Article Source: msnbc.com
from:msnbc.comOnly half of patients at high risk of heart disease are given the right targets for cutting their cholesterol and millions may suffer heart attack or stroke due to doctors' poor advice, scientists said on Thursday.
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You don't always need name brand lipitor or crestor. The generic statins can usually get people to goal on the LDL.
Dr. Mike
Why are they blaming the doctors anyway?
It's no secret that lower LDL means lower risk of heart disease.
Nutritional changes, exercise and statins are all pretty much common knowledge.
It's getting the patients on board that seems more the problem to me.
serious
You are absolutely right. We've all known about cholesterol and the risks involved with it for over 25 years. When is it the patients responsibility to get off their fat a$$ and become responsible. I understand some people don't respond to diet and exercise routines but I also understand 60% of our nation is overweight or obese.
If you want to go through life fat, lazy and stupid it doesn't matter how many lipid lowering agents I give you. I don't know how many patients I've treated that start off doing everything they're supposed to and then as time goes and it becomes more and more routine they regress and their cholesterol and subsequent risks for heart attacks and strokes among others go up.
Americans are a very lazy, in general, society. Our solution for everything is a pill, liposuction or implants. It's time to blame the person most responsible.
YOU!!!!!!!
I agree with both of you. I'd be interested to see the data on how many of these so called preventable heart attacks were experienced by people who failed to meet their doctor's recommendations in the first place. If they couldn't meet those then how do you expect doctors to get their patients to meet even more stringent goals? I know my father takes cholesterol medicine and he knows his doctor has his best interests at heart but he does and eats what he wants, regardless. He wouldn't blame his doctor, however, if something happened because that would be hypocritical. I think this study assumes that doctors have far more persuasion with their patients than they really have.
Serious - a study recently released showed some LDLs might actually be good for you and that we are doing the population a disservice by using statins that remove all LDL's without regard for the good ones.
USARogue - I have had high cholesterol for the last 20+ years. It has never been below 240 ever and up until last year it was 327 (now it is 270). I have never been fat a day in my life (BMI at 24-25) and I get plenty of exercise, and nutritionists have been all over my diet and still can't figure out how my cholesterol could be that bad (I have no family history of high cholesterol or heart disease). The article stated quite clearly that some of the people who get missed for statin therapy are those with no heart risk factors (that would include weight), but rather have an accumulation of other risk factors. Don't be so quick to assume that every person with bad cholesterol levels is fat, lazy, or spend all day on the couch.
I turned down statin therapy because one of the contraindications is someone who is planning on being pregnant. At 30, I was offered a statin but declined for this reason even though I was not planning a PG nor was I married. I chose to not wear out my liver for that reason, especially since my HDLs were very high. I was asked again at 40 if I wanted to take a statin, but I was definitely PG at that point. So the answer was no. Again, my HDLs are still very high so most docs think I will be ok for most of my 40's. I sure hope so because taking statins slowly adversely affects your liver and I'd like my liver to continue working, thank you very much. The new study I mentioned for Serious has me cautiously optimistic that there might be a better group of drugs to be developed over the next 20 years that may be better for me.
In the meantime, I will continue to eat well, ski, snowshoe, ride my bike, rollerblade, and chase after my little boys. :-)
There are several contributing problems:
1) Many physicians do not like to give their patients their actual numbers because it seems to enhance their own feelings of self-worth if they know something their patient does not know. Other physicians refer to them as "mushroom" docs.
2) Anyone who is up-to-date on cholesterol research has seen numerous recent published studies that say that LDL is far more complicated that just a single number. There appear to be multiple densities within LDL's with some being good and some being bad. There has also been a lot of recent doubt placed on the HDL:LDL ratio and on the "good" effects of HDL. There's nothing wrong with the science, it's just that we are learning more about cholesterol as we go along and it is much more complex than was initially assumed. The understanding of cholesterol today is much, much different than that of 25 years ago. It is definitely not current science that the lower your LDL, the lower your risk of heart attack.
3) The drug industry has caused physicians to buy in to a bogus "one size fits all" dosage myth. That is, a 300-lb physically active NFL lineman gets the same recommended dosage as a 90-lb woman with an office job. This makes it extremely difficult for physicians to determine the correct dosage and they have to kind of feel their way along using blood tests as a guide. But patients hate this process and hate having their dosage switched a lot. It makes them feel like the physician doesn't know what he is doing. Also at issue is the fact that different statins have different effectiveness in different people. Another problem is that the FDA is forbidden to do, and the NIH is forbidden from funding research on which statins are the most effective. All this adds up to making the physician's job much more difficult.
