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Medical Forum / General / Cardiology / September 2004Cholesterol Advice Needed
Hello I have the following results and would appreciate suitable advice:- Chol Tot - 251 HDL - 63 LDL - 175 Chol Tot/HDL - 4.0 Triglycerides - 73 I am 43, exercise a lot (>7hrs/week), not overweight, diet reasonable, borderline hypertension (not treated). my doctor thinks I should not wait any longer before taking cholesterol lowering drugs. He says there is a high chance that I will have a heart attack/ stroke within 10 years. 1. Is my doctor correct? 2. What are your top 3 suggestions for me to lower my chol. (without drugs) 3. Will increasing excercise help? 4. How long do lifestyle changes take to affect chol. levels) 5. How is tot chol. calculated to get the 251? 6. The above units are mg%, I assume this is the same as mg/dl? > Hello > > I have the following results and would appreciate suitable advice:- > > Chol Tot - 251 Optimal is less than 200. > HDL - 63 Optimal ( > 50) > LDL - 175 Optimal is less than 100. > Chol Tot/HDL - 4.0 Optimal is less than 3. > Triglycerides - 73 Optimal. > I am 43, exercise a lot (>7hrs/week), not overweight, There are many who believe they are not overweight but they are actually still heavier than ideal. > diet reasonable, > borderline hypertension (not treated). my doctor thinks I should not [quoted text clipped - 3 lines] > > 1. Is my doctor correct? Possibly. > 2. What are your top 3 suggestions for me to lower my chol. (without > drugs) (a) Lose weight if you are heavier than ideal. (b) Regular exercise. (c) Decrease fat/chol intake especially avoiding trans fats. > 3. Will increasing excercise help? Yes. > 4. How long do lifestyle changes take to affect chol. levels) 6-8 weeks. > 5. How is tot chol. calculated to get the 251? See FAQs on the web site linked below my name in the sig below. > 6. The above units are mg%, I assume this is the same as mg/dl? Yes it is. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > Hello > > [quoted text clipped - 24 lines] > There are many who believe they are not overweight but they are actually > still heavier than ideal. I am 6 foot 1 inch and 78kg, what is ideal? It is difficult to see where I could loose weight. > > diet reasonable, > > borderline hypertension (not treated). my doctor thinks I should not [quoted text clipped - 10 lines] > > (a) Lose weight if you are heavier than ideal. If I am heavier than ideal then it is only marginally. > (b) Regular exercise. > (c) Decrease fat/chol intake especially avoiding trans fats. I already try to avoid trans fats, but I can stop completely. How about also restricting to fish, chicken, nuts? What about skimmed milk or low fat yogurts? Oats every day? > > 3. Will increasing excercise help? > > Yes. Would increasing above 7hrs/week still have further/significant benefit? > > 4. How long do lifestyle changes take to affect chol. levels) > [quoted text clipped - 26 lines] > Is this spam? > http://makeashorterlink.com/?N69721867 Thanks for you reply > > > Hello > > > [quoted text clipped - 26 lines] > > I am 6 foot 1 inch and 78kg, what is ideal? Your use of English and Metric is unusual. Your ideal body weight might be 165 lbs (75 kg). > It is difficult to see where I could loose weight. > > [quoted text clipped - 20 lines] > > I already try to avoid trans fats, but I can stop completely. That would be wise. > How about also restricting to fish, chicken, nuts? Might be helpful. > What about skimmed milk or low fat yogurts? Also might be helpful. > Oats every day? Good idea. > > > 3. Will increasing excercise help? > > > > Yes. > > Would increasing above 7hrs/week still have further/significant benefit? Probably not. > > > 4. How long do lifestyle changes take to affect chol. levels) > > [quoted text clipped - 28 lines] > > Thanks for you reply You are welcome. All praises belong to my heavenly Father, whom I love with all my heart, soul, and mind :-) Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 >Subject: Re: Cholesterol Advice Needed >From: "Dr. Andrew B. Chung, MD/PhD" andrew@heartmdphd.com >Date: 9/16/2004 6:33 AM Pacific Daylight Time >Message-id: <1095341696.x1uoGMF+gKi1IkvxM1Ap6g@teranews> > > > Chol Tot - 251 >> > >> > Optimal is less than 200. correct > > HDL - 63 >> > >> > Optimal ( > 50) so he is above optimal...great >> > LDL - 175 >> > >> > Optimal is less than 100. ahhhh...not true according to the ATP III most recent guidelines; "for patients with DIAGNOSED atherosclerotic disease,,diabetes or other CHD risk equivalents,,,the LDL goal is less than 100" "the LDL goal for pts with two or more CVD risk factors (ie age,,gender,,htn..family history etc) AND a Framingham risk assessment score or 10-20%...LDL goal is 130: For patients at LOW risk,,,with fewer than two CVD risk factors,,,the LDL goal is 160" "snip...patients with CVD risk factors..et al..whose LDL is 130 or above...ARE candidates for drug therapy,,,AND simultaneous lifestyle modifications,,ie diet and exercise" the above from: "Reducing cardiovascular risk: using new data to achieve better outcomes" August 2004 I read all the stuff that is sent to me and try to keep current(as I also treat these patients..tho the Andrew's of the world would like you to believe that ONLY the great docs do) that said..my hubby...after major MI...angioplasty ..three stents that occluded..now 18 months post CABG..has an LDL of 99...at last visit his doc mentioned that perhaps LDL around 70 would be better (since he is a repeat offender)..but he was reluctant to increase his meds ...on Pravachol and Niacin... hope this helps.... hawki..... > >Subject: Re: Cholesterol Advice Needed > >From: "Dr. Andrew B. Chung, MD/PhD" andrew@heartmdphd.com [quoted text clipped - 18 lines] > > ahhhh...not true Sorry, it is. > according to the ATP III most recent guidelines; > > "for patients with DIAGNOSED atherosclerotic disease,,diabetes or other CHD > risk equivalents,,,the LDL goal is less than 100" The motivation behind stating this goal is a recognition that less than 100 would be optimal. > "the LDL goal for pts with two or more CVD risk factors (ie > age,,gender,,htn..family history etc) AND a Framingham risk assessment score or > 10-20%...LDL goal is 130: You seem to be confused about the difference between what is "goal" and what is "optimal." > For patients at LOW risk,,,with fewer than two CVD risk factors,,,the LDL goal > is 160" You still seem confused. > "snip...patients with CVD risk factors..et al..whose LDL is 130 or above...ARE > candidates for drug therapy,,,AND simultaneous lifestyle modifications,,ie diet [quoted text clipped - 5 lines] > > I read all the stuff that is sent to me and try to keep current That would be a good thing, imo. > (as I also > treat these patients..tho the Andrew's of the world would like you to believe > that ONLY the great docs do) (If you are treating patients, you would be in a position to better help them by understanding the difference between what is optimal and what is goal. When it comes to CV risk factors, folks should strive for what is believed to be optimal even if they are at goal). > that said..my hubby...after major MI...angioplasty ..three stents that > occluded..now 18 months post CABG..has an LDL of 99...at last visit his doc > mentioned that perhaps LDL around 70 would be better (since he is a repeat > offender)..but he was reluctant to increase his meds ...on Pravachol and > Niacin... Is your hubby at his optimal (ideal) weight? If not, you would help your hubby by teaching him about the 2PD Approach to help him achieve permanent weight loss safely. This would be a way of getting LDL less than 70 mg/dl without increasing medications. > hope this helps.... > hawki..... Hope you help yourself and your hubby. You remain in my prayers, dear Hawki whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 >Subject: Re: Cholesterol Advice Needed >From: "Dr. Andrew B. Chung, MD/PhD" andrew@heartmdphd.com >Date: 9/16/2004 2:33 PM Pacific Daylight Time >Message-id: <1095370493.PLsBhL14aUDTJTgMyXd8Wg@teranews> >Optimal is less than 100. >> >> ahhhh...not true > >Sorry, it is. in your opinion I believe in evidence based medicine...not opinions of ONE cardiologist.. >> according to the ATP III most recent guidelines; >> >> "for patients with DIAGNOSED atherosclerotic disease,,diabetes or other CHD >> risk equivalents,,,the LDL goal is less than 100" >The motivation behind stating this goal is a recognition that less than 100 >would >be optimal. my hubby's cardiologist is satisfied with LDL of 100 >You seem to be confused about the difference between what is "goal" and what >is >"optimal." No I am not... > For patients at LOW risk,,,with fewer than two CVD risk factors,,,the LDL >goal >> is 160" > >You still seem confused. no I am not goal is goal...optimal is likely unattainable it is also optimal to be your age...less than 40 I assume.. unfortunately age happens.. >would be in a position to better help them by >understanding the difference between what is optimal and what is goal. When >it >comes to CV risk factors, folks should strive for what is believed to be >optimal >even if they are at goal). my guidelines state "goal"... >Is your hubby at his optimal (ideal) weight? yes >teaching him about the 2PD Approach to help >him achieve permanent weight loss safely. This would be a way of getting LDL >less >than 70 mg/dl without increasing medications. ah...perhaps he should eat nothing but lettuce and your 2pd solution but...there is quality and there is quantity of life... this man is capable of volunteering often 10 hours a day "tearing down houses" for Habitat for Humanity...there is hardly a day he is not 100% active his entire waking hours...he has never had angina..sob..etc...and he looks better than in the 30 years we have been together... if he wants a piece of pie