OT - Statins and You

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Janknitz
Posts: 8410
Joined: Sat Mar 20, 2010 1:05 pm
Location: Northern California

Re: OT - Statins and You

Post by Janknitz » Mon May 14, 2012 2:04 pm

DTSM, I hope you will forgive me if you feel personally attacked, I assure you that is not my intent. Nor is it my intent to tell anybody if they should or should not take statins. That is a personal decision one should make in consultation with a physician whom you trust and who will thoroughly discuss the issues with you at your own level of interest and understanding.

I don't think there's anything wrong with dialog, just as there's nothing wrong with dialog about CPAP treatment or USDA dietary recommendations. Nor do I “question the proper use of statins”, though I do think that there is a whole lot of improper use of statins.

I hope that this dialog will remain open here, just like we tackle other issues here that affect our health and well-being. Most of us are here because we are independent and analytic thinkers, not followers “just because we are told so”. I don’t take ATP guidelines at face value any more than I take USDA “My Plate” guidelines (and we all see how well that’s turning out with rates of obesity, CVD, dementia and cancer soaring since the USDA started to tell us how to eat!), DME “rules” about what machines an insurance covers, or admonitions not to touch the settings on a CPAP machine at face value. I’m going to read what you so nicely provided, and then I’m going think for myself. I hope others will, too.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

dtsm
Posts: 1097
Joined: Sun Mar 08, 2009 8:34 am
Location: CT

Re: OT - Statins and You

Post by dtsm » Wed May 16, 2012 5:40 pm

Update re HDL. http://nyti.ms/Jtsf35

User avatar
Jay Aitchsee
Posts: 2936
Joined: Sun May 22, 2011 12:47 pm
Location: Southwest Florida

Re: OT - Statins and You

Post by Jay Aitchsee » Thu May 17, 2012 8:20 am

Oh great!

This is just the kind of thing that makes a person crazy (higher HDL levels do not protect from heart disease).

I wouldn’t be surprised if eventually it is determined that cholesterol levels have no correlation with heart disease (as some are saying now, but this article argues against) and efforts to reduce total cholesterol and LDL reduce risk, not by actually reducing those levels, but by simultaneously improving another condition, such as inflammation.

One thing, I bet, is that this study will be followed by several studies sponsored by drug companies which seem to contradict these findings and that drug X, which raises HDL, results in reduced risk of heart disease.

Thanks for the link,

Jay

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: S9 Auto, P10 mask, P=7.0, EPR3, ResScan 5.3, SleepyHead V1.B2, Windows 10, ZEO, CMS50F, Infrared Video

Janknitz
Posts: 8410
Joined: Sat Mar 20, 2010 1:05 pm
Location: Northern California

Re: OT - Statins and You

Post by Janknitz » Thu May 17, 2012 8:35 am

I wouldn’t be surprised if eventually it is determined that cholesterol levels have no correlation with heart disease (as some are saying now, but this article argues against) and efforts to reduce total cholesterol and LDL reduce risk, not by actually reducing those levels, but by simultaneously improving another condition, such as inflammation.
Jay, you're on the right path there. The reduction of inflammation will turn out in the end, I think, to be the only real benefit of statins. Meanwhile there are safer, easier, and less expensive means to reduce inflammation without pharmaceutical intervention that will work for most people.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

dtsm
Posts: 1097
Joined: Sun Mar 08, 2009 8:34 am
Location: CT

Re: OT - Statins and You

Post by dtsm » Thu May 17, 2012 1:23 pm

Jay Aitchsee wrote: I wouldn’t be surprised if eventually it is determined that cholesterol levels have no correlation with heart disease (as some are saying now, but this article argues against) and efforts to reduce total cholesterol and LDL reduce risk, not by actually reducing those levels, but by simultaneously improving another condition, such as inflammation.
This deals with HDL and underlying assumptions made in the past re positives of same. It's not a definitive study, just the first of it's kind.. The study has NOTHING to do with total cholesterol or LDL....don't jump to any conclusions [just yet]. Reduction of total cholesterol and LDL does reduce heart disease -- you too didn't take the time to read references cited in earlier link?

Jay Aitchsee wrote:One thing, I bet, is that this study will be followed by several studies sponsored by drug companies which seem to contradict these findings and that drug X, which raises HDL, results in reduced risk of heart disease.
If they do, they will be peer reviewed and evaluated accordingly. Trust me at this!

Janknitz
Posts: 8410
Joined: Sat Mar 20, 2010 1:05 pm
Location: Northern California

Re: OT - Statins and You

Post by Janknitz » Thu May 17, 2012 2:01 pm

Peter Attia, M.D. has a very detailed discussion of cholesterol which begins here: http://waroninsulin.com/nutrition/the-s ... rol-part-i

(VERY detailed! )

My only quibble is that he fails to cite all his peer-reviewed references, but he does respond to comments and I'm sure he can point you to his references.

