preventive statins - yes, no, maybe?

what do you want to accomplish?

--
Winning against heart attack and stroke
sonoscore.comsonoscore.comOpen ↗

Quoted message said:

What is the consensus - if there is one - on starting
statins as a prophylactic measure?

G.P.

Using statins for primary prevention of heart disease (i.e.
people with risk factors but no disease present) is still a
very grey area, as far as I understand.

Usually your doctor or cardiologist will tally up your risk
factors. You seem to have 2. Age and family history.

The more risk factors the lower they want to set a
target for LDL.

I would be very surprised if you were recommended for a
statin at this time with your ratio and risk factor profile.
But then again I am not your doctor. If you are overweight,
losing weight can lower your LDL.

George Prager said:

male, 51, good overall health, 5'9", 147 lbs, BP 110/70,
2-3 miles walk daily. Consistently high overall cholesterol
numbers: total - 250 LDL - 156 HDL - 75 ratio - 3.3

My doctor and my cardiologist assure me that my ratio is
excellent and my high HDL very protective. Nevertheless, in
light of family history (father died following an MI at 60)
I am concerned What is the consensus - if there is one - on
starting statins as a prophylactic measure?

G.P.

Just curious. You have seen both your family doctor and a
cardiologist and discussed this with them. What possible
benefit could hearing opinions on an internet chat group
be to you?

It's interesting as a discussion point, since the role of
statins in primary prevention is controversial, but if
anything you heard here were to result in your altering
treatment (or lack thereof) then I personally think you
would have used the internet to harm your health not improve
it. How could some anonymous stranger's opinion be more
valuable than the 2 doctors who have followed you
personally?

If you are savy enough to post here, surely you can goggle
and surf to examine the latest research yourself and form
your own opinions.

Quoted message said:

Quoted message said:

Just curious. You have seen both your family doctor and a
cardiologist and discussed this with them. What possible
benefit could hearing opinions on an internet chat group
be to you?

It's interesting as a discussion point, since the role of
statins in primary prevention is controversial, but if
anything you heard here were to result in your altering
treatment (or lack thereof) then I personally think you
would have used the internet to harm your health not
improve it. How could some anonymous stranger's opinion be
more valuable than the 2 doctors who have followed you
personally?

If you are savy enough to post here, surely you can goggle
and surf to examine the latest research yourself and form
your own opinions.

George, what is it about newsgroups that encourages
hostility? I asked a simple question. You are at liberty to
ignore it. Why does it concern you how I go about collecting
information and what I do with it?

G.P.

George said:

How could some anonymous stranger's opinion be more
valuable than the 2 doctors who have followed you
personally?

usenet is about conversation that cannot take place in any
other way. it is one of many tools to learn.

--
Winning against heart attack and stroke
sonoscore.comsonoscore.comOpen ↗

George said:

Using statins for primary prevention of heart disease
(i.e. people with risk factors but no disease present) is
still a very grey area, as far as I understand.

it is because risk factors do not translate into the
amount of atherosclerosis someone has in a reliably
consistent pattern.

Quoted message said:

Usually your doctor or cardiologist will tally up your
risk factors. You seem to have 2. Age and family history.

and many people have no risk factors, but have clinically
significant atherosclerosis.

Quoted message said:

The more risk factors the lower they want to set a target
for LDL.

LDL has not been proven to cause atherosclerosis.
'prophalactic' use of statins does not necessarily stem
from the desire to lower cholesterol. Rather, to take
advantage of the many other effects statins have on
atheroslcerosis pathways.

Quoted message said:

I would be very surprised if you were recommended for a
statin at this time with your ratio and risk factor
profile. But then again I am not your doctor. If you are
overweight, losing weight can lower your LDL.

But you don't have to be a doctor to understand the disease
and its treatment. In fact, lay people often trump their
doctor with knowledge about a disease and its treatment. A
good doctor recognizes this humbling fact and deals with it
rather than against it.

--
Winning against heart attack and stroke
sonoscore.comsonoscore.comOpen ↗

George Prager said:

male, 51, good overall health, 5'9", 147 lbs, BP 110/70,
2-3 miles walk daily. Consistently high overall cholesterol
numbers: total - 250 LDL - 156 HDL - 75 ratio - 3.3

My doctor and my cardiologist assure me that my ratio is
excellent and my high HDL very protective. Nevertheless, in
light of family history (father died following an MI at 60)
I am concerned What is the consensus - if there is one - on
starting statins as a prophylactic measure?

G.P.

George,

This is quite a contentious issue in this newsgroup (!).

