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Old 03-15-2019, 05:07 PM   #121
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Originally Posted by Chuckanut View Post
I used a different calculator to see how my lipid ratios worked out:

Cholesterol HDL/LDL/Triglycerides Ratios Calculator

Before statin usage


After one month on 20mg of Atorvastatin


Before After
Total C 267 high risk 179 desirable
LDL 169 high risk 91 optimal
HDL 73 optimal 71 optimal
Trigs 75 normal 65 normal
Chol/HDL good ideal
HDL/LDL ideal ideal
Trigs/HDL ideal ideal

Other than total cholesterol and LDL my numbers are pretty good.
However, a month on Avrostatin makes them all good or great.

This is my interpretation of what is, I believe, a confusing issue. LDL is still key to lowering overall CVD risk, though good ratios are certainly protective even with high LDL. It's not simple, and I don't think the medical profession knows for certain how to evaluate all of this.

I can't tell others what do to. But, for me, a low-dose of the statin eliminates my only two risk factors, and so far I don't seem to be suffering any bad effects. But, I will be watching. Hopefully, medical science will come up with better guidelines in the near future.
Best calculator!! The ratios are what matter, not the actual numbers. My ratios came out ideal, even though cholesterol slightly high and trigs high
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Old 03-15-2019, 05:34 PM   #122
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Originally Posted by PatrickA5 View Post
What if the four people you know didn't have any side effects? Would you still try to convince them to quit?

Some people have serious side effects and should talk to their doctor about alternatives. Millions of others tolerate the drug just fine. The fact that you have "no patience" for these types of people seems kind of odd to me. Or, maybe I'm misreading what you're trying to say?
None of my friends/family had side effects before I advised them to quit. They were all on statins for primary prevention, where the risk/reward ratio is poor. I learned later that 2 quit due to muscle pain. DM had muscle pain on 2 statins. Not sure how many DBiL tried before giving up on statins.

So, yes I would advise them to quit despite no visible side effects. The full explanation involves statin effects on CoQ10 production, but that's a red pill topic.
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Old 03-15-2019, 05:48 PM   #123
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What if the four people you know didn't have any side effects? Would you still try to convince them to quit?

Some people have serious side effects and should talk to their doctor about alternatives. Millions of others tolerate the drug just fine. The fact that you have "no patience" for these types of people seems kind of odd to me. Or, maybe I'm misreading what you're trying to say?

I'm not going to try and convince anybody to go against their doctors suggestions. Everybody should do their own research and talk to their Doctor if they have questions or concerns.

i would strongly suggest , research and careful thought when using these , there might be a better alternative for you .

especially when this is used long term
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Old 03-16-2019, 08:19 AM   #124
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If your HDL is high enough, 60, maybe 70, you're pretty close to bullet-proof & your LDL doesn't much matter. Very very low density is worse also than run of the mill LDL.



If the pharma industry doesn't fund studies, who will?


The data doesn’t support that.

But my guess is that realistically, it might not be a bad idea, if one tolerates them as the vast majority of users do.

Cholesterol numbers are nice as a guide, but statins probably are working independent of the effect upon LDL levels. They seem to stabilize plaque... and if you’re 60, I can almost guarantee you have coronary plaque.
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Old 03-16-2019, 08:26 AM   #125
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Did you read the study? They didn't include patients prescribed statins. But just for grins let's say they did that wrong and 100% of the control subjects were on statins. Factoring in the benefits of statins, the calculator overstated the risk by 3x (Yes, that's right - 3x).



Other factors do play a role, but you'll have to explain how those other factors account for a .67x reduction in risk. That's a lot better than the 0.3x reduction in risk you get from statins. We need to explore those other factors.



We also need to factor in that somewhere between 30 and 60% of patients discontinue their statins, and "as many as 20%" complain of side effects. https://www.latimes.com/science/scie...724-story.html Apparently these "well tolerated agents" are not so well tolerated.



I personally know 4 people on statins, and I was unable to convince any of them to discontinue them. If you think it's easy to get someone to go against doctor's orders, you should give it a try. Now 2 of those people have discontinued the drugs due to muscle pain. Another complains of pain, but he won't go against the doctor's orders.



The benefit of statins depends entirely on your heart disease risk. If your risk is 30%, then statins lower your risk 10%. That's pretty good, even if there is (for example) a 10% risk of side effects. But if your risk is 3%, then statins lower your risk only 1%. That's not a very good tradeoff against 10% side effect rate. This is why it's so important to know your real risk and the real side effect rate.



The risk calculators don't take into account hsCRP or triglycerides, both of which are important risk factors. They don't take into account exercise or diet, which are also important, even though the evidence is mostly epidemiological.


You didn’t understand my point.

The risk calculators are off because they are based upon population risk of patients who were not getting the optimal care we enjoy today, especially statin use.

