiologist, for that.
Tim
Statistics
Speaking as a patient who has high cholesterol but none of the other factors i.e high blood pressure, family heart disease, (grandfather lived to 88 with a cholesterol level over 500), it seems to me that we are talking about odds here.
Given the above, one in five patients develop a reaction serious enough to stop the medications. Can anyone tell me how much I am reducing my risk of a MI on statins.
BTW, my personal history is that I have been on max dose statins for years and it only reduced my levels 20%. I will cop to the fact that I do not eat like a rabbit but I cook at home most of the time and rarely sit in front of a large piece of red meat. My side effect was gaining weight on the statins. Have been off for a year, doing a better job watching my diet and hobbling through exercise to try and get my weight down. Will soon see if that has managed to lower my levels. If not I hear there is a new super-drug on the way!!
Speaking as a patient who has high cholesterol but none of the other factors i.e high blood pressure, family heart disease, (grandfather lived to 88 with a cholesterol level over 500), it seems to me that we are talking about odds here.
Given the above, one in five patients develop a reaction serious enough to stop the medications. Can anyone tell me how much I am reducing my risk of a MI on statins.
BTW, my personal history is that I have been on max dose statins for years and it only reduced my levels 20%. I will cop to the fact that I do not eat like a rabbit but I cook at home most of the time and rarely sit in front of a large piece of red meat. My side effect was gaining weight on the statins. Have been off for a year, doing a better job watching my diet and hobbling through exercise to try and get my weight down. Will soon see if that has managed to lower my levels. If not I hear there is a new super-drug on the way!!
There are also a lot of people out there who are just not going to work good, healthy (expensive) diets and regular exercise into their lives. Should they? Sure. But if they're not going to and a pill can help them avoid coronary heart disease, should they develop a deadly illness instead of taking the pill? On a couple of levels, this whole conversation is just silly. This is not an either/or proposition. Statins have probably saved millions of lives. The side effects are easy to test for. Where is the problem? I fyou can control cholesteral with diet and exercise, good for you. Are we just afraid big pharma is going to make money? Lord knows that's not going to happen if I get off statins, huh? And I gotta tell you, while there are, no doubt, people in this country taking meds they don't really need, I categorically disagree with the idea that the proliferation of drug treatment in modern medicine is a bad thing unless you think it's bad to avoid surgery, bad to control the symptoms of chronic conditions, bad to slow the advance of disease, bad to reduce pain, make sick people well and chroically sick people more functional and comfortable.
I've got two medical conditions to manage: I have a tendency toward high cholesteral and I have colitis. I've tried to get off of the statins a couple of times, and my cholesteral levels went up. I went back on the statins. When I got off of the mass quantities of Balsalazide I took for colitis, my state of "semi-remission" (my term, not my doc's) changed not a bit, and I stayed off the Balsalazide.
Pretty simple, really.
Tim
I never said that I did. I do however believe that given a certain set of predisposing conditions in patients of this age, indeed statins should be prescribed.
Personally I would now treat the 33 yo who had the AMI and stent with lipids, diet and exercise and would strongly recommend his 35 yo brother (who BTW is also a doctor)consider his options as well after a full evaluation
Please show me where I ever suggested that? (BTW I guess all medical researchers are MDs?). But as I added, it's important that patients play a role in their medical decisions. Nor does that make up for your snide, condescending remark. FYI Pathobiology is the study of disease. Guess what CHD is?
However, estimates are that if the new guidelines are followed at least half of all adult americans will be taking statins. So you either agree that the new guidelines are not so great or you think half of adult americans should be on statins. Which is it?
As far as the brother of the young gentleman with the AMI, wouldn't you want to know more before making a recommendation? without knowing anything more I agree he could be offered statins, but I'd feel that way about anyone. What his brother's problem was (there are causes for AMI and stenting other than ASCVD) and what his individual risk profile is (BMI, body habitus, blood pressure, smoking and alcohol history and lipid profile at the least) for starters?
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