There is a small group here (3 people, actually) that
essentially feel that taking statins for primary prevention
is completely bogus. I think two of them also question its
use for secondary prevention. (BTW, one of them admits
having a cholesterol level over 500 and is unconcerned, one
of them has admitted to having a medicine "phobia" since the
age of 17 and the third is standing in for her husband who
apparently has suffered from side effects, which of course
is most unfortunate but luckily a small percentage of
overall statin users)

They perhaps will post interesting links for you to read and
by all means, do. If you go back in time for this newsgroup
you will find that many of their links have been critically
challenged.

Research is finding that statins, besides dramatically
lowering cholesterol levels, apparently has other
cardiovascular beneficial effects. A good place to start is

bmj.bmjjournals.comsearchallOpen ↗

an advanced search engine that searches through hundreds of
journals and publications.

L.

Quoted message said:

Research is finding that statins, besides dramatically
lowering cholesterol levels, apparently has other
cardiovascular beneficial effects.

In all fairness listener, while recent studies show
surprising results from statin therapy, primarily from
apparent inflammation reduction and the media has jumped on
the bandwagon (cover story of Time Magazine this week) there
isn't the science (yet) to show that treating healthy people
with statins (primary prevention) is beneficial or even
advisable. My own family doctor and cardiologist when asked
by me about this say that at this time they would not treat
patients with statins unless there was a need to lower their
LDL or raise HDL to specific targets to treat specific
conditions. This may change but to my limited knowledge the
double blind studies on a healthy study group has not been
done. And even when some are finished (I think I read
somewhere that some were underway) there will probably need
to be many more before it becomes standard therapy like ASA
treatment is today.

And like we have both said it is controversial. We don't
want to screw our body up in the pursuit of trying to make
it better.

And I am not even mentioning all the paranoid drug company
conspiracy theories that are rampant on internet/usenet,
that say all the positive and promising studies are being
published in a duplicitous manner by companies who are
hiding the truth or bending it to make billions in profit.
To me those theories are pure bunk, although independent
peer reviews of the studies in question ARE
important/necessary.

Quoted message said:

what is it about newsgroups that encourages hostility? I
asked a simple question. You are at liberty to ignore it.
Why does it concern you how I go about collecting
information and what I do with it?

G.P.

G.P. Let's get our facts straight here. I answered your
original post with a reasonable reply. Thank you very
much for not even acknowledging that.

Secondly the only hostility I sense in this thread is coming
from you directed at me.

I was merely pointing out the fact that people in general
and in this case you in particular, get competent medical
advice (in your case from 2 doctors who have been treating
you) and then want strangers with almost no knowledge of
their case to give them advice. Plus the information you
seek is so well documented that you could read the studies
and form your own opinions.

What is hostile about pointing this out? And who is being
hostile here anyways?

"George Prager" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

male, 51, good overall health, 5'9", 147 lbs, BP 110/70,
2-3 miles walk daily. Consistently high overall
cholesterol numbers: total - 250 LDL - 156 HDL - 75
ratio - 3.3

My doctor and my cardiologist assure me that my ratio is
excellent and my high HDL very protective. Nevertheless,
in light of family history (father died following an MI at
60) I am concerned What is the consensus - if there is one
- on starting statins as a prophylactic measure?

G.P.

I'm not sure there is a firm consensus, but the weight of
the evidence, from what I've seen, seems to be moving
toward statins.

One question you did not ask which is just about as
important is: what about aspirin. I think most people would
agree that a daily aspirin might be a good idea in your
situation - assuming there are no contraindications such as
ulcers or other drugs that might interact. There is some
debate about the dosage 81 mg (baby aspirin) to 325 (1 full
tablet/day). Check with your Dr.

Good luck.

Bill - not a Dr.

Quoted message said:

There is some debate about the dosage 81 mg (baby aspirin)
to 325 (1 full tablet/day). Check with your Dr.

There is also debate about coated vs uncoated ASA. I have
tried to start a thread on this topic a few times but no one
responded so I gave up. There was a study last year that
concluded that uncoated ASA had virtually no impact on MI
and stroke prevention and that only uncoated ASA achieved
the results that have been the basis for current primary
prevention therapy. The study authors also reported that
their findings were not what they were expecting when they
began the study.

Most doctors still recommend coated ASA because of gastro
bleeding, but this is still another large grey area but one
getting no attention at the moment.

I did some searching. It's called Aspirin Resistance. This
link is from a commercial manufacturer but has links to
many studies.

accumetrics.comdetails.aspOpen ↗

"George Prager" <[email hidden]> wrote ...