per day...so be it!! we eat healthy...lots of fruits and vegs..etc etc... >Hope you help yourself and your hubby. again...HIS cardiologist is very pleased...his one year post CABG echo showed his grafts to be 100% open (unlike the stents)...his cardiac output is excellent... in my mind he is a medical success... hawki..... > >Subject: Re: Cholesterol Advice Needed > >From: "Dr. Andrew B. Chung, MD/PhD" andrew@heartmdphd.com [quoted text clipped - 8 lines] > > in your opinion Based on research data. > I believe in evidence based medicine...not opinions of ONE cardiologist.. If you don't believe in the opinion's of your husband's cardiologist, why don't you have him change doctors? > >> according to the ATP III most recent guidelines; > >> [quoted text clipped - 6 lines] > > my hubby's cardiologist is satisfied with LDL of 100 Is it your claim that if your hubby lowered this to 65 with lifestyle changes, that your hubby's cardiologist would object and advise him to stop those lifestyle changes? (Example of God's gift of truth discernment at work :-) You remain in my prayers, dear neighbor whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 >Subject: Re: Cholesterol Advice Needed >From: "Dr. Andrew B. Chung, MD/PhD" andrew@heartmdphd.com >Date: 9/17/2004 9:49 AM Pacific Daylight Time >Message-id: <1095439963.a4CX93mmdIVZe9LK+MhMow@teranews> >> I believe in evidence based medicine...not opinions of ONE >cardiologist.. >If you don't believe in the opinion's of your husband's cardiologist, why >don't >you have him change doctors? ha ha ha was referring to you..and you know it "our" cardiologist has privileges at least 4 hospitals... >Is it your claim that if your hubby lowered this to 65 with lifestyle >changes, >that your hubby's cardiologist would object and advise him to stop those >lifestyle >changes? there are NO other lifestyle changes that this man needs to make...nor that his doc advises him to make... sorry..at 65 he could outdo you in just about ANY physical endeavor... hawki..... > > > > Hello > > > > [quoted text clipped - 28 lines] > > Your use of English and Metric is unusual. I suppose it is because I have not measured my height since I left bonnie Scotland 6 years ago but I measure my weight more frequently and kg is the only option here. I still convert Euro prices to GBP to compare prices for value but my GBP mind is stuck in a time warp, the way things were priced 6 years ago, it is a complete shock to see the inflation over 6 years when I visit the UK. > Your ideal body weight might be 165 lbs (75 kg). I might have some 3kg excess fat on bum and thighs (only about 22000 calories) > > It is difficult to see where I could loose weight. > > > [quoted text clipped - 19 lines] > > > > > > (c) Decrease fat/chol intake especially avoiding trans fats. OK (a)I excercise enough, (b)I am not overweight (maybe by 3kg) and (c) I am attending to. What would you re-evaluate my top 3 actions to be? Assuming I am already saved I only have a 3% chance of a heart attack in the next 10 years. I have also read enough bad press as not to take statins. > > I already try to avoid trans fats, but I can stop completely. > > That would be wise. My family eat much more, snacks, fries etc Are trans fats the no 1 bad guy? Should all tran fats be eliminated at all costs? If so what is the justification? > > How about also restricting to fish, chicken, nuts? > [quoted text clipped - 71 lines] > Is this spam? > http://makeashorterlink.com/?N69721867 > > Your ideal body weight might be 165 lbs (75 kg). > > I might have some 3kg excess fat on bum and thighs (only about 22000 > calories) Actauly, in you case, any dieting in long term would likely end in gaining a weight. Do not do it, yout weight is correct. > What would you re-evaluate my top 3 actions to be? > [quoted text clipped - 3 lines] > I only have a 3% chance of a heart attack in the next 10 years. > I have also read enough bad press as not to take statins. No 1: calm down :) > Are trans fats the no 1 bad guy? Yes, with sugar. > Should all tran fats be eliminated at all costs? As much as possible. It is probably better to use butter, if you need, than margarine containing transfats. Avoid processed snacks at any cost as they tend contain both trans fats and sugar - that is indeed deadly combination. > > > How about also restricting to fish, chicken, nuts? Eating everything as raw as possible helps. Avoid any processed stuff. > > > What about skimmed milk or low fat yogurts? Prefer fermented dairy. Yougurt is ideal - anyway low-fat version often contain harmful additions. I would advise using regular version - with 3% fat. Mirek > > > Your ideal body weight might be 165 lbs (75 kg). > > [quoted text clipped - 3 lines] > Actauly, in you case, any dieting in long term would likely end in > gaining a weight. Not for the 2PD Approach. > Do not do it, yout weight is correct. You'll have to decide what is best for you based on what you discern to be the truth. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > Actauly, in you case, any dieting in long term would likely end in > > gaining a weight. > > Not for the 2PD Approach. How many people are on 2PD for more than 5 years? Mirek > > > Actauly, in you case, any dieting in long term would likely end in > > > gaining a weight. > > > > Not for the 2PD Approach. > > How many people are on 2PD for more than 5 years? More than a busy cardiologist like me can track :-) You remain in my prayers, dear neighbor whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 >> > > Actauly, in you case, any dieting in long term would likely end in >> > > gaining a weight. [quoted text clipped - 4 lines] > > More than a busy cardiologist like me can track :-) That's a pretty good trick, since you state on your website that you were watching the film that inspired it in 1998.  Signaturejamie (jamiemck@newsguy.com) "There's a seeker born every minute." >>>>>Actauly, in you case, any dieting in long term would likely end in >>>>>gaining a weight. [quoted text clipped - 7 lines] > That's a pretty good trick, since you state on your website that > you were watching the film that inspired it in 1998. <LOL> Bob >>>>Actauly, in you case, any dieting in long term would likely end in >>>>gaining a weight. [quoted text clipped - 4 lines] >> > More than a busy cardiologist like me can track :-) Translation: None. HTH Bob > > > > > Hello > > > > > [quoted text clipped - 35 lines] > way things were priced 6 years ago, it is a complete shock to see the > inflation over 6 years when I visit the UK. Your story interests me more than Bob Pastorio's obsession with food ever could. > > Your ideal body weight might be 165 lbs (75 kg). > > I might have some 3kg excess fat on bum and thighs (only about 22000 > calories) In other words, you would not look optimal in a Speedo bikini trunks. > > > It is difficult to see where I could loose weight. > > > > [quoted text clipped - 27 lines] > > I am already saved Excellent :-) > I only have a 3% chance of a heart attack in the next 10 years. Imo, better to get that 3% to under 1% if at all possible. > I have also read enough bad press as not to take statins. Then you should be motivated toward being able to look "optimal" in bikini Speedos. > > > I already try to avoid trans fats, but I can stop completely. > > [quoted text clipped - 3 lines] > > Are trans fats the no 1 bad guy? It's up there. Smoking is higher. > Should all tran fats be eliminated at all costs? Every attempt should be made. > If so what is the justification? The biochemistry and clinical research data. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > Your story interests me more than Bob Pastorio's obsession with food ever could. <LOL> Poor debilitated Chung has to demonize everyone who questions him or points out his belligerent failures. He can't see the simplest answer to it - stop being such a know-it-all jerk. I'm obsessed with food, he says, because I *used* to own restaurants. <LOL> Is he obsessed with hearts because he *currently* works on them? How silly a thing to say. It's like science doesn't interest the self-proclaimed scientist Chung. And mathematics with all the implied rigor. And reliable, tested sources. And the strength of logic. He denies his humanity for some after-death future he thinks is guaranteed and for which he has no evidence. Any questions...? Bob It seems to me I heard somewhere that Paul Eaton wrote in article <13eed8fa.0409160131.5842f2af@posting.google.com>: >> > I have the following results and would appreciate suitable advice:- [...] >> > I am 43, exercise a lot (>7hrs/week), not overweight, >> There are many who believe they are not overweight but they are actually >> still heavier than ideal. >I am 6 foot 1 inch and 78kg, what is ideal? >It is difficult to see where I could loose weight. Here's a good current discussion of a number of thoughts on body weight, obesity, and norms. http://members.nuvox.net/~on.jwclymer/bmi.html Because it deals with more than just weight and thus has wider relevance I probably will post this link in a separate thread before I log off later today. [...] >> > 2. What are your top 3 suggestions for me to lower my chol. (without >> > drugs) >> (a) Lose weight if you are heavier than ideal. > >If I am heavier than ideal then it is only marginally. >> (b) Regular exercise. >> (c) Decrease fat/chol intake especially avoiding trans fats. >I already try to avoid trans fats, but I can stop completely. >How about also restricting to fish, chicken, nuts? >What about skimmed milk or low fat yogurts? >Oats every day? >> > 3. Will increasing excercise help? >> Yes. >Would increasing above 7hrs/week still have further/significant benefit? >> > 4. How long do lifestyle changes take to affect chol. levels) >> 6-8 weeks. >> > 5. How is tot chol. calculated to get the 251? >> See FAQs on the web site linked