Raynine
Gold Member
- Oct 28, 2023
- 304
- 468
- 173
77-year-old male:
I got a new doctor and he wants to put me on statins because my thyroid is underactive and this is causing LDL cholesterol levels to rise. No history of smoking, no alcohol, no street drugs. Active lifestyle since 1973. Competitive runner for 12 years, cyclist since 1983. I did gain some weight the winter before I saw the doctor but I have since lost 22 pounds and changed my diet to include more vegitables. The presence of raised LDL cholesterol introduces a conundrum of correlation vs. causation and the evidence from studies does not support the use of statins at this time.
If a person has no history of smoking, obesity, and sedantary lifestyle does age related LDL cholesterol pose a heath risk? I submitted this question to Chat GBT. The answer I got was interesting to say the least.
Me:
If a person has no history of smoking, obesity, and sedantary lifestyle does age related LDL cholesterol pose a heath risk?
ChatGPT:
Age-related LDL cholesterol can still pose a health risk even in the absence of other risk factors like smoking, obesity, and a sedentary lifestyle. High levels of LDL cholesterol are a significant risk factor for atherosclerosis, which can lead to cardiovascular diseases such as coronary artery disease, heart attack, and stroke.
As people age, their risk of cardiovascular disease naturally increases due to changes in blood vessels and heart function.
Here are some points to consider:
Atherosclerosis: Over time, LDL cholesterol can build up in the walls of arteries, forming plaques. These plaques can narrow arteries and restrict blood flow, which increases the risk of cardiovascular events.
Inflammation:
Aging is associated with increased inflammation, which can exacerbate the effects of high LDL cholesterol on blood vessels.
Other Age-Related Factors: Aging can also be accompanied by changes in metabolism, blood pressure, and other lipid levels (like HDL and triglycerides), which can contribute to overall cardiovascular risk.
Genetics:
Genetic factors can influence how cholesterol is processed and how much risk it poses. Some individuals may have a genetic predisposition to higher LDL cholesterol levels or to conditions like familial hypercholesterolemia.
Residual Risk:
Even in the absence of traditional risk factors, age itself is a significant risk factor for cardiovascular disease. Monitoring and managing LDL cholesterol remains important as part of overall cardiovascular health management.
Therefore, it is essential for older adults to have regular check-ups that include lipid profiles. Lifestyle modifications (such as a healthy diet and regular exercise), along with medications like statins if necessary, can help manage LDL cholesterol levels and reduce cardiovascular risk.
Me:
There is no credible evidence that statins prolong life in people who have never had a heart attack. Nor is there any proof that statins prevent heart attacks and strokes in healthy people. In addition other factors like blood type appear to be ignored. One-size-fits-all statin prescriptions do little to actually prevent heart disease so why are they used?
ChatGPT:
The use of statins for primary prevention of cardiovascular disease in people who have never had a heart attack or stroke is indeed a topic of ongoing debate. Here are some key points to consider:
Efficacy and Evidence:
Primary Prevention Trials:
Some large-scale clinical trials have shown that statins can reduce the risk of first-time heart attacks and strokes in people at high risk for cardiovascular disease, even if they haven't had an event before. These studies include:
The JUPITER trial, which found that statins reduced cardiovascular events in people with elevated C-reactive protein levels.
The HOPE-3 trial, which demonstrated benefits in an intermediate-risk population.
Meta-Analyses:
Meta-analyses combining data from multiple studies generally support the use of statins for primary prevention in certain high-risk groups. However, the absolute risk reduction is smaller compared to those with existing cardiovascular disease.
Controversies and Considerations:
Absolute vs. Relative Risk: While statins may reduce relative risk of cardiovascular events, the absolute benefit for primary prevention can be modest, leading to debates about their overall value for individuals with lower baseline risk.
Side Effects:
Concerns about side effects (such as muscle pain, increased risk of diabetes, and cognitive effects) influence the risk-benefit analysis for statin use in primary prevention.