Be sure to wade through the comments as well--many thought provoking discussions.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

User avatar
NightMonkey
Posts: 801
Joined: Sat Jan 15, 2011 2:43 pm
Location: Three seats, orchestra right

Re: OT - Statins and You

Post by NightMonkey » Thu May 17, 2012 5:07 pm

The water gets muddier.
Some genetic mechanisms that raise plasma HDL cholesterol do not seem to lower risk of myocardial infarction. These data challenge the concept that raising of plasma HDL cholesterol will uniformly translate into reductions in risk of myocardial infarction.
Lancet
May 17, 2012
http://www.thelancet.com/journals/lance ... 2/fulltext

and http://www.forbes.com/sites/matthewherp ... ing-drugs/
NightMonkey
Blow my oropharynx!

the hairy, hairy gent who ran amok in Kent

User avatar
Jay Aitchsee
Posts: 2936
Joined: Sun May 22, 2011 12:47 pm
Location: Southwest Florida

Re: OT - Statins and You

Post by Jay Aitchsee » Sat May 19, 2012 7:33 am

dtsm wrote:...This deals with HDL and underlying assumptions made in the past re positives of same. It's not a definitive study, just the first of it's kind.. The study has NOTHING to do with total cholesterol or LDL....don't jump to any conclusions [just yet]. Reduction of total cholesterol and LDL does reduce heart disease -- you too didn't take the time to read references cited in earlier link?
No conclusions dtsm, more of an aside. Most of your citations use the Framingham Study to draw conclusions regarding total cholesterol, LDL, and HDL among other things. Here's a link to the 10 year CVD risk calculator based on the Framingham findings. http://hp2010.nhlbihin.net/atpiii/calculator.asp It's interesting to play around with. It is also interesting that LDL is not an input.

And, speaking of interesting, I offer my calculated risk assesment before and about 3 months after stopping statins and starting a low carb diet. Not asked for was my LDL score which went from 85 to 135mg/dl. Now, what conclusions do you suppose we can make from the apparent decrease in Risk Score?

Image

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: S9 Auto, P10 mask, P=7.0, EPR3, ResScan 5.3, SleepyHead V1.B2, Windows 10, ZEO, CMS50F, Infrared Video

dtsm
Posts: 1097
Joined: Sun Mar 08, 2009 8:34 am
Location: CT

Re: OT - Statins and You

Post by dtsm » Sat May 19, 2012 1:51 pm

Jay Aitchsee wrote: Now, what conclusions do you suppose we can make from the apparent decrease in Risk Score?
Framingham Study was the benchmark for heart disease, including hypertension as well as other potential factors [including cholesterol]. Using the risk score just tells you statistically your chances of developing certain diseases, and therefore the basis for developing guidelines for the population as a whole. One would dare not try to extrapolate for one individual...and certainly that would be something only a qualified medical researcher or practitioner could respond to?

Example -- that everyone agrees to - cessation of cigarette smoking after 6-12 months drastically reduces your chance of a coronary disease event, over time chances of other heart and lung ailments also are reduced. But that doesn't mean that if you stop smoking today, you're guaranteed to not develop heart issues and/or cancer. It does mean statistically your chances have been great reduced.

User avatar
Jay Aitchsee
Posts: 2936
Joined: Sun May 22, 2011 12:47 pm
Location: Southwest Florida

Re: OT - Statins and You

Post by Jay Aitchsee » Sat May 19, 2012 4:00 pm

dtsm wrote: Using the risk score just tells you statistically your chances of developing certain diseases, and therefore the basis for developing guidelines for the population as a whole. One would dare not try to extrapolate for one individual
A small point, dtsm, but I believe the risk calculator is designed to assess the risk of CVD for an individual; to help the individual and his clinician to determine the proper course of treatment (if any) and lifestyle changes (if any) which are appropriate for that particular individual.

Jay

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: S9 Auto, P10 mask, P=7.0, EPR3, ResScan 5.3, SleepyHead V1.B2, Windows 10, ZEO, CMS50F, Infrared Video

Janknitz
Posts: 8410
Joined: Sat Mar 20, 2010 1:05 pm
Location: Northern California

Re: OT - Statins and You

Post by Janknitz » Sun May 20, 2012 1:09 pm

The original Framingham study was designed to find that link between dietary fat and blood cholesterol because it was assumed that there was a link and it was the key to cardiovascular disease. The interesting thing is that link wasn't found, but many people think that's what Framiningham stands for. Years after the initial study, the original director summed it uup by saying "In Framingham, Massachusetts, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower people's serum cholesterol...we found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories weighed the least and were the most physically active." Dr William Castelli 1992 (Director of the Framingham study). Nevertheless, Framingham was used as a basis to foist the low fat diet on the American people. Interesting, isn't it. And, as you look at the consumer website that DTSM points to, Framingham scores form a basis for the ATP III recommendations DTSM feels are so important.

