Medications

[cdcastillo]

...The best thing is to eat food that our body naturally is acustomed to. That means fruit, vegetables, meat and fish.
Avoid processed food like carbohydrates, bread and vegetable oil.

To make that oversimplification, your level of ignorance on lipid metabolism and causes of clinical dyslipidaemia should be astonishing, but hey, you are the expert, keep giving medical advice against that of physicians, if someone listens to it, they deserve what they get.

 

[D.T.]

To make that oversimplification, your level of ignorance on lipid metabolism and causes of clinical dyslipidaemia should be astonishing, but hey, you are the expert, keep giving medical advice against that of physicians, if someone listens to it, they deserve what they get.

FWIW, they haven't been active for going on 3 years, not that your assessment isn't' totally accurate, but they're kind of a ghost at this point 😀

 

[A.Goldberg]

FWIW, they haven't been active for going on 3 years, not that your assessment isn't' totally accurate, but they're kind of a ghost at this point 😀

Always trust the medical advice given by an anonymous forum member citing sketchy “health” websites with no scientific backing, typically citing anecdotal cases, poorly conducted studies, and “professional” opinions not based on the concepts of evidence based medicine. 😀

Thanks for asking. It's 2 doctors in 3 years. Apparently there is a reason I've resisted. After I've educated myself online, it seems like these doctors should speak of the pros and cons of these medicines, along with their effectiveness, and any controversy surrounding them. I got none of that, "just take this". The info in the links I've read in this thread really troubles me.

My test results: (standard range)
Cholesterol 208 (100-199)
Triglycerides 214 (0-149)
HDL Cholesterol 29 (>39)
LDL Cholesterol 136 (0-99)

I know the people on this thread will jump at me again but please read up very sincerely on cholesterol counts.
Your count is considered quite normal for your age.
Also: your count can vary from day to day.

The 'ideal' counts given by the lab are very unprecise since counts vary acording to gender, age and your diet that day.

Prescribing medication based on one blood reading is irresponsible to say the least.

It’s worth noting between @Huntn’s post in 2014 the American Heart Association has changed its guidelines for cholesterol. In fact 2013 had a massive change in guidelines- and the reality is many prescribers are slow to adopt new protocols.

As it stands now, LDL/HDL/TG levels and goals aren’t the exactly the focus of treating cholesterol. The current (2018) guidelines largely determine treatment based on the patients calculate ASVCD (atherosclerotic cardiovascular disease) risk. The ASVCD algorithm considers LDL and HDL, but also other factors like age, sex, race, blood pressure, diabetes, smoking status, etc to estimate (based on statistics from decades of research) the patient’s percent risk of a stroke or heart attack within the next 10 years.

Medication therapy (mainly Statins, ie Lipitor) and dose are largely determined by this risk score. For those with lower risk scores (generally <5% + in good health), proper diet and exercise may be sufficient to reduce their ASVCD risk score and avoid the recommendation for medications. (...however, many patients scoring borderline who attempt lifestyle changes first often fail and eventually are recommended meds)

Some conditions guarantee or nearly guarantee statin treatment- such as heart failure, kidney disease, and most diabetics. Also it’s strongly suggested to consider with people age 75+.

Years ago a correlation was made between high cholesterol and risk of cardiovascular events (ie stroke, heart attack). Over decades a number of drug classes were discovered and marked to lower lipids/cholesterol (about 8-9 total, with 1-10 individual medications in each class).

In the 90’s statins were discovered (ie simvastain/Zocor, atorvastatin/Lipitor, rouvastatin/Crestor, etc. After years of research and meta-analysis it was realized that the pre-Statin drugs, while effective at lowering lipids to varying degrees, were not really effective at reducing CV events and mortality.

Statins however actually so reduce risk of CV events and mortality, in addition to lipid levels. Statins were designed to inhibit cholesterol synthesis, but were found to also increase LDL uptake by the liver (a favorable effect). Years later, it research suggests statins has effects that ultimately stabilize plaque formations, improve blood vessel function/health, prevent clots, and help modulate vessel inflammation— which explains why these seem to be more effective than the previous drugs.