Individual Risk Assessment:
Factors like age, family history, LDL levels, blood pressure, diabetes, smoking status, and possibly blood type, should all be considered when assessing cardiovascular risk. Tools like the ASCVD Risk Calculator help in personalizing decisions.
Lifestyle Factors:
Statins are not a substitute for healthy lifestyle choices. Diet, exercise, weight management, and smoking cessation remain critical components of cardiovascular risk reduction.
Why Statins Are Used:
Clinical Guidelines: Many clinical guidelines, including those from the American Heart Association (AHA) and the European Society of Cardiology (ESC), recommend statins for primary prevention in individuals with elevated cardiovascular risk.
Broad Application:
Statins are used broadly because they are well-studied, generally well-tolerated, and can provide a measurable reduction in cardiovascular events.
Preventive Strategy: For individuals at higher risk of cardiovascular events (e.g., due to high LDL levels, hypertension, or diabetes), statins can be an important part of a comprehensive preventive strategy.
Moving Forward:
Personalized Medicine: The trend in medicine is moving towards more personalized approaches, considering genetic factors, biomarkers, and other individual characteristics to tailor treatments.
Research on Alternatives: Ongoing research is exploring alternatives to statins and ways to enhance cardiovascular prevention through different mechanisms and interventions.
Patient-Doctor Discussions:
Ultimately, the decision to use statins for primary prevention should be based on a detailed discussion between a patient and their healthcare provider, considering all risk factors, potential benefits, and side effects.
Conclusion:
While statins are widely used and can be beneficial for primary prevention in certain high-risk groups, their use should be carefully considered on an individual basis. The focus should remain on a comprehensive approach to cardiovascular risk reduction, including lifestyle modifications and other preventive measures.
Me:
Nothing against the doctor. He is under pressure to prescibe those statins. I will volunteer to take part in a clinical trial to see if healthy people with normal weight and good body mass index combined with vigoruous daily excercise are more effective than statins. I'm still waiting to hear back from the doctor.
I got a new doctor and he wants to put me on statins because my thyroid is underactive and this is causing LDL cholesterol levels to rise. No history of smoking, no alcohol, no street drugs. Active lifestyle since 1973. Competitive runner for 12 years, cyclist since 1983. I did gain some weight the winter before I saw the doctor but I have since lost 22 pounds and changed my diet to include more vegitables. The presence of raised LDL cholesterol introduces a conundrum of correlation vs. causation and the evidence from studies does not support the use of statins at this time.
If a person has no history of smoking, obesity, and sedantary lifestyle does age related LDL cholesterol pose a heath risk? I submitted this question to Chat GBT. The answer I got was interesting to say the least.
Me:
If a person has no history of smoking, obesity, and sedantary lifestyle does age related LDL cholesterol pose a heath risk?
ChatGPT:
Age-related LDL cholesterol can still pose a health risk even in the absence of other risk factors like smoking, obesity, and a sedentary lifestyle. High levels of LDL cholesterol are a significant risk factor for atherosclerosis, which can lead to cardiovascular diseases such as coronary artery disease, heart attack, and stroke.
As people age, their risk of cardiovascular disease naturally increases due to changes in blood vessels and heart function.
Here are some points to consider:
Atherosclerosis: Over time, LDL cholesterol can build up in the walls of arteries, forming plaques. These plaques can narrow arteries and restrict blood flow, which increases the risk of cardiovascular events.
Inflammation:
Aging is associated with increased inflammation, which can exacerbate the effects of high LDL cholesterol on blood vessels.
Other Age-Related Factors: Aging can also be accompanied by changes in metabolism, blood pressure, and other lipid levels (like HDL and triglycerides), which can contribute to overall cardiovascular risk.
Genetics:
Genetic factors can influence how cholesterol is processed and how much risk it poses. Some individuals may have a genetic predisposition to higher LDL cholesterol levels or to conditions like familial hypercholesterolemia.
