OT high cholesterol/Pravastatin

[biker72]

I've been on statins since around 1990. Diet and exercise got my cholesterol down to 230 overall with HDL's at 25. This is awful.

Statins have reduced my overall cholesterol to 160 with HDL's at 45 and LDL's at 78. Still riding a bike almost daily with no apparent side effects.

[SoCalSteve]

Originally Posted by dziehr

Foremost, if you have had an MI, lowering your LDL with a statin has been shown repeatedly in large, blinded, randomized controlled trials to reduce both cardiovascular morbidity and overall mortality. In other words, for secondary prevention, there are exceedingly few cases when you should not be on a statin (or other lipid-lowering therapy). Period.

Most folks here are commenting on statins for primary prevention (ie prevention of the first MI for someone at risk of atherosclerotic coronary disease). There is unequivocal evidence from both prospective randomized trials as well as epidemiological studies with hundreds of thousands of patients that show that: 1. there is a dose response between LDL and incidence of heart disease and all-cause mortality and 2. when patients lower their LDL (with medication or lifestyle modification), this risk decreases.

It's also worth mentioning that many of the cardiologists and endocrinologists who study statins believe that their effects are pleiotropic; that is, they lower LDL but also have other antiinflammatory off-target effects that reduce atherosclerosis and stabilize coronary plaques. (And we know that inflammation is a prime driver of atherosclerosis.)

For those with elevated LDL, there are risk calculators that use strong epidemiological data to determine if you and your doctor should consider a statin. These calculators are helpful but not a panacea. Statin myopathy can be troublesome, and folks will sometimes need to try different meds (we handle different statins differently) or dosing strategies. The decision to start a medication should always be collaborative, but expert guidance with facts from innumerable studies should outweigh uniformed anecdote.

Finally, there's new evidence to suggest that it's not just the degree of elevation of LDL but also the duration of that elevation (tracking back decades, before other risk factors were introduced) that contributes to coronary artery disease. (Which is common sense I suppose.) There's a lot of hereditary hypercholesterolemia and we Western folk in the 21st century are exposed to an environment that is driving up our lipids for various other reasons. I know several folks (physicians) in my age cohort (30s) who know the data and take a statin.

Nota bene: I'm an MD.

I’ll add my $.02 as well. Thank you!!!

One of the MANY reasons why this forum is such a great place. We can discuss ETap vs wired til the cows come home...but in the end, it’s people like the doc here who make this place such an amazing resource.

Happy Thanksgiving to everyone!!!!

[2metalhips]

Let's pump the brakes on the drugs. Do some research.
Documentaries: Forks over Knives. Cowspiracy. What the Health.
Dr Caldwell Esselstyn of the Cleveland Clinic.
Dr Michael Greger founder of NutritionFacts,org.
Dr Dean Ornish
Dr John McDougall
Dr T Colin Campbell PHD Author of The China Study
Dr Neal Barnard
Dr Kim Williams Past President of The American College of Cardiology

These distinguished gentlemen are the giants/pillars of diet and lifestyle medicine. The medical profession doesn't like them because they threaten their bottom line.

If your doctor prescribes statins or you are already taking them you owe it to yourself and your family to learn about this research. It is all about the food. Some have mentioned a good diet. What exactly is that, well if you are not eating 95-100% plant based you are not eating a "good diet".

A popular analogy is the overflowing sink, your md is more than happy to write you a scrip for some paper towels to mop up the floor. Why not just turn off the faucet. The high blood pressure and diabetes sink are running over also, time for more paper towels.

"There are two kinds of cardiologists: vegans and those who haven't read the data" Dr Kim Williams. PPACC

[jimcav]

one of the interesting things I learned after my dad's 1st stroke was the relationship between cavities/gingivitis and cardiovascular health. He grew up poor with bad dental hygiene (1930s)leading to many cavities and a lifelong avoidance of the dentist until really needed... and there was some pretty compelling research that there is systemic low grade inflammation from poor dental health that accounts for a significant portion of cardiovascular lesion development and progression. this never seems to get much attention, but I'd research that more and take care of your teeth and gums...