below my name in the sig below. >> > 6. The above units are mg%, I assume this is the same as mg/dl? >> Yes it is. >> Dr. Andrew B. Chung, MD/PhD >> Board-Certified Cardiologist >> http://www.heartmdphd.com/ SignatureDon donkirk@covad.net > I have the following results and would appreciate suitable advice:- > [quoted text clipped - 11 lines] > > 1. Is my doctor correct? You can try this sites to find out: http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=pub Here it what it says about your condition: Information about your risk score: Age: 43 ender: male Total Cholesterol: 250 mg/dL HDL Cholesterol: 63 mg/dL Smoker: No Systolic Blood Pressure: 140 mm/Hg On medication for HBP: No Risk Score* 3% Means 3 of 100 people with this level of risk will have a heart attack in the next 10 years. > 2. What are your top 3 suggestions for me to lower my chol. (without > drugs) Lossing weight might help, but for many people significant reduction of LDL can be achieved only by drugs. Anyway, taking most potent class of drugs (statins) seems to reduce your chances by average 50% - so that in your case you would get from 3% to 2%. BTW, it is really impossible to get under 1% (you can have no risk factors at all and still have heart attack). BTW, besides lipid panel, the most important risk factor is family history of CAD. Others are smoking and metabolic syndrome. All these are probably more predictive than lipid panel. > 3. Will increasing excercise help? It will raise HDL. Anyway, it helps only to some degree and your HDL is already high (that is a very good thing). > 5. How is tot chol. calculated to get the 251? LDL = TC - HDL - TG/5 Mirek > > I have the following results and would appreciate suitable advice:- > > [quoted text clipped - 44 lines] > history of CAD. Others are smoking and metabolic syndrome. All these are > probably more predictive than lipid panel. There is no history of CAD, although my Grandmother died of a stroke at 92, and had hardening of the arteries my aunts and uncles are healthy 70+ , my mother at 66 is healthy and has hypertension and high cholesterol, my father (53, no CAD) and both Grand Fathers have died of various cancers. How much should my doctor take this into account? > > 3. Will increasing excercise help? > [quoted text clipped - 6 lines] > > Mirek Paul, Mirek is right, your risk (3%) is "low". Furthermore, your high exercise totals would lower your risk even further. Taking statin drugs would reduce it still lower, but you're risking side effects. I'd suggest trying these things to lower your chol: 1) try having a bowl of oatmeal daily. 2) Replace saturated fats (butter) with "good" fats olive oil or "new balance" spread. 3) replace some carbs with with fatty fish or good fats. 4) have one or two drinks daily (increase hdl). > > > I have the following results and would appreciate suitable advice:- > > > [quoted text clipped - 63 lines] > > > > Mirek > Paul, > > Mirek is right, your risk (3%) is "low". As if you can rely on such risk calculations in this internet vacuum. I would suggest that Paul listen to his doctor's counsel instead of either Mirek or yours. Fwiw, I am not that much younger than Paul and my "score" comes up to be less than 1% but I know better than to stop my daily aspirin or to stop following the 2PD Approach. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > Fwiw, I am not that much younger than Paul and my "score" comes up to be less than 1% but I know better > than to stop my daily aspirin or to stop following the 2PD Approach. Interesting. Do you suggest daily aspirin for everybody? Or you have other risk factors you want to address (only comes to mind family history)? What about the risk of bleeding stroke (0.1% increase with daily aspirin)? Mirek > > Fwiw, I am not that much younger than Paul and my "score" comes up to > be less than 1% but I know better > > than to stop my daily aspirin or to stop following the 2PD Approach. > > Interesting. Do you suggest daily aspirin for everybody? No. > Or you have other risk factors you want to address (only comes to mind > family history)? Being male, over the age of 35, and exposed to lots of radiation from cathing folks are 3 that immediately come to mind. > What about the risk of bleeding stroke (0.1% increase with daily > aspirin)? My blood pressure running at 110/65 thanks to God through the 2PD Approach addresses that. You remain in my prayers, dear neighbor whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 >Subject: Re: Cholesterol Advice Needed >From: "Dr. Andrew B. Chung, MD/PhD" andrew@heartmdphd.com >Date: 9/17/2004 3:17 PM Pacific Daylight Time >Message-id: <1095463451.yrAb+lGMP7KzhxdXfA3PMA@teranews> >Being male, over the age of 35, and exposed to lots of radiation from >cathing folks are 3 that immediately come to mind. hmmm...without hospital privileges where do you cath?? also ...surely they have lead aprons.. that is...if you really do catheterize hearts... IMHO...all knowledgable interventional cardiologists wear lead aprons.. hawki..... > >Subject: Re: Cholesterol Advice Needed > >From: "Dr. Andrew B. Chung, MD/PhD" andrew@heartmdphd.com [quoted text clipped - 5 lines] > > hmmm...without hospital privileges where do you cath?? Such information about my access to hospitals is strictly need to know. You can imagine how many stalkers would like to know. When I die again, it won't be because I invited it but because my heavenly Father called me home. > also ...surely they have lead aprons.. None that cover the shoulders or under the arm. Radiation is line of sight like bullets. And just as bullet-proof vests are vulnerable under the arm or through the shoulder so too are lead vests. > that is...if you really do catheterize hearts... I do. Dr. Spencer King, III (Lead investigator in the EAST trial) taught me how years ago. I use the King MP-A2 (yes the catheter is named after him) to engage the left main in my angiograms. Yes, I am thankful to my heavenly Father and the "side holes" of the multi-purpose when I engage a tight ostial left main. If I ever have a cath, may the person doing mine know to use a multi-purpose. > IMHO...all knowledgable interventional cardiologists wear lead aprons.. I also wear custom-made prescription lead-glasses. > hawki..... You remain in my prayers, dear neighbor whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > Or you have other risk factors you want to address (only comes to mind > > family history)? > > Being male, over the age of 35, and exposed to lots of radiation from OK, so being male over 35 warrants taking ASA? Please do no get me wrong, I think that it is quite reasonable, I just want to know your opinion. Mirek > > > Or you have other risk factors you want to address (only comes to > mind [quoted text clipped - 3 lines] > > OK, so being male over 35 warrants taking ASA? Maybe. However, my rule of thumb is 3 strikes or more plus no contraindications. "Three strikes and you are out." > Please do no get me wrong, I think that it is quite reasonable, I just > want to know your opinion. You've got it. > Mirek You remain in my prayers, dear neighbor whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > OK, so being male over 35 warrants taking ASA? > > Maybe. However, my rule of thumb is 3 strikes or more plus no > contraindications. "Three strikes and you are out." Thanks. Sound reasonable. Mirek If Paul wants to follow the medical guidelines, he should allow himself 3 months of diet/lifestyle changes - and if necessary - still take the statins. > > Paul, > > [quoted text clipped - 24 lines] > Is this spam? > http://makeashorterlink.com/?N69721867 > If Paul wants to follow the medical guidelines, he should allow > himself 3 months of diet/lifestyle changes - and if necessary - still > take the statins. Better would be to place greater weight on his doctor's suggestions than on either yours or mine. You remain in my prayers, dear Brad whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > If Paul wants to follow the medical guidelines, he should allow > himself 3 months of diet/lifestyle changes - and if necessary - still > take the statins. I would suggest six months Brad (and Paul). It takes approx. three months to build the habit of daily exercise. And it takes approx. six months of progressive increased difficulty before he would be exercising daily at a high enough intensity to lower cholesterol. By that time he should be doing 45 minutes gym at his maxiumum (upper body one day lower next) 30-45 at heart rate running or power walking, and appropriate cool down, maybe followed by a swim, yoga or meditation. Zee > > > Paul, > > > [quoted text clipped - 24 lines] > > Is this spam? > > http://makeashorterlink.com/?N69721867 > > I have the following results and would appreciate suitable advice:- > > [quoted text clipped - 29 lines] > Means 3 of 100 people with this level of risk will have a heart attack > in the next 10 years. Wow, this is very low risk, whereas my doctor appeared very concerned that I should consider start taking statins pretty soon, he really did unravel me. Taking statins is not worthwhile for going 3% to 2% considering the health risks I have since read about re statins. Even articles stating high cholesterol is good. > > 2. What are your top 3 suggestions for me to lower my chol. (without > > drugs) [quoted text clipped - 21 lines] > > Mirek > > Risk Score* 3% > > Means 3 of 100 people with this level of risk will have a heart attack [quoted text clipped - 3 lines] > that I should consider start taking statins pretty soon, he really did > unravel me. Well, there are to possible view on this situation: a) never trust stranger unqualified in medicine you over USENET b) there is "cholesterol hype" induced by statin producing companies and docs eager to cure disease that does not exist > Taking statins is not worthwhile for going 3% to 