OT - Cardiologists recommend wider use of statin drugs

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zoocrewphoto
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Re: OT - Cardiologists recommend wider use of statin drugs

Post by zoocrewphoto » Thu Nov 14, 2013 3:36 am

robysue wrote: I can tell you this: Most fresh fruit tastes way, way too sweet to me. (As do many sugar filled "treats". But I do confess a weakness for almost all things chocolate.) And veggies? Cooked veggies are either very mushy (which I don't like) or very strong smelling (which can trigger a migraine ) or both. (And yes, I do mean I can get a migraine from things like the smell of cooked cabbage.) Raw veggies? As long as my TMJs are not acting up, I'll eat them. But salads and raw veggies get old if you eat them day after day without much break ....

At any rate, it is very, very difficult to eat food that you do not really enjoy eating day after day while surrounded by food that you do like, but has been made "forbidden" for you to eat.

I am very similar with the problem, but my taste aversions are the opposite

Even as a child, I refused to eat most foods due to texture and smell. (Also, I do not eat anything spicy) The smell of plain steamed rice and worse, oatmeal, will make me gag. You can't pay me enough to eat even a bite of oatmeal. At summer camp, I quietly refused to eat oatmeal. I asked for cereal the first day, and they said I had to eat to 3 bites of the oatmeal first. I went back to my table and skipped breakfast. As a child, I went to bed a lot, without finishing dinner. My parents didn't have to say anything or even get the timer. I ate what I wanted and then went to bed. If something, such a burrito, contained an item I would not eat, I would pick through it and remove the offending ingredients.

My mom learned early on that I would eat foods with granulated onion powder, but not pieces of onion. I still use that powder in my recipes. It is not the taste the bothers me. It is the crunchy stuff in the food.

Fruits and veggies. Fruits - I came up with a list of 11 fruits that I like. But none are ones I like all that much. Unlike you, I find that fruit is often too sour for me. I used to think I was really bad at picking fruit. I always got the sour ones. But then I did an experiment. I would get an orange and have a few other people taste it with me. I would find it somewhat sour, while everybody else thought it was sweet. The best orange I ever had was after a 5 hour hike in 90+ weather. I can get most oranges down, but I do find them to be more sweet & sour. I also like my fruit very ripe, about as ripe as it can go before it goes bad. My sister likes sour. She will eat the strawberries with green and pink on them. I want deep red. Smaller oranges are sweeter than larger oranges. Apples. I can eat them with caramel, or I can eat them in pie, but I cook the pie 100 degrees lower than the directions and about an hour longer. I want them soft. If they are crunchy, I eat the crust and toss the apples.

Veggies. Even worse. I like broccoli and cauliflower. I can eat them both raw, with ranch dip. Or I can eat them overcooked, once they are soft. I do not like them in between. And I don't like them enough to eat them more than once a week. Other than corn and potatoes, which seem to be more starch than veggie, I am stuck with broccoli, cauliflower, lettuce, and cabbage. Not much variety. Oh, I can eat peas in split pea soup, and overly cooked peas in stew. But not the way that most people cook them. There used to be a canned stew that had peas, and I found that I could eat them. I do pick all the carrots out. Yuck.

I also do not like a lot of seasonings. I do like garlic, and I can put up with very small pieces in my food. Onions are still a big no. Can't stand rosemary. And I don't like the texture of any leafy things, twigs, etc that are in food. I like my seasonings pulverized so that they have no texture. And I like a lot of foods plain. If I order steak at a restaurant, I have to specify no seasoning, or I can't eat it sometimes. When I cook fish at home, I use no seasoning at all. My favorites are catfish and steelhead. I love them plain. I absolutely love those, and i love cooking it so that some of it is really juicy and some of it is a little crunchy. Perfect. Almost heaven. No seasoning

Texture is a really big deal for me. Here is the perfect example. I like nuts. I like almonds, peanuts, walnuts, and hazelnuts. I can eat them for a snack, no problem. I like cookies, ice cream, brownies, and fudge. But I will NOT eat any of them if it has nuts in it. In the past few years, I finally managed to like 2 things with nuts in them - chicken salad and almond chicken. Those are the only two exceptions.

