For the past year or so it’s been my custom on the H&N board to post on point articles from a longevity site I’ve been following. Primarily marketing to tempt folk to subscribe (which I have) Here’s the latest of interest to me.
Particularly relevant right now as I’ve recently discovered that this pertains to me…and that I haven’t been doing everything possible to prevent atherogenic cardiovascular disease. This particular episode challenges many of the commonly held myths regarding risk assessment…some of which I was unaware of.
All my physicals have had a favorable lipid profile where the Usual Suspects were concerned. LDL just a hair high (most recent 115) but since all other numbers were “good”…including a high HDL (high 70s-low 80s) and hs-CRP <1 (recent.6)…along with a long history of the sort of lifestyle choices we’re all supposed to make, my risk of a cardiovascular event has always been determined as low.
Because I’m a proactive person, I decided to discuss a few things with my new primary care physician and, long story short, I had a Coronary Artery Calcium scan last week. Turns out my Agatson score indicates significant calcification…which is a measure of past disease. Who knew? Turns out that I am one of those folk statins were developed to for…folk with a familial predisposition to dyslipidemia. Seems that my healthy lifestyle and weight/body composition bamboozled everyone (including me). Should probably have been taking a statin as soon as they came on the market.
Don’t let the ASCVD risk calculator lead you astrat.
I take a statin. Hope it helps.
I’m sure it will. Not as much as if I’d started in my 20s, mind…but they weren’t on the market then.
I’m down to a 5mg statin, the generic Crestor, and still on the 81mg aspirin my old Doc started me on in the 80s I think…
I here rumbles of stopping the aspirin, resisting until my cardiologist tells me more and why, etc… Similar with the statin, so we’ll have nice discussion later this month…
Still trying to get back home sort of stamina after a couple years of avoiding crowds. No gym yet, they were rather blasé about the whole pandemic thing, so, we didn’t
t drop 'em, but went to a maintenance mode for now…
Local county case counts, Sonoma County, CA, have been rising, so still being cautious…
I know too many people who experienced bad side effects from statins. Several developed T2D, my mother experienced balance problems–had a couple of falls and finally broke her hip (before taking a statin she walked 1-3 miles a day, after? She had too stop walking), several folks with muscle problems–one person never got over them even after stopping the statin, my husband experienced most of the entire list of possible side-effects and was diagnosed with a rare dementia shortly thereafter (coincidence? I am not convinced of that-).
I here rumbles of stopping the aspirin, resisting until my cardiologist tells me more and why, etc…
For what it’s worth I changed cardiologists about a year and a half ago and one of the first things he did was put me on a baby aspirin. I didn’t care for the idea of adding another pill to the morning and evening ritual but went ahead and complied. Then about 6-8 months ago the news media came out with this story about baby aspirin being unnecessary. I figured ah ha I’ve got my ammunition needed to argue against the need for another pill. So on the next visit I brought it up with the doc and basically what he told me was the story on the news was basically a standard for all aspirin recommendations but that I was specifically being treated for something that required blood thinning to prevent clogging.
Anyway I lost my battle and continue to take the 81 mg baby aspirin.
YMMV. Good luck with your discussion with your doc. By the way the aspirin story is in the news again.
I know too many people who experience bad side effects from statins…
How would that number stack up against the people who have bad side effects from severe atherosclerotic coronary artery disease…like, say, strokes, heart attacks, angina etc.
Statins, like all drugs that have a definite, known mode of action (i.e, they work) have sides effects. They’re probably the most frequently prescribed and studied drugs around so the side effects are pretty well known and recognised. The side effects aren’t as common as the statin phobics like to promote on internetsites…or only as common as you’d find with a very commonly prescribed drug…especially if you count those suffering from nocebo effects or count the signs and symptoms of a concurrent disease into those numbers.