2% considering the > health risks I have since read about re statins. c) statin health risks are hyped by anti statin activists. Actually, less that 5% of people have any problems with statins. Maybe going from 3% to 2% is worth it. > Even articles stating high cholesterol is good. Be careful. It is possible to post virtually anything using web... In any case, there is not hurry. You probably had high LDL last 30 years or so. Several more months with high LDL are unlikely to change a lot. Study, try lifestyle changes (but not everything commonly adviced is good, especially low-fat dieting might not give endpoints you expect) and then decide. Mirek > Hello > [quoted text clipped - 19 lines] > 5. How is tot chol. calculated to get the 251? > 6. The above units are mg%, I assume this is the same as mg/dl? Paul Some information you should print out and discuss with your physician: http://www.newsday.com/news/health/columnists/ny-dsrabin3881826jul06,0,869402.co lumn?coll=ny-health-columnists "Last year, scientists at the University of British Columbia's Therapeutics Initiative came to a similar conclusion about the use of statins in men who didn't have prior heart disease. Sure, they had fewer heart attacks - but they still died at the same rate. "What we're hypothesizing is that there was some other harm" associated with the medication, said Dr. Jim Wright, the clinical pharmacologist who did the study, funded entirely by a grant from British Columbia's health department. "That really should concern people." "Before we prescribe this to millions of people who are basically healthy, we should be proving that the overall benefits outweigh the harms," he said. "And we don't think that's the case." Health consumer advocates, such as Maryann Napoli of the Center for Medical Consumers, have expressed concerns about statins, which have been linked to muscle problems, including a rare condition that can be fatal. The FDA banned Baycol in 2001; last week, Public Citizen's Health Research Group called for banning Crestor. The drugs do reduce blood cholesterol levels. But the relationship between high cholesterol and heart disease is not so simple,... ." ~~~~~~~~~~~~~~~~~~~~~~~~~~ Do statins have a role in primary prevention? http://www.ti.ubc.ca/pages/letter48.htm Conclusions: If cardiovascular serious adverse events are viewed in isolation, 71 primary prevention patients with cardiovascular risk factors have to be treated with a statin for 3 to 5 years to prevent one myocardial infarction or stroke. This cardiovascular benefit is not reflected in 2 measures of overall health impact, total mortality and total serious adverse events. Therefore, statins have not been shown to provide an overall health benefit in primary prevention trials." Zee > > Hello > > [quoted text clipped - 26 lines] > > http://www.newsday.com/news/health/columnists/ny-dsrabin3881826jul06,0,869402.co lumn?coll=ny-health-columnists OK, but there appears to be big differences between men and women, this article is primarily about women. > "Last year, scientists at the University of British Columbia's > Therapeutics Initiative came to a similar conclusion about the use of [quoted text clipped - 35 lines] > > Zee >> Some information you should print out and discuss with your physician: >> >> http://www.newsday.com/news/health/columnists/ny-dsrabin3881826jul06,0,869402.co lumn?coll=ny-health-columnists > > OK, but there appears to be big differences between men and women, > this article is primarily about women. And note this is by a columnist giving her opinion in a newspaper. Not a medical journal, not even a reporter. Bill > >> Some information you should print out and discuss with your physician: http://www.newsday.com/news/health/columnists/ny-dsrabin3881826jul06,0,869402.co lumn?coll=ny-health-columnists > > OK, but there appears to be big differences between men and women, > > this article is primarily about women. [quoted text clipped - 3 lines] > > Bill The quote was from Dr. James Wright, member of the Cochrane Collaboration and head of Therapeutics Initiative. James Wright is a doctor of pharmacology, member of the Cochrane Collaboration, and head of Therapeutics Initiative, an epidemiology group at the University of British Columbia Canada. TI receives no industry funding but is funded entirely by the British Columbia Ministry of Health. I apologize for not ending my quoted material at the end of Wright's quote. It made it confusing. Here is what I posted, with the information I should have dropped, as it introduces someone else, in brackets... ****************************************** Some information you should print out and discuss with your physician: http://www.newsday.com/news/health/columnists/ny-dsrabin3881826jul06,... "Last year, scientists at the University of British Columbia's Therapeutics Initiative came to a similar conclusion about the use of statins in men who didn't have prior heart disease. Sure, they had fewer heart attacks - but they still died at the same rate. "What we're hypothesizing is that there was some other harm" associated with the medication, said Dr. Jim Wright, the clinical pharmacologist who did the study, funded entirely by a grant from British Columbia's health department. "That really should concern people." "Before we prescribe this to millions of people who are basically healthy, we should be proving that the overall benefits outweigh the harms," he said. "And we don't think that's the case." {{{{Health consumer advocates, such as Maryann Napoli of the Center for Medical Consumers, have expressed concerns about statins, which have been linked to muscle problems, including a rare condition that can be fatal. The FDA banned Baycol in 2001; last week, Public Citizen's Health Research Group called for banning Crestor. The drugs do reduce blood cholesterol levels. But the relationshipbetween high cholesterol and heart disease is not so simple,... ."}}}} >From the Therapeutics Initiative website: ~~~~~~~~~~~~~~~~~~~~~~~~~~ Do statins have a role in primary prevention? http://www.ti.ubc.ca/pages/letter48.htm Conclusions: If cardiovascular serious adverse events are viewed in isolation, 71 primary prevention patients with cardiovascular risk factors have to be treated with a statin for 3 to 5 years to prevent one myocardial infarction or stroke. This cardiovascular benefit is not reflected in 2 measures of overall health impact, total mortality and total serious adverse events. Therefore, statins have not been shown to provide an overall health benefit in primary prevention trials." > > > Hello > > > [quoted text clipped - 24 lines] > > > > Some information you should print out and discuss with your physician: http://www.newsday.com/news/health/columnists/ny-dsrabin3881826jul06,0,869402.co lumn?coll=ny-health-columnists > OK, but there appears to be big differences between men and women, > this article is primarily about women. [quoted text clipped - 38 lines] > > > > Zee "Last year, scientists at the University of British Columbia's Therapeutics Initiative came to a similar conclusion about the use of statins in men who didn't have prior heart disease. Sure, they had fewer heart attacks - but they still died at the same rate. "What we're hypothesizing is that there was some other harm" associated with the medication, said Dr. Jim Wright, the clinical pharmacologist who did the study, funded entirely by a grant from British Columbia's health department. "That really should concern people." "Before we prescribe this to millions of people who are basically healthy, we should be proving that the overall benefits outweigh the harms," he said. "And we don't think that's the case." The quote pertaining to you is from the newspaper article. The person quoted is this person. He is Dr. James Wright head of Therapeutics Initiative and a member of the Cochrane Collaboration. James Wright Therapeutics Initiative http://www.ti.ubc.ca/pages/letter48.htm Zee Here is some reading material for you: http://www.thincs.org/ Alan > Hello > [quoted text clipped - 19 lines] > 5. How is tot chol. calculated to get the 251? > 6. The above units are mg%, I assume this is the same as mg/dl? > Here is some reading material for you: > > http://www.thincs.org/ Alan How widely are some of these issues accepted - Dangers/side effects of statins? Mortality generally not improved with statins? High cholesterol is good for you? > Alan > [quoted text clipped - 21 lines] > > 5. How is tot chol. calculated to get the 251? > > 6. The above units are mg%, I assume this is the same as mg/dl? The truth of the matter may have little to do with what is currently widely accepted. Science is not a democratic process, and truth is not a matter for a vote. I find the arguments against the established ideas more than credible. The financial interests which back the status quo are formidable, however. Many who argue against them seem to have few vested interests and do support their claims with extensive references in the peer-reviewed literature. Typically these are retirees since they would otherwise have suffered professionally to go public sooner. You might want to do some reading on the history of the whole cholesterol/sat fat/heart disease idea. Ravnskov's book is a quick and thorough read on the subject. I also enjoyed books by Enig, McGee, and a couple of others listed on that site. One other good cross reference on this is to look at recent books by aging researchers (e.g. Austad, Finch, Kirkwood) as well as studying some nutritional biochemistry (e.g. Stipanuk). Seems a great deal can be found in accordance with the idea that the lipid theory is wrong, and that we should be more worried about refined carbohydrates, processed foods, and chronic imflammatory processes. If you also do some Pubmed searches on research into atherogenesis, you will find a great deal