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Old 01-27-2008, 07:35 PM   #61
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Originally Posted by Buckeye View Post
I thought the discussion of inflammation and its relation to CV disease was the most interesting part of the article and we are not discussing any of that in this thread. It sounded like the ability of statins to reduce inflammation was actually more important than the cholesterol reduction itself and maybe that's why Zetia doesn't work because although it reduces cholesterol, it is not reducing inflammation and therefore not reducing CV disease. Dr. Nissen's (Cleveland Clinic) had some interesting comments.

Does anyone here get their CRP (C-reactive protein) tested to determine the level of systemic inflammation? Is the medical community moving toward using this number on a wider scale to determine risk?

Do we know what is the average cholesterol level of people who have heart attacks and what is the average cholesterol level of people who don't have heart attacks? Is there much difference? Do more people with low good cholesterol have heart attacks than people with high bad cholesterol?

My CRP has been always under .06 nice and low. Cholesterol runs between 179 and 229 depending on the time of the year and what I have been eating during the 6 month prior.

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Old 01-30-2008, 10:30 PM   #62
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Another thing to consider is that studies have shown continual but diminishing improvement with ALL reductions in LDL, not just down to 100mg/dL - it is really not clear what the 'optimal' LDL level should be.

On inflammation:
There have been a couple very small trials (do not draw major conclusions) looking at using statins as a treatment for multiple sclerosis based on the inflammation component. It seems statins have potent immunomodulatory effects - specifically on the ability of certain white blood cells to translocate to the site of inflammation. In MS, thats the brain / spinal cord. It may be that in CV disease a potential mechanism is to prevent the inflammatory immune response in the arterial wall.

Isolated pieces such as these do little to explain the complex picture we're seeing. For further interest, you might consider the CV risk profiles between the French and the Scottish. Both tend to have horrible diets, yet the French have markedly lower incidence of CV events. Google 'French paradox' for more information. Good stuff.

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