When I have new coworkers, they are puzzled how I can eat the same thing for breakfast every day before work. And I eat the same thing for lunch almost every day. The thing is, when you don't like many things, you have to eat the same things over and over again. I can't eat a lot of premade food with dissecting it. I always have trouble at new restaurants because there is guaranteed to be something I do not like. I try to pick something simple that can either have something easily skipped, or easily picked out, such as fish and chips. A pasta dish can easily have chunky sauce or stuff that I have to pick out. I don't like to dissect my food in public.

I have learned to try more foods than I used to. But most foods that are considered healthy are on the bad texture list for me. I wish I liked healthy food. But I don't know how to change the way a texture bothers me. I also have textures I don't like the feel of, such as flour when baking. I have to wear gloves. Non-powdered gloves. Hate those too. Certain textures of clothing too.

As I said, this started when I was a child, too young to understand what I did and did not like about foods. My parents both love just about anything, and they offered just about everything. My brother and sister and not picky like I am. I think this is something that is built in, not taught. Just like my allergies. I am even allergic to metal and can't wear jewelry very long.

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Re: OT - Cardiologists recommend wider use of statin drugs

Post by 49er » Thu Nov 14, 2013 4:18 am

DoriC wrote:I read a similar long article in our paper but I'm concerned not only about the science but about 2 paragraphs..."Roughly half the panel members have financial ties to makers of heart drugs, but panel leaders said no one with industry connections could vote on the recommendations".
"It is practically impossible to find a large group of outside experts in the field who have no relationships to industry", said Dr. George Mensah of the Heart Institute.

I'll be very interested in the opinions of our Primary, Cardio and my son(The Doctor)!
That is exactly what I suspected Dori. Pretty sad.

I have never been had issues with cholesterol but if that ever changes, the chances of my taking a statin would very low unless I had tried everything else to remedy the situation and was unable to.

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Re: OT - Cardiologists recommend wider use of statin drugs

Post by ChicagoGranny » Thu Nov 14, 2013 6:55 am

Janknitz wrote:
My risk is 1%,
I haven't looked at the calculator, but is a calculator worth anything if it rates 1% for someone who has sleep apnea?
"It's not the number of breaths we take, it's the number of moments that take our breath away."

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Re: OT - Cardiologists recommend wider use of statin drugs

Post by Iowamv » Thu Nov 14, 2013 7:20 am

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Contrary Opinion Piece in this morning's New York Times!

Post by NateS » Thu Nov 14, 2013 7:54 am


November 13, 2013
Don’t Give More Patients Statins

By JOHN D. ABRAMSON and RITA F. REDBERG


ON Tuesday, the American Heart Association and the American College of Cardiology issued new cholesterol guidelines that essentially declared, in one fell swoop, that millions of healthy Americans should immediately start taking pills — namely statins — for undefined health “benefits.”

This announcement is not a result of a sudden epidemic of heart disease, nor is it based on new data showing the benefits of lower cholesterol. Instead, it is a consequence of simply expanding the definition of who should take the drugs — a decision that will benefit the pharmaceutical industry more than anyone else.

The new guidelines, among other things, now recommend statins for people with a lower risk of heart disease (a 7.5 percent risk over the next 10 years, compared with the previous guidelines’ 10 to 20 percent risk), and for people with a risk of stroke. In addition, they eliminate the earlier criteria that a patient’s “bad cholesterol,” or LDL, be at or above a certain level. Although statins are no longer recommended for the small group of patients who were on the drugs only to lower their bad cholesterol, eliminating the LDL criteria will mean a vast increase in prescriptions over all. According to our calculations, it will increase the number of healthy people for whom statins are recommended by nearly 70 percent.

This may sound like good news for patients, and it would be — if statins actually offered meaningful protection from our No. 1 killer, heart disease; if they helped people live longer or better; and if they had minimal adverse side effects. However, none of these are the case.

Statins are effective for people with known heart disease. But for people who have less than a 20 percent risk of getting heart disease in the next 10 years, statins not only fail to reduce the risk of death, but also fail even to reduce the risk of serious illness — as shown in a recent BMJ article co-written by one of us. That article shows that, based on the same data the new guidelines rely on, 140 people in this risk group would need to be treated with statins in order to prevent a single heart attack or stroke, without any overall reduction in death or serious illness.