going on in areas unrelated to cholesterol or fat intake. Seems quite a few researchers are betting that answers to the CHD puzzle will be found elsewhere (and implicitly that current hypotheses are lacking). Personally I've adopted a restricted carbohydrate, high sat-fat diet over a year a go. (I eat mainly whole unprocessed foods, no fast food, and cook everything fresh or eat it raw.) I've effortlessly lost all of the excess weight I gained over 25 years, and have had complete relief from several long term health problems, one of them chronically debilitating. My blood sugar stays locked in at the levels my liver maintains, my triglycerides are very low, and my LDL has remained the same as it was on the low fat diet I was on for 20 years. Other measures have improved, and I've had an echocardiogram which showed no sign of disease. For now this is the choice I am making, though I'm keeping my eye on the scientific literature as new findings come out, and of course watching the impact on my own health. So far ignoring the established advice has been all good for me. Alan > > Here is some reading material for you: > > [quoted text clipped - 33 lines] > > > 5. How is tot chol. calculated to get the 251? > > > 6. The above units are mg%, I assume this is the same as mg/dl? > The truth of the matter may have little to do with what is currently > widely accepted. Science is not a democratic process, and truth is [quoted text clipped - 40 lines] > > Alan Very interesting Alan. Thank you for posting this. Although I don't follow the Thincs ideas (too afraid to with a very elevated cholesterol level) I am familiar with the web site and converse regularly with Dr. Ravnskov on the statin issue. But the food theories, for me, I just don't know.... . So happy it is working for you. Zee > > "Alan Wright" <alan@yahoo.com> wrote in message > news:<IISdnbpQA-Iub9XcRVn-rg@giganews.com>... [quoted text clipped - 35 lines] > > > > 5. How is tot chol. calculated to get the 251? > > > > 6. The above units are mg%, I assume this is the same as mg/dl? > The truth of the matter may have little to do with what is currently > widely accepted. Science is not a democratic process, and truth is > not a matter for a vote. Correct. > I find the arguments against the established > ideas more than credible. That does not mean these arguments represent the truth. > The financial interests which back the > status quo are formidable, however. The financial interests actually back *new* drugs and *new* targets. Patents do expire afterall. > Many who argue against them > seem to have few vested interests and do support their claims with > extensive references in the peer-reviewed literature. All is not what they may seem. > Typically these > are retirees since they would otherwise have suffered professionally > to go public sooner. That is one way to look at it. Another way would be that these folks were always on the fringe and retired early because of this. > You might want to do some reading on the history of the whole > cholesterol/sat fat/heart disease idea. Ravnskov's book is a quick > and thorough read on the subject. I also enjoyed books by Enig, > McGee, and a couple of others listed on that site. They all have a hard time explaining the animal models of atherosclerosis. > One other good cross reference on this is to look at recent books > by aging researchers (e.g. Austad, Finch, Kirkwood) as well as studying [quoted text clipped - 4 lines] > searches on research into atherogenesis, you will find a great deal going > on in areas unrelated to cholesterol or fat intake. Most regard elevated serum cholesterol as a permissive condition. > Seems quite a few > researchers are betting that answers to the CHD puzzle will be found > elsewhere (and implicitly that current hypotheses are lacking). These folks have lost the bet with the discovery of "reverse cholesterol transport." > Personally I've adopted a restricted carbohydrate, high sat-fat > diet over a year a go. (I eat mainly whole unprocessed foods, > no fast food, and cook everything fresh or eat it raw.) Uh-oh. > I've > effortlessly lost all of the excess weight I gained over 25 years, > and have had complete relief from several long term health > problems, one of them chronically debilitating. I would be concerned about hyperketonemia being behind your loss of appetite. > My blood sugar > stays locked in at the levels my liver maintains, my triglycerides > are very low, and my LDL has remained the same as it was on > the low fat diet I was on for 20 years. With the weight loss, it should be lower. > Other measures have > improved, and I've had an echocardiogram which showed no > sign of disease. An echocardiogram won't until *after* your heart has suffered injury. > For now this is the choice I am making, though I'm keeping > my eye on the scientific literature as new findings come out, > and of course watching the impact on my own health. So far > ignoring the established advice has been all good for me. May that not be your epitaph. > Alan You will be in my prayers, dear neighbor whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > Seems quite a few > > researchers are betting that answers to the CHD puzzle will be found > > elsewhere (and implicitly that current hypotheses are lacking). > > These folks have lost the bet with the discovery of "reverse cholesterol > transport." What do you exactly mean by "reverse cholesterol transport"? HDL and atherogenic ratio? (Please, I do not expect detailed answer, but some link would be helpful.) Mirek > > > Seems quite a few > > > researchers are betting that answers to the CHD puzzle will be found [quoted text clipped - 5 lines] > > What do you exactly mean by "reverse cholesterol transport"? http://makeashorterlink.com/?L2A913059 > HDL and > atherogenic ratio? Not quite. > (Please, I do not expect detailed answer, but some link would be > helpful.) (You've got it) > Mirek You remain in my prayers, dear Mirek whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > What do you exactly mean by "reverse cholesterol transport"? > > http://makeashorterlink.com/?L2A913059 I gess it is not the most informative link, but interesting anyway. I just hope these drugs will be available when I will need them:) Mirek > > Seems quite a few > > researchers are betting that answers to the CHD puzzle will be found > > elsewhere (and implicitly that current hypotheses are lacking). > > These folks have lost the bet with the discovery of "reverse cholesterol > transport." BTW, as you probably really mean the role of HDL and TC/HDL ratio, how do you think they lost the bet? Mirek > > > Seems quite a few > > > researchers are betting that answers to the CHD puzzle will be found [quoted text clipped - 6 lines] > BTW, as you probably really mean the role of HDL and TC/HDL ratio, how > do you think they lost the bet? http://makeashorterlink.com/?L2A913059 > Mirek YOu remain in my prayers, dear Mirek whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > > > Seems quite a few > > > > researchers are betting that answers to the CHD puzzle will be found [quoted text clipped - 8 lines] > > http://makeashorterlink.com/?L2A913059 Sorry, Andrew, but I do not understand what exactly do you mean. This link is about drug, not about lipid theory. This drug is able to raise HDL and it is also able to remove plague. Did you want to say that this drug demonstrates that low HDL causes CAD? Or what? Mirek > > > > > Seems quite a few > > > > > researchers are betting that answers to the CHD puzzle will be [quoted text clipped - 13 lines] > Sorry, Andrew, but I do not understand what exactly do you mean. This > link is about drug, not about lipid theory. The existence of such a "drug" and its properties supports the theory of "reverse cholesterol transport." > This drug is able to raise HDL and it is also able to remove plague. Did > you want to say that this drug demonstrates that low HDL causes CAD? No. > Or > what? See above. > Mirek You remain in my prayers, dear Mirek whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > Sorry, Andrew, but I do not understand what exactly do you mean. This > > link is about drug, not about lipid theory. > > The existence of such a "drug" and its properties supports the theory of > "reverse cholesterol transport." OK, so we have reverse cholesterol transport. Good to know, but one would expect it based on Framingham study. How does it makes scientists doubting significance of TC levels on heart disease wrong? I think it equivalently makes them right. Mirek > > > Sorry, Andrew, but I do not understand what exactly do you mean. > This [quoted text clipped - 6 lines] > OK, so we have reverse cholesterol transport. Good to know, but one > would expect it based on Framingham study. The Framingham Heart Study was an epidemiological study. Such studies rarely if ever shed light on the underlying mechanism of an observed phenomenon. > How does it makes scientists doubting significance of TC levels on heart > disease wrong? Those opposed to the "cholesterol theory of vascular disease" have generally proposed mechanisms that are independent of cholesterol. "Reverse cholesterol transport" is a mechanism of vascular disease reversal that firmly entrenches the role of cholesterol in the pathophysiology of this disease. > I think it equivalently makes them right. You are entitled to hold unfounded opinions. > Mirek You remain in my prayers, dear Mirek whom I love. May God bless you today. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > How does it makes scientists doubting significance of TC levels on heart > > disease wrong? [quoted text clipped - 4 lines] > reversal that firmly entrenches the role of cholesterol in the > pathophysiology of this disease. Good and reasonable answer. Anyway, just because drug that is _supposed_ to perform reverse cholesterol transport decreases plague does not neccessary imply that LDL levels alone are causative to creation of this plague. Permisive condition - perhaps. But as long as there are people with high LDL, low HDL and no CAD, things seem to be more complicated than simple cholesterol balance. Mirek > > > How does it makes scientists doubting significance of TC levels on > heart [quoted text clipped - 11 lines] > cholesterol transport decreases plague does not neccessary imply that > LDL levels alone are causative to creation of this plague. Those who subscribe to the "cholesterol theory of vascular disease" are not claiming that LDL levels *alone* cause the disease but rather that it is an important risk factor that should be lowered if one of the goals is prevention (either primary or secondary). > Permisive > condition - perhaps. But as long as there are people with high LDL, low > HDL and no CAD, things seem to be more complicated than simple > cholesterol balance. The problem is that short of a autopsy we do not have a good way of definitively saying that someone has *no CAD*. And, indeed autopsies of young men who have died in combat leads us to believe the there is some degree of CAD in *everyone* with high LDL and low HDL. > Mirek You remain in my prayers, dear Mirek whom I love. May God bless you on this Lord's day. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > And, indeed autopsies > of young men who have died in combat leads us to believe the there is > some degree of CAD in *everyone* with high LDL and low HDL. At my last checkup and review of my stress-echo my cardiologist stated that plaque build up on the order of up to 40 and 50% of the arterial cross section are quite common and come and go over time. If this is an accurate observation, then perhaps the military autopsies merely showed instances of the ebb and flow rather than the foundations for a continuous build up over a lifetime. > > And, indeed autopsies > > of young men who have died in combat leads us to believe the there is [quoted text clipped - 3 lines] > that plaque build up on the order of up to 40 and 50% of the arterial > cross section are quite common and come and go over time. I might believe such a conversation taking place after an angiogram but not after a stress-echo which is not a test that can quantify the degree of plaque build-up. > If this is an > accurate observation, It is not. > then perhaps the military autopsies merely showed > instances of the ebb and flow rather than the foundations for a > continuous build up over a lifetime. That would not explain the pristinely clean coronary arteries of those young men with low LDL and high HDL. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > > And, indeed autopsies > > > of young men who have died in combat leads us to believe the there is [quoted text clipped - 38 lines] > Is this spam? > http://makeashorterlink.com/?N69721867 Why do you have to post all of your Jesus nonsense in Usenet? There are many people who do not believe in such fairy tales. -- Robert Schuh "Everything that elevates an individual above the herd and intimidates the neighbour is henceforth called evil; and the fair, modest, submissive and conforming mentality, the mediocrity of desires attains moral designations and honors" - Nietzsche > Why do you have to post all of your Jesus nonsense in Usenet? There are many > people who do not believe in such fairy tales. [quoted text clipped - 6 lines] > the mediocrity of desires attains moral designations and honors" > - Nietzsche Save your breath. Andrew Chung is a religious zealot and cross-posting internet whacko of long standing. He is convinced that he is on a mission from god, and has been granted special powers of "truth discernment" that other mere mortals are not privy to. A Google Groups search for "Andrew Chung Troll" returns nearly 1700 hits: http://groups.google.com/groups?sourceid=navclient&ie=UTF-8&q=andrew+chung+troll A similar search for "Andrew Chung idiot" returns over 2000 hits: http://groups.google.com/groups?sourceid=navclient&ie=UTF-8&q=andrew+chung+idiot GG > > Why do you have to post all of your Jesus nonsense in Usenet? There are > many [quoted text clipped - 10 lines] > Save your breath. Andrew Chung is a religious zealot and cross-posting > internet whacko of long standing. Ouch. You may have at the other cheek. > He is convinced that he is on a mission > from god, and has been granted special powers of "truth discernment" that > other mere mortals are not privy to. There remains others who have also been given this spiritual gift from God. > A Google Groups search for "Andrew Chung Troll" returns nearly 1700 hits: As discussed before, the same search for "Andrew Chung Cardiologist returns over 14,400 hits. http://groups.google.com/groups?sourceid=navclient&ie=UTF-8&q=andrew+chung+cardi ologist Truth is simple. You remain in my prayers, dear Gary whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 >> > > And, indeed autopsies >> > > of young men who have died in combat leads us to believe the [quoted text clipped - 42 lines] > Why do you have to post all of your Jesus nonsense in Usenet? There > are many people who do not believe in such fairy tales. Uh...because he's a kook? L. > >> That would not explain the pristinely clean coronary arteries of > >> those young men with low LDL and high HDL. > > Why do you have to post all of your Jesus nonsense in Usenet? There > > are many people who do not believe in such fairy tales. [quoted text clipped - 3 lines] > http://groups.google.com/groups?sourceid=navclient&ie=UTF-8&q=andrew+chung+cardi ologist > L. Correct. You remain in my prayers, dear Frank whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > Why do you have to post all of your Jesus nonsense in Usenet? There are many > people who do not believe in such fairy tales. Since when is Usenet only for the posting of what you determine to be untrue? >>Why do you have to post all of your Jesus nonsense in Usenet? There are many >>people who do not believe in such fairy tales. > > Since when is Usenet only for the posting of what you determine to be > untrue? Um... somebody wanna help him with this... Bob > >>Why do you have to post all of your Jesus nonsense in Usenet? There are many > >>people who do not believe in such fairy tales. [quoted text clipped - 3 lines] > > Um... somebody wanna help him with this... What? Are you having trouble setting up a killfile? Priscilla >>>>Why do you have to post all of your Jesus nonsense in Usenet? There are many >>>>people who do not believe in such fairy tales. [quoted text clipped - 5 lines] > > What? Are you having trouble setting up a killfile? Of course not; I wasn't asking for anything for myself. I was just asking for help for my worthy brother here from people who can see his logical and language flaws and help him into the light of English usage that makes sense. It was a purely altruistic plea for remedial assistance for a downtrodden loser to be brought to the level of, like, a normal person. Oh, I see what you mean. Better to just lop him off at the knees, huh? Bob > >>>>Why do you have to post all of your Jesus nonsense in Usenet? There are many > >>>>people who do not believe in such fairy tales. [quoted text clipped - 9 lines] > > Bob You poor guy. You remain in my prayers, dear Bob whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 >>>>>>Why do you have to post all of your Jesus nonsense in Usenet? There are many >>>>>>people who do not believe in such fairy tales. [quoted text clipped - 7 lines] >> >><hiss sputter hiss hiss> <LOL> Bob > > >>Why do you have to post all of your Jesus nonsense in Usenet? There are many > > >>people who do not believe in such fairy tales. [quoted text clipped - 7 lines] > > Priscilla Bob is in a lot of trouble. Would suggest you pray for him, dear Priscilla whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 BOB: >>> Um... somebody wanna help him with this... >> What? Are you having trouble setting up a killfile? >> >> Priscilla > Bob is in a lot of trouble. > > Would suggest you pray for him, dear Priscilla whom I love. Prayer will help. My sense is he will need, in the near future, "temporal" assistance. Maybe he and Nagler can eat lunch together. >> >>Why do you have to post all of your Jesus nonsense in Usenet? There >> >>are many people who do not believe in such fairy tales. [quoted text clipped - 7 lines] > > Priscilla I finally set one up. Should have done it a while ago. Now, it's almost a pleasure reading the group (....well, not really). Seriously, it's unfortunately, the *only* way to deal (cope) with kooks like Dr. Chung, Carol T and the like. L. <snip> > > That would not explain the pristinely clean coronary arteries of those > > young men with low LDL and high HDL. > Why do you have to post all of your Jesus nonsense in Usenet? Sorry you feel that Christ is nonsense. > There are many > people who do not believe in such fairy tales. Sorry you feel that the Gospels are fairy tales. You will be in my prayers, dear Robert whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > The problem is that short of a autopsy we do not have a good way of > definitively saying that someone has *no CAD*. And, indeed autopsies > of young men who have died in combat leads us to believe the there is > some degree of CAD in *everyone* with high LDL and low HDL. As is *some* degree of CAD in *everyone* with high HDL and low LDL.... Mirek > > The problem is that short of a autopsy we do not have a good way of > > definitively saying that someone has *no CAD*. And, indeed autopsies > > of young men who have died in combat leads us to believe the there is > > some degree of CAD in *everyone* with high LDL and low HDL. > > As is *some* degree of CAD in *everyone* with high HDL and low LDL.... The latter folks have no CAD on autopsy. > Mirek You remain