4) And many people have their own therapies such as Cheerios in the morning or homeopathic of naturopathic remedies that they believe in, even though there is absolutely no concrete science to back them up. I have a neighbor who swears that monthly accupuncture has taken 40 points off his cholesterol even though he hasn't had a blood test in over 10 years. They seldom, if ever confide these snake oil remedies to their physicians because they know the physician will tell them that they are discredited or unproven.
5) And as this country becomes more and more Luddite and anti-science, people distrust their physicians, drugs, the FDA, and science and medicine in general. They would rather trust someone who says that eating cactus will do the trick --- or maybe eight bowls of Cheerios or the geeky kid at the health food store swears by it. Everything else is always some sort of drug company, political, or academic conspiracy.
I follow this stuff pretty closely because I am high-risk for a heart attack. I am 66 with hereditary low HDL and my father died at 37 from a heart attack. I take my statins and low-dose aspirin regularly. But my wife is a PhD university researcher and I can use her account to look at journal articles without having to rely on media "interpretations." Right now too little is known about cholesterol's role in the body and its role in both preventing and causing heart attacks. But scientists are working on it and we'll probably have the basics worked out in 20-25 more years. In addition, there are appearing to be strange side effects (such as reductions in colon cancer) associated with the use of statins, so I stay tuned.
But until then, it is a struggle for physicians to inform patients on such a complex subject in a 2 min 22 second average office visit.
USARogue--I agree that the individual should be more responsible. However, YOU have to be the biggest bull artist on here. Your earlier comment suggests you treat others? I doubt it. But, if true, only an idiot would come to you for treatment.
Sounds like drug company propaganda to me. Would you like a flu shot with that?
There are natural alternatives that are much cheaper than drugs - like red yeast rice and nopal cactus. In Mexico, nopal capsules cost $7.00 a month as opposed to $100.00 a month for statin drugs. And they work just as well.
Red Yeast Rice did not work for me. My doctor gave me free reign for a RYR regament for six months. When I checked, my cholestrol didn't budge one ioda.
I am currently on Zocor; I eat right and exercise. It has been dramatic dropping from 220 to 120.
p.s. Take statins at night since this is when your body produces the most cholestrol
Yeah Big Pharma has to love this study, probably means another 2 million fish on the hook to buy their drugs instead of people getting out and exercising and eating better.
I have exercised and eaten right all all my life and had a heart attack 4 months ago and my cholesterol wasn't high. It is more genetic than diet and exercise.
What if people stopped putting pure crap in their mouths? Maybe the heart attacks would decrease.
This is why the american PEOPLE ARE CORRECT when they demand that the healthcare bill currently in the congress be passed by next Thursday !!!!!!!
Yes, because that will magically lower everyone's cholesterol, shed all the fat, make smoking healthy, and cure cancer. Try to stay on target or take it elsewhere where you can debate politics to your heart's content. You should have plenty of people to argue with since just about everyone I've talked to is against the current proposed healthcare reform.
For those who would say that America is against this healthcare bill/reform - talk to me at the end of the month when it is law !!!!!!!!
Praise allah.
Wow
You're kinda out there, aren't you? Hate to tell you but I'm really not interested in talking to you today or in a month, particularly since this vine has nothing to do with the healthcare bill.
Hope you have a good life.
Did you ever notice how much contradiction about diet there is. One day avocado's are vilified for having fat, the next day they are a miracle food. This goes on and on. Some say eat a vegetarian diet soon afterwards a report appears that a vegetarian only diet leads to neurological damage. WE have medical groups and food lobbyists pulling on everyone with "facts". I think people get tired of it and just eat the HFCS foods being pushed at low cost resulting in more calories and in addition people do not exercise because of laziness but also distorted information on how much and what type. I believe I read the food pyramid was based on feeding regiments for livestock. LOL. Now it seems over the years the diet of the average citizen of Francde is heart healthy if so let's start eating butter, fish, chicken and drinking lots of wine to stay healthy plus runnin/walking 2 or 3 miles per day.
I was given beta blockers and advised to take aspirin 50-100 milligrams a day plus taking fish oil pills - I don't like eating fish, and it has worked so far.
Albeit having a BMI over 30, my LDL/HDL ratio is OK, I'm fine.