If you don’t understand the simple basics of epidemiology, you really shouldn’t be putting people’s health at risk trying to convince them they shouldn’t be taking the medicine that they have been prescribed.

Google is not a substitute for a medical degree.
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Old 03-16-2019, 08:32 AM   #126
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You didn’t understand my point.

The risk calculators are off because they are based upon population risk of patients who were not getting the optimal care we enjoy today, especially statin use.

If you don’t understand the simple basics of epidemiology, you really shouldn’t be putting people’s health at risk trying to convince them they shouldn’t be taking the medicine that they have been prescribed.

Google is not a substitute for a medical degree.
Medical Schools do not teach nutrition effectively. Google does provide in depth articles from many legitimate sources regarding health issues. I am not an MD, but most of my docs over the years rarely addressed nutrition in my health and well being. Although, all of my docs over the years had a prescription pad on their desk.

https://www.hsph.harvard.edu/news/hs...ion-education/
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Old 03-16-2019, 09:19 AM   #127
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Well let's see, there's governments, universities, NGO's, philanthropists...
What's stopping them? Think they have as much incentive to advance science that makes money?
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Old 03-16-2019, 09:22 AM   #128
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It's not that drug companies shouldn't fund studies, it is that they should not have exclusive control of the data and have investigators sign non-disclosure agreements or attempt to discredit or threaten those who bring issues to light.
LOL. IOW, they should be philanthropists.

BTW, who do you think controls the data generated by universities & NGO's?
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Old 03-16-2019, 01:57 PM   #129
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Old 03-16-2019, 02:03 PM   #130
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My statin costs me $0.57 every 3 months.
This year with my el cheapo Part D plan, my statin is free! Big Pharma must me making a killing off me taking statins. And all those statin commercials blanketing the airwaves oh wait...

I also take the minimum dose (1/2 a 10 mg tablet daily) needed to get my cholesterol numbers into the good range.
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Old 03-16-2019, 02:22 PM   #131
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At the risk of asking the obvious quuestion: Does High LDL (bad cholesterol) cause death?
What is the evidence?


A contrary view: https://www.nhs.uk/news/heart-and-lu...heart-disease/


"
Researchers chose 30 studies in total to analyse. 28 studies looked at the link with death from any cause. Twelve found no link between LDL and mortality, but 16 actually found that lower LDL was linked with higher mortality risk – the opposite to what was expected.
Only nine studies looked at cardiovascular mortality link specifically – seven found no link and two found the opposite link to what was expected."
"
Where did the story come from?

The study was carried out by researchers from the University of South Florida, the Japan Institute of Pharmacovigilance and various other international institutions in Japan, Sweden, UK, Ireland, US and Italy.
Funding was provided by the Western Vascular Institute. The study was published in the peer-reviewed BMJ Open and, as the journal name suggests, the article is open-access, so can be read for free."


Just to cherry pick an example; Tim Russert... had good numbers. "Russert had earlier been diagnosed with asymptomatic coronary artery disease, but it was well-controlled with medication and exercise, and he had performed well on a stress test in late April, Newman said. An autopsy revealed that he also had an enlarged heart, Newman said. " http://www.nbcnews.com/id/25145431/n...-heart-attack/





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Old 03-16-2019, 03:27 PM   #132
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At the risk of asking the obvious quuestion: Does High LDL (bad cholesterol) cause death?
What is the evidence?


A contrary view: https://www.nhs.uk/news/heart-and-lu...heart-disease/


"
Researchers chose 30 studies in total to analyse. 28 studies looked at the link with death from any cause. Twelve found no link between LDL and mortality, but 16 actually found that lower LDL was linked with higher mortality risk – the opposite to what was expected.
Only nine studies looked at cardiovascular mortality link specifically – seven found no link and two found the opposite link to what was expected."
"
Where did the story come from?

The study was carried out by researchers from the University of South Florida, the Japan Institute of Pharmacovigilance and various other international institutions in Japan, Sweden, UK, Ireland, US and Italy.
Funding was provided by the Western Vascular Institute. The study was published in the peer-reviewed BMJ Open and, as the journal name suggests, the article is open-access, so can be read for free."


Just to cherry pick an example; Tim Russert... had good numbers. "Russert had earlier been diagnosed with asymptomatic coronary artery disease, but it was well-controlled with medication and exercise, and he had performed well on a stress test in late April, Newman said. An autopsy revealed that he also had an enlarged heart, Newman said. " NBC's Tim Russert dead at 58 - politics | NBC News





Fire away
Seems they came up with some conclusions that need to be considered:

"However, before accepting this as fact, there are many important limitations to consider – both to the review and the included studies – many of which the review authors themselves acknowledge:
There is the potential that many studies relevant to this question may have been missed out. The review searched only a single literature database, excluded studies only available in non-English language, and excluded studies where the title and abstract did not appear to contain information on the link between LDL and mortality in older adults.