in my prayers, dear Mirek whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > The truth of the matter may have little to do with what is currently > > widely accepted. Science is not a democratic process, and truth is [quoted text clipped - 6 lines] > > That does not mean these arguments represent the truth. Nor does it mean they are not. But I am qualified to judge their merits, especially when it comes to the mathematical sleight of hand employed in interpreting statistical results. > > The financial interests which back the > > status quo are formidable, however. > > The financial interests actually back *new* drugs and *new* targets. Patents do > expire afterall. Let's then hope that we eventually get new drugs that do something helpful, rather than a nightmare like statins and predecessors. > > Many who argue against them > > seem to have few vested interests and do support their claims with > > extensive references in the peer-reviewed literature. > > All is not what they may seem. Perhaps, but I often run down the references and look at raw data myself. I also focus on papers or books which do provide extensive references to the peer-reviewed literature. > > Typically these > > are retirees since they would otherwise have suffered professionally > > to go public sooner. > > That is one way to look at it. Another way would be that these folks were > always on the fringe and retired early because of this. Irrelevant. Does not change the data, nor my personal results. > > You might want to do some reading on the history of the whole > > cholesterol/sat fat/heart disease idea. Ravnskov's book is a quick > > and thorough read on the subject. I also enjoyed books by Enig, > > McGee, and a couple of others listed on that site. > > They all have a hard time explaining the animal models of atherosclerosis. Not at all. The subject is well treated in the literature I've been exposed to. And of course animal models are not in general directly relevant or predictive for humans. Until results with animals are actually shown to be reproducible in humans, it cannot be assumed that they will. > > One other good cross reference on this is to look at recent books > > by aging researchers (e.g. Austad, Finch, Kirkwood) as well as studying [quoted text clipped - 6 lines] > > Most regard elevated serum cholesterol as a permissive condition. As distinct from a causative factor. It is irrational to attempt to defeat a normal and essential biochemical condition simply because it is permissive of a potential disease process with a separate cause, especially when the methods are exceedingly crude and on the whole ineffective, and in fact promote a wide range of other disease processes. Studies show that cholesterol lowering is a bad idea for almost everyone. > > Seems quite a few > > researchers are betting that answers to the CHD puzzle will be found > > elsewhere (and implicitly that current hypotheses are lacking). > > These folks have lost the bet with the discovery of "reverse cholesterol > transport." Just another questionable way to attack symptoms when instead the cause should be prevented. > > Personally I've adopted a restricted carbohydrate, high sat-fat > > diet over a year a go. (I eat mainly whole unprocessed foods, > > no fast food, and cook everything fresh or eat it raw.) > > Uh-oh. Not! Best decision I ever made relative to current quality of life improvement. Try not to be so confined to old-school and cardiocentric thinking. I do note that since you cannot get past the rather primitive superstitions your were taught as a child, you may well have similar trouble accepting scientific data that conflict with your current medical indoctrination. > > I've > > effortlessly lost all of the excess weight I gained over 25 years, > > and have had complete relief from several long term health > > problems, one of them chronically debilitating. > > I would be concerned about hyperketonemia being behind your loss of appetite. Not even a remote possibility. I have not needed to achieve ketosis for quite a long long time (if I ever did). My appetite is great, but non carbohydrate rich foods do not cause me to gain weight. You ought to bone up on how these diets are done and what they achieve past the initial rapid weight loss phases. Now if you want to argue that my exceptionally stable and low blood sugar levels (achieved via almost constant gluconeogenesis) are harmful then show me the research. Note that high blood sugar levels have much better correlation with cardiovascular disease that any level of any cholesterol fraction. > > My blood sugar > > stays locked in at the levels my liver maintains, my triglycerides > > are very low, and my LDL has remained the same as it was on > > the low fat diet I was on for 20 years. > > With the weight loss, it should be lower. It's not. But my levels have never been very high, and they have followed a pretty typical age-related curve. > > Other measures have > > improved, and I've had an echocardiogram which showed no > > sign of disease. > > An echocardiogram won't until *after* your heart has suffered injury. Duh! Obviously, I've suffered no injury to date. Until I see at least some inkling that I have, I see no reason to alter my course. > > For now this is the choice I am making, though I'm keeping > > my eye on the scientific literature as new findings come out, > > and of course watching the impact on my own health. So far > > ignoring the established advice has been all good for me. > > May that not be your epitaph. Time will tell, and for now I place my bets on nutritional biochemistry and other science over cardiology, as the latter has been a complete and utter failure for all those in my extended family that have had such involvement. None of the drugs, surgeries, or devices has done anything to extend or improve quality of life. I will try a different path until new data comes out that can change my mind. Alan > > > The truth of the matter may have little to do with what is currently > > > widely accepted. Science is not a democratic process, and truth is [quoted text clipped - 8 lines] > > Nor does it mean they are not. However, I discern that thay do not represent the truth. > But I am qualified to judge > their merits, especially when it comes to the mathematical > sleight of hand employed in interpreting statistical results. I would suggest you look at the data. You can start with Framingham. > > > The financial interests which back the > > > status quo are formidable, however. [quoted text clipped - 5 lines] > Let's then hope that we eventually get new drugs that do something > helpful, rather than a nightmare like statins and predecessors. Most folks on statins are not having nightmares with it. > > > Many who argue against them > > > seem to have few vested interests and do support their claims with [quoted text clipped - 5 lines] > data myself. I also focus on papers or books which do provide > extensive references to the peer-reviewed literature. Then you should conclude that LDL should be lowered and HDL should be raised if the goal is to prevent atherosclerosis. > > > Typically these > > > are retirees since they would otherwise have suffered professionally [quoted text clipped - 4 lines] > > Irrelevant. Does not change the data, nor my personal results. The same could be said for your current view. > > > You might want to do some reading on the history of the whole > > > cholesterol/sat fat/heart disease idea. Ravnskov's book is a quick [quoted text clipped - 5 lines] > Not at all. The subject is well treated in the literature I've been exposed > to. It seems by your next statement, your exposure has been "kill-filtered." > And of course animal models are not in general directly relevant or > predictive > for humans. Until results with animals are actually shown to be reproducible > in humans, it cannot be assumed that they will. The disease that is reproduced in the animal models occurs under conditions that humans are currently exposed to in the societies with high rates of atherosclerotic disease. > > > One other good cross reference on this is to look at recent books > > > by aging researchers (e.g. Austad, Finch, Kirkwood) as well as studying [quoted text clipped - 14 lines] > promote a wide range of other disease processes. Studies show that > cholesterol lowering is a bad idea for almost everyone. You are welcome to cite the studies. I would be more than happy to give you my professional comments on each. > > > Seems quite a few > > > researchers are betting that answers to the CHD puzzle will be found [quoted text clipped - 5 lines] > Just another questionable way to attack symptoms when instead the > cause should be prevented. This is a observed phenomenon rather than a treatment. > > > Personally I've adopted a restricted carbohydrate, high sat-fat > > > diet over a year a go. (I eat mainly whole unprocessed foods, [quoted text clipped - 5 lines] > improvement. > Try not to be so confined to old-school and cardiocentric thinking. The mission here is to prevent catastrophic cardiovascular events. > I do > note [quoted text clipped - 3 lines] > conflict > with your current medical indoctrination. Sorry my being openly Christian distracts you. > > > I've > > > effortlessly lost all of the excess weight I gained over 25 years, [quoted text clipped - 9 lines] > rich > foods do not cause me to gain weight. They would if you ate more of them. > You ought to bone up on how these > diets are done and what they achieve past the initial rapid weight loss > phases. It is doubtful that my reviewing your diet methodologies would reveal another explanation for your loss of appetite. > Now if you want to argue that my exceptionally stable and low blood sugar > levels (achieved via almost constant gluconeogenesis) are harmful then show > me the research. Why would I