Quoted message said:

male, 51, good overall health, 5'9", 147 lbs, BP 110/70,
2-3 miles walk daily. Consistently high overall
cholesterol numbers: total - 250 LDL - 156 HDL - 75
ratio - 3.3

My doctor and my cardiologist assure me that my ratio is
excellent and my high HDL very protective. Nevertheless,
in light of family history (father died following an MI at
60) I am concerned What is the consensus - if there is one
- on starting statins as a prophylactic measure?

G.P.

A co-worker had your same concern, though his father died at
48. His total cholesterol numbers were consistently in the
240 - 250 range over 10 years, so he, after consulting his
doctor, decided not to start statins. If the cholesterol had
changed suddenly or had been climbing over the last few
years, he probably would have been started on statins or
niacin therapy.

May (not a doc)

I found this report to easily understandable to the
layperson

nhlbi.nih.govcholesterolOpen ↗

Regards,

"George Prager" <[email hidden]> wrote in
message
"]news:[email hidden]...

Quoted message said:

male, 51, good overall health, 5'9", 147 lbs, BP 110/70,
2-3 miles walk daily. Consistently high overall
cholesterol numbers: total - 250 LDL - 156 HDL - 75
ratio - 3.3

My doctor and my cardiologist assure me that my ratio is
excellent and my high HDL very protective. Nevertheless,
in light of family history (father died following an MI at
60) I am concerned What is the consensus - if there is one
- on starting statins as a prophylactic measure?

G.P.

On Fri, 2 Apr 2004 17:56:55 -0500, "smyrna45" <[email hidden]>

Quoted message said:

I found this report to easily understandable to the
layperson

nhlbi.nih.govcholesterolOpen ↗

Very good link thank you

"George Prager" <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

male, 51, good overall health, 5'9", 147 lbs, BP 110/70,
2-3 miles walk daily. Consistently high overall
cholesterol numbers: total - 250 LDL - 156 HDL - 75
ratio - 3.3

My doctor and my cardiologist assure me that my ratio is
excellent and my high HDL very protective. Nevertheless,
in light of family history (father died following an MI at
60) I am concerned What is the consensus - if there is one
- on starting statins as a prophylactic measure?

G.P.

George P. said: "My doctor and my cardiologist assure me
that my ratio is excellent and my high HDL very protective.

Me too George. My doctor assures me that my ratio is
excellent and my high HDL very protective. I will not
attempt to control my very high cholesterol beyond what I
can achieve through prudent eating, vigorous exercise and
good living (including meditation and as stress free a life
as possible). Salut, B'adant

George Prager said:

male, 51, good overall health, 5'9", 147 lbs, BP 110/70,
2-3 miles walk daily. Consistently high overall
cholesterol numbers: total - 250 LDL - 156 HDL - 75
ratio - 3.3

My doctor and my cardiologist assure me that my ratio is
excellent and my high HDL very protective. Nevertheless,
in light of family history (father died following an MI at
60) I am concerned What is the consensus - if there is one
- on starting statins as a prophylactic measure?

You could seek out another physician for a second
opinion since you remain concerned though your current
doctors are not.

Servant to the humblest person in the universe,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

**
Who is the humblest person in the universe?
makeashorterlink.commakeashorterlink.comOpen ↗

What is all this about?
makeashorterlink.commakeashorterlink.comOpen ↗

Is this spam?
makeashorterlink.commakeashorterlink.comOpen ↗

Quoted message said:

Subject: Re: preventive statins - yes, no, maybe?
From: George [email hidden]
Date: 4/2/2004 10:12 AM Pacific Standard Time
Message-id: <[email hidden]>

Quoted message said:

Usually your doctor or cardiologist will tally up your risk
factors. You seem to have 2. Age and family history.

3. he is male (and these 3 are unchangeable)

hawki.....

Quoted message said:

Subject: Re: preventive statins - yes, no, maybe?
From: [email hidden] (Zee)
Date: 4/2/2004 4:45 PM Pacific Standard Time
Message-id: <[email hidden]>

Quoted message said:

Me too George. My doctor assures me that my ratio is
excellent and my high HDL very protective. I will

don't recall reading what your HDL is..but if total is over
500....you would need an HDL of about 150 to givee you a
ratio around 3.5 (which is desirable)

I don't think it is possible for an HDL to be that high

care to comment

hawki.....

Quoted message said:

Me too George. My doctor assures me that my ratio is
excellent and my high HDL very protective. I will not
attempt to control my very high cholesterol beyond what I
can achieve through prudent eating, vigorous exercise and
good living (including meditation and as stress free a life
as possible). Salut, B'adant

Problem Zee is as it was put to my by a cardiologist, you
could eat only lettuce and still have sky high LDL. It's
genetic too. Certainly lifestyle changes are important, but
for some people those are not always enough. And while many
people have good intentions, some have a hard time sticking
with radical lifestyle changes.