Residual Risk:
Even in the absence of traditional risk factors, age itself is a significant risk factor for cardiovascular disease. Monitoring and managing LDL cholesterol remains important as part of overall cardiovascular health management.
Therefore, it is essential for older adults to have regular check-ups that include lipid profiles. Lifestyle modifications (such as a healthy diet and regular exercise), along with medications like statins if necessary, can help manage LDL cholesterol levels and reduce cardiovascular risk.
Me:
There is no credible evidence that statins prolong life in people who have never had a heart attack. Nor is there any proof that statins prevent heart attacks and strokes in healthy people. In addition other factors like blood type appear to be ignored. One-size-fits-all statin prescriptions do little to actually prevent heart disease so why are they used?
ChatGPT:
The use of statins for primary prevention of cardiovascular disease in people who have never had a heart attack or stroke is indeed a topic of ongoing debate. Here are some key points to consider:
Efficacy and Evidence:
Primary Prevention Trials:
Some large-scale clinical trials have shown that statins can reduce the risk of first-time heart attacks and strokes in people at high risk for cardiovascular disease, even if they haven't had an event before. These studies include:
The JUPITER trial, which found that statins reduced cardiovascular events in people with elevated C-reactive protein levels.
The HOPE-3 trial, which demonstrated benefits in an intermediate-risk population.
Meta-Analyses:
Meta-analyses combining data from multiple studies generally support the use of statins for primary prevention in certain high-risk groups. However, the absolute risk reduction is smaller compared to those with existing cardiovascular disease.
Controversies and Considerations:
Absolute vs. Relative Risk: While statins may reduce relative risk of cardiovascular events, the absolute benefit for primary prevention can be modest, leading to debates about their overall value for individuals with lower baseline risk.
Side Effects:
Concerns about side effects (such as muscle pain, increased risk of diabetes, and cognitive effects) influence the risk-benefit analysis for statin use in primary prevention.
Individual Risk Assessment:
Factors like age, family history, LDL levels, blood pressure, diabetes, smoking status, and possibly blood type, should all be considered when assessing cardiovascular risk. Tools like the ASCVD Risk Calculator help in personalizing decisions.
Lifestyle Factors:
Statins are not a substitute for healthy lifestyle choices. Diet, exercise, weight management, and smoking cessation remain critical components of cardiovascular risk reduction.
Why Statins Are Used:
Clinical Guidelines: Many clinical guidelines, including those from the American Heart Association (AHA) and the European Society of Cardiology (ESC), recommend statins for primary prevention in individuals with elevated cardiovascular risk.
Broad Application:
Statins are used broadly because they are well-studied, generally well-tolerated, and can provide a measurable reduction in cardiovascular events.
Preventive Strategy: For individuals at higher risk of cardiovascular events (e.g., due to high LDL levels, hypertension, or diabetes), statins can be an important part of a comprehensive preventive strategy.
Moving Forward:
Personalized Medicine: The trend in medicine is moving towards more personalized approaches, considering genetic factors, biomarkers, and other individual characteristics to tailor treatments.
Research on Alternatives: Ongoing research is exploring alternatives to statins and ways to enhance cardiovascular prevention through different mechanisms and interventions.
Patient-Doctor Discussions:
Ultimately, the decision to use statins for primary prevention should be based on a detailed discussion between a patient and their healthcare provider, considering all risk factors, potential benefits, and side effects.
Conclusion:
While statins are widely used and can be beneficial for primary prevention in certain high-risk groups, their use should be carefully considered on an individual basis. The focus should remain on a comprehensive approach to cardiovascular risk reduction, including lifestyle modifications and other preventive measures.
Me:
Nothing against the doctor. He is under pressure to prescibe those statins. I will volunteer to take part in a clinical trial to see if healthy people with normal weight and good body mass index combined with vigoruous daily excercise are more effective than statins. I'm still waiting to hear back from the doctor.
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