At the same time, 18 percent or more of this group would experience side effects, including muscle pain or weakness, decreased cognitive function, increased risk of diabetes (especially for women), cataracts or sexual dysfunction.

Perhaps more dangerous, statins provide false reassurances that may discourage patients from taking the steps that actually reduce cardiovascular disease. According to the World Health Organization, 80 percent of cardiovascular disease is caused by smoking, lack of exercise, an unhealthy diet, and other lifestyle factors. Statins give the illusion of protection to many people, who would be much better served, for example, by simply walking an extra 10 minutes per day.

Aside from these concerns, we have more reasons to be wary about the data behind this expansion of drug therapy.

When the last guidelines were issued by the National Heart, Lung, and Blood Institute in 2001, they nearly tripled the number of Americans for whom cholesterol-lowering drug therapy was recommended — from 13 million to 36 million. These guidelines were reportedly based strictly on results from clinical trials. But this was contradicted by the data described in the document itself.

For example, even though the guidelines recommended that women between the ages of 45 and 75 at increased risk of heart disease and with relatively high LDL levels take statins, the fine print in the 284-page document admitted, “Clinical trials of LDL lowering generally are lacking for this risk category.” The general lack of evidence for LDL level targets is why they have been dropped from the current guidelines. In fact, committee members noted that cholesterol lowered by drugs may not have the same effect as cholesterol lowered by nondrug methods, such as diet, exercise and being lucky enough to have good genes.

The process by which these latest guidelines were developed gives rise to further skepticism. The group that wrote the recommendations was not sufficiently free of conflicts of interest; several of the experts on the panel have recent or current financial ties to drug makers. In addition, both the American Heart Association and the American College of Cardiology, while nonprofit entities, are heavily supported by drug companies.

The American people deserve to have important medical guidelines developed by doctors and scientists on whom they can confidently rely to make judgments free from influence, conscious or unconscious, by the industries that stand to gain or lose.

We believe that the new guidelines are not adequately supported by objective data, and that statins should not be recommended for this vastly expanded class of healthy Americans. Instead of converting millions of people into statin customers, we should be focusing on the real factors that undeniably reduce the risk of heart disease: healthy diets, exercise and avoiding smoking. Patients should be skeptical about the guidelines, and have a meaningful dialogue with their doctors about statins, including what the evidence does and does not show, before deciding what is best for them.

John D. Abramson, a lecturer at Harvard Medical School and the author of “Overdosed America: The Broken Promise of American Medicine,” serves as an expert in litigation involving the pharmaceutical industry. Rita F. Redberg is a cardiologist at the University of California, San Francisco Medical Center and the editor of JAMA Internal Medicine.

http://tinyurl.com/qxdeu4d

http://www.nytimes.com/2013/11/14/opini ... nted=print

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Re: OT - Cardiologists recommend wider use of statin drugs

Post by Iowamv » Thu Nov 14, 2013 8:18 am

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Re: OT - Cardiologists recommend wider use of statin drugs

Post by DeadlySleep » Thu Nov 14, 2013 8:24 am

while on the treadmill

I ended up getting a tasteless salad with iceberg lettuce
If you participate in such a boring activity in such a banal setting and eat like that, why would you want to live a long life?

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Re: OT - Cardiologists recommend wider use of statin drugs

Post by JohnO » Thu Nov 14, 2013 9:05 am

Janknitz wrote:BTW: the heart risk calculator the articles talk about is here: http://cvdrisk.nhlbi.nih.gov/calculator.asp
Thanks for that. I'm at 6%.