Meanwhile, the Framingham risk calculators look at only a narrow range of confounding factors. I have to laugh because it puts my risk at 1%. I'm obese, pre-diabetic with a high degree of insulin resistance (PCOS) and have what is considered to be a high total cholesterol (235), but I also have a high HDL (79). I don't have the studies at my fingertips to cite at the moment, but Fasting Blood Glucose (FBG) has been found (I believe this was part of the Nurse's Health Study) to be a much better predictor of cardiovascular disease than any of the lipid numbers, yet Framingham ignores it. If Framingham looked at FBG levels, I guarantee you the ATP III dietary and medical guidelines would look a LOT different.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

User avatar
Jay Aitchsee
Posts: 2936
Joined: Sun May 22, 2011 12:47 pm
Location: Southwest Florida

Re: OT - Statins and You

Post by Jay Aitchsee » Sun May 20, 2012 1:46 pm

Jan, here's a link to an interview with Dr Wiilliam Castelli conducted in February 2011. I've just given it a quick read and I must say it appears to be at odds with the quote you attributed to him. You might want to take a look. http://www.prescription2000.com/Intervi ... cript.html

Jay

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: S9 Auto, P10 mask, P=7.0, EPR3, ResScan 5.3, SleepyHead V1.B2, Windows 10, ZEO, CMS50F, Infrared Video

Janknitz
Posts: 8410
Joined: Sat Mar 20, 2010 1:05 pm
Location: Northern California

Re: OT - Statins and You

Post by Janknitz » Sun May 20, 2012 7:05 pm

Well, he did say the above (published in the Archives of Internal Medicine Jul 1992, 152:(7):1371-1372) if you want to look it up) and he's kind of all over the place in that interview, isn't he?

He points to high triglycerides and LDL concentration in the bloodstream, NOT LDL number, as a predictor of CVD, which is just what I've been saying. He also says the higher the HDL the better but perhaps in agreement with the recent study he says that if your trigs are low enough and your LDL concentration is low enough then perhaps HDL doesn't matter so much. But otherwise high HDL is desireable.

And about diet he first says " Now diet-wise, they (triglycerides) are more or less related to the refined carbohydrate in your diet, the white flour, the sugar, the candies, the cookies, the cakes, the ice creams. If you can get them to get away from a lot of that refined carbohydrate stuff you can lower those triglycerides."

Later he claims that meat and fat lead to artery blockage unless they are from "game animals" and skirted the questions about the Paleo approach (which recommends "pastured" animals high in omega 3 FATS like the sardines he likes). BTW, his own diet appeared to be very low in carbs (only oatmeal in the morning), while still eating some meat and fat. If he contradicted anyone it was himself.

This is kind if cherry picking but here are some interesting PEER-REVIEWED "facts and myths about cholesterol": http://splawebsite.storage.s3.amazonaws ... x.doc.docx. Now I'm not putting this link here to claim that I'm right and DTSM is wrong but only to show that there is a difference of opinion among the scientific experts. The conventional approach gets a lot more support perhaps because there is money to be had in selling statins and the junk food products that proliferate our stores and fast food and the governmental role in bolstering those business concerns economically.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm

dtsm
Posts: 1097
Joined: Sun Mar 08, 2009 8:34 am
Location: CT

Re: OT - Statins and You

Post by dtsm » Mon May 21, 2012 5:53 am

Janknitz wrote: The conventional approach gets a lot more support perhaps because there is money to be had in selling statins and the junk food products that proliferate our stores and fast food and the governmental role in bolstering those business concerns economically.
The conventional approach is and always has been to encourage exercise n diet as the first line of treatment.

Now who is cherry picking: your logic is identical to what you are accusing others of doing. How does the statins n junk food n gov role in promoting business all get thrown into one bag?

Related news http://usat.ly/KqMvhm [and no, this is not sponsored by the greedy pharma companies - it's a USDA study, LOL ]

Janknitz
Posts: 8410
Joined: Sat Mar 20, 2010 1:05 pm
Location: Northern California

Re: OT - Statins and You

Post by Janknitz » Mon May 21, 2012 8:18 am

I said I was the one cherry picking, only to illustrate that there are other sides to the coin--it's not at all settled in the scientific community as people often think.
What you need to know before you meet your DME http://tinyurl.com/2arffqx
Taming the Mirage Quattro http://tinyurl.com/2ft3lh8
Swift FX Fitting Guide http://tinyurl.com/22ur9ts
Don't Pay that Upcharge! http://tinyurl.com/2ck48rm