Sometimes I drink red wine, preferably Chilian - might be advised because of the earthquakes there, and because I heard that French or Italian treat the beverage as nutrient, and obiviously, it works.
Sometimes you don 't need expensive drugs who only help share-holders increase their assets.
I did something like this.
In order to avoid HFCS and other artificial crap added to our foods, I began 2 years ago to eat plain simple stuff I made rather than packaged or pre-made foods. Not that I ate lots of that stuff before but I never paid attention to HFCS or partially hydrogenated oils, or any incomprehensible additives to foods.
Now that every thing I eat is natural, organic, and locally grown or raised, my cholesterol finally went down for the first time in 15 years. Personally, I see no reason to change that idea since it may well be working.
Oddly enough though as you mention, my diet now consists of using real butter, 2% or whole milk, plenty of grass-fed beef and pork, veggies bought from our local CSA, and lots of my favorite, cheeses (dairy in general). I drink a glass of wine or a dark red juice (cranberry, grape, prune) whenever I eat any of those high fat foods. I read somewhere that they go better together (like eating egg whites with the yolks is actually better for you). You'd think I was this frenchie, eating all that supposedly high-fat, bad for you food, but again my cholesterol went down this year. I am hoping to see a repeat for next year.
Plus, my husband has lost 45 pounds because we changed to this "diet." We also removed gluten for him since he seems intolerant and the effect on his health has been amazing.
It probably is worthwhile for some people to really take a look at what they eat and change up a few things.
This article is simply pharm propaganda. All the study did was see how many docs were pushing their patients to the extreme guidelines of the drug companies. It did not prove people were dying for failure to meet those bogus levels. The reason docs do not comply is that the meds make people sick. We have measures, like C-reactive protein, which are far better at predicting MIs (heart attacks) than cholesterol. Over dosing on statins to get super low cholesterol predisposes people to a wide range of serious illness including heart and kidney failure.
yvonnemari and Jack Wiseheimer;
Somewhere out there is an optimal spectrum of human foods. I think there is a successful element in the French diet. I have found a reduction of foods high in gluten and/or starches to make me feel more vitalized and I have actually diminished my appetite. I also believe a exercise regime that alters muscle groups by contraction/expansion every other day along with some sort of cardiovascular training each day helps me. Admittedly I still have my battle with my waistline but the things I mentioned have helped me. Thanks for sharing your experiences. By the way I also enjoy Chilean red wine, Casillero del Diablo very good and inexpensive!
Without pretending to know too much, I can tell you right off the bat, that there is another culprit for high cholesterol: It's your thyroid... Yes, a subclinically underactive thyroid... Been there, done that!
No matter how healthy I've eaten all my life, how much I have exercised, how many natural supplements I've taken, my cholesterol levels have never gone lower than 240!!
There seems to be a correlation between hypothyroidism and high cholesterol. This is a well documented fact. And yet, all the physicians I've seen failed repeatedly to help me achieve the right dosage of thyroid medication in order to lower my cholesterol. My PCP has consoled me by stating that the medical establishment usually likes to "keep within the desired levels indicated for cholesterol."
Given all the side effects of all these cholesterol-lowering pills, I have decided to opt, once again for a more natural way to keep those numbers down. I chose this after a friend died from complications and side effects from those pills. He was healthy, but he always had high cholesterol. His physician insisted that he should try cholesterol-lowering medication. He also had hypothyroidism....
I would need to read this entire study to make a fully informed comment here but in general in my observation I feel that the doctors that I work with do an excellent job of attempting to keep their patients cholesterol levels under control. Statin drugs are very effective but along with that goes diet and exercise and therein lies the problem. Most patiets do not follow those guidelines. Most patients would not need medications if they followed a good diet plan along with an regular exercise plan, but they do not. You cannot imagine the number of patients that I see in the hospital every day who are on statin drugs who are greatly overweight who continue to eat what ever they want. There is a hereditary component but most studies have shown that the major influence on our cholesterol levels is what we eat and our lack of exercise.
There is a component of patient compliance to not reaching goals in the treament of all chronic problems. Studies have shown that half of patients taking statins following a cardiac event are still taking them after six months. These are people with disease! I can't imagine the numbers are better in primary prevention. The same holds true for beta blockers after MI, hypertensive treatment and most or all other conditions. The doctors, like football quarterbacks, are given too much credit when results are good and too much blame when they are not. They have a large part to play but cannot control all variables or succeed on their own.