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Thread: Cholesterol - any doctor here ?

  1. #11
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    Unless someone with a high cholesterol has had an "event" (angina, stent insertion, heart attack, stroke, symptoms of peripheral vascular insufficiency) then the chances of them benefitting from being on a statin are essentially zero.

  2. #12
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    So my familial high cholesterol value was halved to put it into normal range after 3 months of statins. Are you telling me this has no value to my asymptomatic coronary artery stenosis with a calcium score of >500??
    I am Kuno....

  3. #13
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    A Coronary Artery Calcium score of > 500 is surely best regarded as an event, so we are talking about secondary prevention. From my reading, a score of 0 meant no benefit from statins; >400 meant a NNT per year of 45 - this is to prevent an event; I could not find NNT to save a life, so presumably it did not save lives, or they would have made a huge deal of it.
    As a Geriatrician, I saw lots of nasty side effects from statins, and stopped them often. I also saw a death from statin associated renal failure, something that is only meant to occur in one in half a million statin treated patients - I suspect it is rather more common than that - there is no way I saw half a million people on statins, busy as my job was!
    Best wishes!

  4. #14
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    What do you mean by 'event'?
    Its not an event but a measure of calcium in the arterial wall that correlates with risk of myocardial event.
    My cardiologist tells me that as a fit, asymptomatic individual, my major risk is sudden cardiac death. Not a risk I want to bear without making every effort to reduce it.
    I was worried about medication side effects but I seem to tolerate atorvastatin,ramipril and indapamide without any undue symptoms. My biggest issue has been stopping with racing.
    So what is Gambatte to do for best? I would say recheck after looking into diet etc. If still off then perhaps getting a calcium score? If that OK, then just monitor rather than starting on cholesterol normalising medication?? Oh, and Gambatte, whats your blood pressure?
    I am Kuno....

  5. #15
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    Of course calcification is a process, not an event, but the people that have had their CAC measured and have a high result are known to have a very different prognosis from those who 1/ have not had it measured 2/ have had it measured and the result is low or zero. So they fall into a different category from true primary prevention, where there is no benefit in terms of lives saved from being on a statin. Hence treating CAC as an "event". Disagree with my terminology if you wish.
    Gambatte should not be on a statin - mediterranean diet, lots of fruit and vegetables, oily fish, olive oil, cut down on/eliminate meat, eliminate free sugars and highly processed foods, achieve/maintain ideal body weight ( BMI < 25 ), remain active, minimal alcohol if any, and of course don't smoke. If I was him I would not be getting a CAC score done - but then, never having had an event, I have no idea what my cholesterol is.

  6. #16
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    And I wish I knew what my cholesterol/calcium score was 10 years ago so I could have started a statin. This might have prevented the arterial narrowing that has now curtailed my racing career!
    I am Kuno....

  7. #17
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    Quote Originally Posted by Wheeze View Post
    And I wish I knew what my cholesterol/calcium score was 10 years ago so I could have started a statin. This might have prevented the arterial narrowing that has now curtailed my racing career!
    But no symptoms? Advised not to race (or even run?) based on a high CAC score? I would be interested to hear the evidence behind this advice. It is my understanding that endurance runners tend to have a higher CAC score than the general population, yet, apart from atrial fibrillation, they have fewer cardiac events.

  8. #18
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    No Mike the advice is following a coronary angiogram that showed 30% flow restriction on 2 diagonal branches of LAD. Anyway let's focus on gambattes issue. How does he manage this one off finding for best?

  9. #19
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    Quote Originally Posted by noel View Post
    We've had enough of experts. I once knew someone who lived to 97 and he ate a lot of prawns.

    But seriously, check this out: https://www.nhsinform.scot/illnesses...gh-cholesterol. I guess you have already.

    And you also asked if fasting makes any difference: https://www.statnews.com/2016/04/29/...terol-testing/

    I am not a medical doctor.
    But the real secret to long life, is two raw eggs a day.
    So said an Italian lady living to 117.

    Is it still true that amongst non smoking , non drinking , non cholesterol taking , non dusty air imbibing , non McDonald ( or Burger King) eating , non salt eating , none coke ( or sugar drink) drinking, none chip eating, healthy lifestylers , the death rate is still 100 percent? Selling funerals is still a reliable market!
    Last edited by Oracle; 29-01-2020 at 10:31 PM.

  10. #20
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    Quote Originally Posted by Wheeze View Post
    No Mike the advice is following a coronary angiogram that showed 30% flow restriction on 2 diagonal branches of LAD. Anyway let's focus on gambattes issue. How does he manage this one off finding for best?
    Advice to Gambatte - see #15. I would be interested to know his BMI. So many are just that bit over 25.

    Did you have an exercise test? In general, 30% narrowing has a minimal effect on flow, if any.

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