The tendency to increase the risk of T2D is certainly real, but relative to the overall risk in a patient…and relevant. Who are the people most likely to be taking a statin these day? Not folk like me or my husband who’ve been good custodians of our bodies for just about the last half century!, and with NONE of the hallmarks of metabolic syndrome, right? Quite the reverse…they’re oftentimes those who’re trending towards T2D even without the statins and doing little to arrest the trend so even a small percentage increase in A1c will put them into that category.
My husband has been taking statins for just over 3 years. The muscle pain he experienced at the beginning was far more likely due to the cardiac rehab after his surgery and introducing a weight training programme (delayed onset muscle soreness) than the coincidental start of statin therapy. His slight increase in A1c is probably due to the Lipitor …but a rise from 5.3 to 5.5 with a HOMA-IR score of 1.25 (very insulin sensitive) doesn’t look like approaching T2D to me. Like I said, it’s all relative and relevant to clinical context.
For sure, I’m not thrilled that I need to take statins…but that’s because of the reason I’m going to be taking them not the drugs themselves. I’m mighty relieved meds such as this are around to slow down a disease process that I played no part in initiating but has the potential for not only a premature death but a big compromise in my quality of life along the way.
…but that I was specifically being treated for something that required blood thinning to prevent clogging
There you go…relevant to the clinical context and the individual patient.
I put myself on 81mg aspirin many years ago. My GP at the time did not object. After a broken ankle that required surgery I had blood clots that got to my lungs. I continued the aspirin. After a while acquired a cardiologist who suggested I stop the aspirin. I stopped it. Three months later I was in the hospital with more blood clots. When I got out I was put on a blood thinner, Xeralto. I also acquired a hematologist to monitor that. When I read up on Xeralto, and aspirin, I noticed that they acted in two different ways. When I discussed that with the hematologist, pointing out the correlation between stopping the aspirin and the clot. He asked if I would be more comfortable back on the aspirin. I said yes, and am back on it, as well as the Xeralto.
(Xeralto was going to be crazy expensive. A pharmacist came up with some sort of coupon that cuts the price to $10 for each refill. That used to be $10 per month, but after a while the prescriptions were changed to 90 days, $10 per quarter. I carry that coupon in my wallet.)
Still trying to get back [s]ome sort of stamina after a couple years of avoiding crowds.
Walk, man. Every day, even if just for 20 or 30 minutes, sustained. Enjoy the outdoors. You’re in a beautiful place. Get a couple of lightweight dumbbells, if you want, and do some full range of motion moves with them while you watch TV. Or even just use a coupla soup cans or somesuch. It doesn’t need to be complicated, or costly. You’ll be happy you did.
My internal med Doc started me on Crestor, but always gave me samples for a month or two, then as they went generic, the samples dried up, but cost also dropped/// Cardio Doc worked on reducing the dosages, so it’s all working out OK…
Sirius’s Doctor Radio (NYU) has a great Cardiologist show I try to catch, but as I drive less, I miss a lot, but I can catch it on my iPhone, if I remember… We were particularly interested years back with our mid-grandson, born with multiple heart defects, missing septum, bad valve, wrong side, and bad plumbing besides, so they operated at birth, to stop the closure of the one vessel, then they did a procedure to convert his heart to a 2 chamber, heart to lungs to body and back. Beats faster, works harder, they thought he’d need a transplant in 20 years, it’s now 25 years later, and doing well, a bit of ADD, but is headed off to Art classes at UCLA next semester! Hence the attention of heart issues way back. Pretty amazing on how it develops, but sometimes that doesn’t work out… Complicated…
Anyway, we’re off to go for a walk with my son & family, just because!
A follow up to this first appropriate podcast. OMG…he’s talking about me!!
At about the 8.40 mark and the mention of the reality that super high HDL-C isn’t as protective as oftentimes touted…especially when non-HDL-C is elevated. Then again at around 10.40 and mention of the Apo-B particle (plays a big role in initiating the whole cascade of atherosclerotic events, apparently)