want to do that? My concern is your possibly having hyperketonemia because of inadequate dietary carbohydrates. Your body stores carbohydrates in the form of glycogen because carbohydrates are an essential macronutrient. > Note that high blood sugar levels have much better > correlation > with cardiovascular disease that any level of any cholesterol fraction. It seems you are confusing diabetes with high blood sugar. > > > My blood sugar > > > stays locked in at the levels my liver maintains, my triglycerides [quoted text clipped - 4 lines] > > It's not. Which is why I would be concerned. > But my levels have never been very high, and they have > followed a pretty typical age-related curve. Such age-related curves are better explained as a weight-related curve. > > > Other measures have > > > improved, and I've had an echocardiogram which showed no [quoted text clipped - 3 lines] > > Duh! There can be severe atherosclerotic disease *before* there is injury. President Clinton would be a timely illustrative case in point. He was also low-carbing. > Obviously, I've suffered no injury to date. Presumably by not obviously to me. > Until I see at > least some inkling that I have, I see no reason to alter my course. That was apparently President Clinton's philosophy on this topic. > > > For now this is the choice I am making, though I'm keeping > > > my eye on the scientific literature as new findings come out, [quoted text clipped - 8 lines] > involvement. None of the drugs, surgeries, or devices has done anything > to extend or improve quality of life. The lifestyle changes and medications work better when done *before* there is a cardiovascular "event." > I will try a different path until new > data comes out that can change my mind. Your informed choice for your health and your soul. > Alan You remain in my prayers, dear Alan whom I love. May Christ heal you as only He can. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 >There can be severe atherosclerotic disease *before* there is injury. > >President Clinton would be a timely illustrative case in point. > >He was also low-carbing. Big Macs and fries are *not* low-carb. Clinton was low-carbing maybe 3 months before the discovery of his heart problems, which were caused by a lifetime of junk food, not by his more recent (moderately) low-carb diet. --- Howard Lee Harkness General insurance information: http://www.HLHins.com Insurance for H1-Bs: http://www.H1Bins.com Healthcare for the uninsurable: http://www.AFFHC.com > >There can be severe atherosclerotic disease *before* there is injury. > > [quoted text clipped - 3 lines] > > Big Macs and fries are *not* low-carb. Correct. > Clinton was low-carbing maybe > 3 months before the discovery of his heart problems, which were caused > by a lifetime of junk food, not by his more recent (moderately) > low-carb diet. There is such an entity as accelerated coronary atherosclerosis (CAD). We can induce laboratory animals to go from *no* CAD to *severe* CAD in a matter of 3-6 months. We do this with a high lipid (low carb and low protein) diet. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > Big Macs and fries are *not* low-carb. Clinton was low-carbing maybe > 3 months before the discovery of his heart problems, which were caused > by a lifetime of junk food, not by his more recent (moderately) > low-carb diet. Your proof of this is.........? >>Big Macs and fries are *not* low-carb. Clinton was low-carbing maybe >>3 months before the discovery of his heart problems, which were caused >>by a lifetime of junk food, not by his more recent (moderately) >>low-carb diet. > > Your proof of this is.........? Step aside, flyweight. It's about science which we both know is far over your pretty little head. Bob > Hello > [quoted text clipped - 19 lines] > 5. How is tot chol. calculated to get the 251? > 6. The above units are mg%, I assume this is the same as mg/dl? I've had good luck using niacin to lower my LDL and triglycerides, and increase my HDL. I'm self-insured, with no drug benefits, so the cost of treatment is an issue for me. The niacin costs me less than 7 cents per day, compared to around $3 per day for prescription statins. Six years ago, my numbers were similar to yours (Total Cholesterol 248, HDL 58, LDL 160, Triglycerides 147). Today, they are: Total Cholesterol 181, HDL 75, LDL 91, Triglycerides 70). I take 3000 mg / day of niacin (2000 in the evening, and 1000 in the morning), but it takes a while to build up to this level, due to the "flushing" phenomenon. Some people can't tolerate it, but most develop a tolerance and I hardly every notice it anymore. You'll need to consult with your doctor before starting on niacin, and get some liver function blood tests after you've been on it a while to make sure you're not causing liver problems. If you're interested in more info on niacin, this book was pretty informative: http://www.amazon.com/exec/obidos/ASIN/0966256875/qid=1095360486/sr=ka-1/ref=pd_ ka_1/104-7862193-1013539 The author is a bit of an "evangelist", but his information is good and I've had very good results in controlling my cholesterol with this inexpensive approach. SignatureGG http://www.WeightWare.com Your Weight and Health Diary One more study for you: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 2818310&dopt=Abstract BACKGROUND: Low-density lipoprotein (LDL)-based guidelines are currently used to initiate and monitor cholesterol-lowering therapy. METHODS: Using stratified analyses, data from the Framingham Heart Study and the Coronary Primary Prevention Trial were evaluated to determine whether (1) cholesterol levels (total cholesterol [TC] or LDL [low-density lipoprotein]) better discriminated risk for coronary heart disease (CHD) than cholesterol ratios (LDL/HDL [high-density lipoprotein] or TC/HDL); and (2) whether changes in ratios better predicted risk reduction than changes in levels. RESULTS: Individuals with similar LDL/HDL ratios had similar risks for CHD regardless of whether they had high LDL levels or low LDL levels (23% vs 23% for the CPPT, 13.8% vs 14% for FHS men, and 8.6% vs 10.9% for FHS women). Among men with similar initial LDL/HDL ratios and similar changes in LDL/HDL ratios, risks for CHD did not differ (20.3% compared with 21.0%; p =0.96) between those with the largest and smallest reductions in LDL levels (21.3% compared with 6.5%). Among men with similar initial LDL levels and similar LDL reductions, a 20% reduction in risk for CHD was seen (19.5% compared with 24.5%; p =0.005) between those with the largest and smallest reductions in LDL/HDL ratios (23% compared with 4.6%). TC/HDL had predictive ability similar to LDL/HDL. CONCLUSIONS: Cholesterol levels do not provide incremental predictive value over cholesterol ratios in identifying people at risk for CHD. Changes in ratios are better predictors of successful CHD risk reduction than changes in levels. Future guidelines should consider incorporating ratios in initiating and monitoring successful lipid-lowering therapy. ************************ According to this study, you can forget about absolute TC values - only TC/HDL (or LDL/HDL) are predictive. 3.98 might not be ideal, but it is not the worst ratio either. Mirek > One more study for you: > [quoted text clipped - 30 lines] > According to this study, you can forget about absolute TC values - only > TC/HDL (or LDL/HDL) are predictive. As is LDL. > 3.98 might not be ideal, but it is not the worst ratio either. Better to strive for optimal. > Mirek You remain in my prayers, dear Mirek whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > One more study for you: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 2818310&dopt=Abstract > > BACKGROUND: Low-density lipoprotein (LDL)-based guidelines are currently > > used to initiate and monitor cholesterol-lowering therapy. METHODS: [quoted text clipped - 28 lines] > > As is LDL. Well, this estudy EXPLICITLY states that "Individuals with similar LDL/HDL ratios had similar risks for CHD regardless of whether they had high LDL levels or low LDL levels." and that "Cholesterol levels do not provide incremental predictive value over cholesterol ratios in identifying people at risk for CHD." I agree that LDL is still something different than TC, but I doubt that high TG would be protective... I also understand that this is just one study and one should not take definitive conclusions from it. > > 3.98 might not be ideal, but it is not the worst ratio either. > > Better to strive for optimal. Agree. Anyway, I think that original question was whether one should use statins in striving for optimal in case of TC/HDL at 4. Mirek > > > One more study for you: > > > [quoted text clipped - 59 lines] > I agree that LDL is still something different than TC, but I doubt that > high TG would be protective... High TG is not protective. > I also understand that this is just one study and one should not take > definitive conclusions from it. [quoted text clipped - 7 lines] > Anyway, I think that original question was whether one should use > statins in striving for optimal in case of TC/HDL at 4. Depends on the goals of treatment and the level of concern. > Mirek You remain in my prayers, dear Mirek whom I love. Servant to the humblest person in the universe, Andrew -- Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/ ** Who is the humblest person in the universe? http://makeashorterlink.com/?L26062048 What is all this about? http://makeashorterlink.com/?R20632B48 Is this spam? http://makeashorterlink.com/?N69721867 > > Anyway, I think that original question was whether one should use > > statins in striving for optimal in case of TC/HDL at 4. > > Depends on the goals of treatment and the level of concern. Sure, with family history, smoking or Mets it would be reasonable. Mirek |
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