As a clinical PharmD I can say statins are one of my favorite classes of drugs. They’re highly effective, generally well tolerated, and low relative risk. CV disease (and resulting CV events- stroke, heart attack) is a serious issue in the US. Too often surviving victims suffer (and their families) with permanent cognitive and physical impairment- which frankly I think can be worse than death.

It’s crazy... in the process writing this rant I just received a text from my mother that a family friend (late 60’s male) just had a stroke and is in the ICU.🙁

 

[Plutonius]

For these type medications, to insist on office visits every 6 months, I regard it as a revenue enhancement for the doctor. 🤔

It probably is but it also might be a response to malpractice suits.

If all the doctors seem to have the same policy, they might have all been given guidance that a 3 - 6 month period on medications is less problematic than a one year period.

If I was told that I had to come back every 3 - 6 months for prescriptions, I wouldn't take the medication.
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To make that oversimplification, your level of ignorance on lipid metabolism and causes of clinical dyslipidaemia should be astonishing, but hey, you are the expert, keep giving medical advice against that of physicians, if someone listens to it, they deserve what they get.

Meister hasn't been on since early 2017.

 

[Huntn]

Always trust the medical advice given by an anonymous forum member citing sketchy “health” websites with no scientific backing, typically citing anecdotal cases, poorly conducted studies, and “professional” opinions not based on the concepts of evidence based medicine. 😀




It’s worth noting between @Huntn’s post in 2014 the American Heart Association has changed its guidelines for cholesterol. In fact 2013 had a massive change in guidelines- and the reality is many prescribers are slow to adopt new protocols.

As it stands now, LDL/HDL/TG levels and goals aren’t the exactly the focus of treating cholesterol. The current (2018) guidelines largely determine treatment based on the patients calculate ASVCD (atherosclerotic cardiovascular disease) risk. The ASVCD algorithm considers LDL and HDL, but also other factors like age, sex, race, blood pressure, diabetes, smoking status, etc to estimate (based on statistics from decades of research) the patient’s percent risk of a stroke or heart attack within the next 10 years.

Medication therapy (mainly Statins, ie Lipitor) and dose are largely determined by this risk score. For those with lower risk scores (generally <5% + in good health), proper diet and exercise may be sufficient to reduce their ASVCD risk score and avoid the recommendation for medications. (...however, many patients scoring borderline who attempt lifestyle changes first often fail and eventually are recommended meds)

Some conditions guarantee or nearly guarantee statin treatment- such as heart failure, kidney disease, and most diabetics. Also it’s strongly suggested to consider with people age 75+.

Years ago a correlation was made between high cholesterol and risk of cardiovascular events (ie stroke, heart attack). Over decades a number of drug classes were discovered and marked to lower lipids/cholesterol (about 8-9 total, with 1-10 individual medications in each class).

In the 90’s statins were discovered (ie simvastain/Zocor, atorvastatin/Lipitor, rouvastatin/Crestor, etc. After years of research and meta-analysis it was realized that the pre-Statin drugs, while effective at lowering lipids to varying degrees, were not really effective at reducing CV events and mortality.

Statins however actually so reduce risk of CV events and mortality, in addition to lipid levels. Statins were designed to inhibit cholesterol synthesis, but were found to also increase LDL uptake by the liver (a favorable effect). Years later, it research suggests statins has effects that ultimately stabilize plaque formations, improve blood vessel function/health, prevent clots, and help modulate vessel inflammation— which explains why these seem to be more effective than the previous drugs.

As a clinical PharmD I can say statins are one of my favorite classes of drugs. They’re highly effective, generally well tolerated, and low relative risk. CV disease (and resulting CV events- stroke, heart attack) is a serious issue in the US. Too often surviving victims suffer (and their families) with permanent cognitive and physical impairment- which frankly I think can be worse than death.

It’s crazy... in the process writing this rant I just received a text from my mother that a family friend (late 60’s male) just had a stroke and is in the ICU.🙁

Before I was on blood pressure medicine I was about 131 and the old guideline was 135, now it’s 130. I am considering stopping my medicine 2 weeks before my new dr appt and get unmedicated readings, but if they go high, I don’t want him telling me to come back in 3 months for retesting to see how effective they are. If I stay medicated them he can see what my current dosage is doing for me.