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Re: OT - Cardiologists recommend wider use of statin drugs

Post by Janknitz » Thu Nov 14, 2013 9:33 am

ChicagoGranny wrote:
Janknitz wrote:
My risk is 1%,
I haven't looked at the calculator, but is a calculator worth anything if it rates 1% for someone who has sleep apnea?
Well, exactly. The risk calculator, like the old system of just looking at LDL , looks only at narrow parameters. From what I understand the new thing is to consider the risk as one factor but to prescribe statins if that calculates a risk greater than 7.5 percent.
Yes, untreated or poorly treated apnea increases cardiac risk, but statins are not going to help apnea.
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Re: OT - Cardiologists recommend wider use of statin drugs

Post by Janknitz » Thu Nov 14, 2013 9:46 am

Sorry, this is way off topic, but it comes up when people have food issues like those described above:

Zoo and Roby Sue, I'm making an educated guess that both of you have other sensory issues as well. Roby Sue has mentioned before that she is hypersensitive to touch and how difficult that made it for her to adjust to the CPAP.

If both of you were children today, you would probably be diagnosed with "sensory processing disorders" and there is treatment for it through occupational therapy. kids respond very well to the treatment because they still have a lot of "neuro plasticity" but adults can be helped too.

I don't mean to embarrass or cause discomfort with my armchair "diagnosis" but I think these issues are very much more common than we realize--they weren't recognized when we were kids, but a lot more is known now. Learning issues are often associated with these sensory processing issues, but highly intelligent people can work around the learning issues and excel despite these challenges.
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Re: OT - Cardiologists recommend wider use of statin drugs

Post by NateS » Thu Nov 14, 2013 9:56 am

In addition to constant pain and weakness in my legs when standing or walking, here is the medical assessment of what pravastatin did to me:

1. Decreased lower extremity range of motion and strength.
2. Inability to single leg stand.
3. Decreased static standing balance.
4. Decreased dynamic standing balance.
5. Increased fall risk.
6. Lack of appropriate and timely ankle hip and step strategies for fall
prevention.
7. Decreased limits of stability.
8. Instability of ambulation.
9. Decreased stability and ambulating with turns.
10.Decreased stability in ambulating over or around obstacles.
11.Decreased independence in stair climbing.
12.Decreased ability to ambulate outdoor uneven surfaces.
13.Sensory deficits.
14.Proprioceptive dependence.


After trips to numerous specialists, all other possible causes of this damage have been ruled out.

Best wishes, Nate

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Re: OT - Cardiologists recommend wider use of statin drugs

Post by ems » Thu Nov 14, 2013 10:48 am

I'm at 5%... which means according to the calculator, 5 out of 100 people will have a heart attack in the next 10 years. Yes, I could be one of those 5 people. And yes, I could be one of the 95 that won't. I could also be hit by a car later today.

Apparently what I've been doing up to now has been working. Could it be better, sure. Will I stop taking statins when I feel fine on them, no. Will I continue to read more, eat more healthfully, use my VPap machine and exercise more... I'll try. Will I enjoy my life and not worry about every ice cream cone I eat b/c worrying definitely contributes to my Migraines and general well being, Yes!
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Re: OT - Cardiologists recommend wider use of statin drugs

Post by Jay Aitchsee » Thu Nov 14, 2013 11:25 am

Janknitz wrote:BTW: the heart risk calculator the articles talk about is here: http://cvdrisk.nhlbi.nih.gov/calculator.asp
See if this one gives you the same result. It's the newest link : http://my.americanheart.org/professiona ... mePage.jsp

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Re: OT - Cardiologists recommend wider use of statin drugs

Post by Janknitz » Thu Nov 14, 2013 12:10 pm

See if this one gives you the same result. It's the newest link : http://my.americanheart.org/professiona ... mePage.jsp
10 year risk on that calculator is 0.9, lifetime risk is 8%.

Playing around with the numbers, even high blood pressure, the only things that seem to raise the risk are age (well, yes, the older you are the higher the risk of developing heart disease, but that doesn't mean you need statins as you age!) and treatment for high blood pressure. Raising the blood pressure or lowering the HDL (mine is 97!) don't change the risk appreciably. Why would the risk be higher if you are treated for HBP than if you are not (unless it assumes a high blood pressure despite being treated?).
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Re: OT - Cardiologists recommend wider use of statin drugs

Post by Jay Aitchsee » Thu Nov 14, 2013 12:36 pm

Yes, a 63 year old male with the optimal values of a 50 year old will have a 10 yr risk factor of 7.5%. Lucky for him (or big pharma), Medicare Part D is just a short wait.

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