The study only looked at the link in older adults aged over 60. LDL-cholesterol levels may show different links with long-term mortality in younger adults. Though this was intended to represent the general older-age population, some studies had excluded people with specific conditions such as dementia, diabetes or terminal illness.

The studies varied widely in adjustment for confounding factors that could be having an influence on the link between LDL and mortality. Age, gender and body mass index (BMI) were common factors that studies took into account, but others variably accounted for lifestyle factors (e.g. smoking, alcohol), socioeconomic factors, presence of conditions, and use of medications.

Only LDL cholesterol was examined. Levels of total cholesterol, trigylcerides, and the ratio of LDL to HDL "good" cholesterol could be having an effect and mediating the link between LDL and mortality.

Most of the evidence for this review is for the link with all-cause mortality – not cardiovascular mortality. High LDL-cholesterol is believed to be linked with the development of atherosclerosis and cardiovascular disease. This review does not provide enough firm evidence to refute this link. The review cannot with certainty explain the reasons for the apparent link between LDL levels and death from any cause – with roughly half of studies finding a link and half not.

Importantly, the study does not provide evidence that statins are "a waste of time". These are not trials examining mortality between people prescribed statins or not. The researchers openly acknowledge that the use of statins – which they haven't directly examined – may be confounding the links in these studies. For example, the people found to have the highest LDL cholesterol levels at the study's start may have then been started on statins, and this could have dramatically cut their reduced mortality risk.

The findings of this review and possible explanations will need to be explored further, but for now this review doesn't provide solid evidence that high LDL cholesterol is good for you, or that statins are of no help. People given statins should continue to take them as prescribed.

"Fat is actually good for you" may be a great headline for a newspaper, and there are always researchers who are willing to make such a case, as we saw with the recent National Obesity Forum report.
These types of stories are often based on a selective view of evidence, rather than a comprehensive systematic review. There is currently no comprehensive body of evidence that contradicts current official advice on saturated fat consumption – which recommends no more than 30g of saturated fat a day for men and 20g for women."
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Old 03-16-2019, 03:52 PM   #133
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Anyone else smell bacon?

No! Because bacon causes high cholesterol!


<yes, this is a (bad) joke>
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Old 03-16-2019, 04:18 PM   #134
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Originally Posted by ls99 View Post
At the risk of asking the obvious quuestion: Does High LDL (bad cholesterol) cause death?
What is the evidence?


A contrary view: https://www.nhs.uk/news/heart-and-lu...heart-disease/


"
Researchers chose 30 studies in total to analyse. 28 studies looked at the link with death from any cause. Twelve found no link between LDL and mortality, but 16 actually found that lower LDL was linked with higher mortality risk – the opposite to what was expected.
Only nine studies looked at cardiovascular mortality link specifically – seven found no link and two found the opposite link to what was expected."
"
Where did the story come from?

The study was carried out by researchers from the University of South Florida, the Japan Institute of Pharmacovigilance and various other international institutions in Japan, Sweden, UK, Ireland, US and Italy.
Funding was provided by the Western Vascular Institute. The study was published in the peer-reviewed BMJ Open and, as the journal name suggests, the article is open-access, so can be read for free."


Just to cherry pick an example; Tim Russert... had good numbers. "Russert had earlier been diagnosed with asymptomatic coronary artery disease, but it was well-controlled with medication and exercise, and he had performed well on a stress test in late April, Newman said. An autopsy revealed that he also had an enlarged heart, Newman said. " http://www.nbcnews.com/id/25145431/n...-heart-attack/





Fire away


It does... but the question is peripheral.

The question is do statins lower mortality risk.

And they do, for both primary and secondary prevention, and its been shown multiple times.

LDL might be the reason, but it might also not be. The bottom line is that statins decrease mortality, and specifically mortality from cardiovascular disease.
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Old 03-16-2019, 05:14 PM   #135
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The question is do statins lower mortality risk.

And they do, for both primary and secondary prevention, and its been shown multiple times.
Despite looking very hard, I've never seen proof of that. Can you provide references?
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Old 03-16-2019, 07:48 PM   #136
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3 goofs, do you or anyone in your family take a statin?
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Old 03-16-2019, 07:59 PM   #137
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3 goofs, do you or anyone in your family take a statin?


Yes.

But why is that relevant?
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Old 03-16-2019, 08:02 PM   #138
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Despite looking very hard, I've never seen proof of that. Can you provide references?


I’m not your scut resident.

The information is readily accessible to you. If you haven’t run across the 4S trial, or cardiology guidelines while ‘looking hard’...
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Old 03-16-2019, 08:32 PM   #139
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I think it’s very relevant. You, close family members, etc.
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Old 03-16-2019, 08:37 PM   #140
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I think it’s very relevant. You, close family members, etc.


Yes. In fact, I take them.

And I probably should have started decades ago, TBH.
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