Off/On Topic …Of Interest/Importance. To a good many, at least.
So, still pondering the realities of finding out about my ASCVD and my induction into the Pill Popping and Shot Giving Hall of Fame, I’m getting a fair bit of unsolicited information drifting my way thanks to my online information gathering. Here’s one of the latest…
It’s an interesting topic and one that’s come up repeatedly over the past few decades of Cholesterol denialism and statin phobia on the H&N board. Was never really interested on a personal level until now.
Well, for me (and dh) it hasn’t happened yet…but then again we’re probably not typical of most patients in the study under discussion.
Another puzzle piece to add to the picture for anyone trying to make an informed decision on personal risk reduction.
My risk is my 80s and particularly upper 80s if I get that far would be stroke. A statin is not necessary since my weight loss but common sense to take regardless. A minor dose.
I already have diabetes from the previous weight problems.
Well, for as much as I beat myself up asking what I did to gift myself with this state of affairs, it’s a big fat nothing…other than dismissing my mum’s cardiovascular issues as due to her smoking.
An exemplar of healthy eating and exercise for the past half century…and even before that if you count the time under my parents’ roof…and it turns out that it’s the genetic hand I’ve been dealt. I’ve come round to the point of view that my high Righteous Living Quotient has itself been a bit of a smokescreen there. For as long as I’ve noticed…say the past 15-20 years (so post menopause)…my lipid profile has been great other than a mildly elevated LDL-C and LDL-P. Up until moving to the Wild West, my PCPs/internists have always been dh’s colleagues so a known entity and their take has always been that there’s more to cardiovascular health than tinkering with individual numbers and I’m obviously doing it right. Which sounds like thinking, enlightened medical care, right? What you want to hear. Well, of course, real enlightened medicine would’ve posed the question “If I’m doing everything “right”, why.is this number still off?” And I do believe that if I’d walked into their offices toting an extra 50lbs or so rather than a BMI of no more than 22 with good body composition, that exact same lipid profile would’ve been attended to!
I started to wonder about this a good couple of years ago when I took out a subscription to Peter Attia’s podcasts…initially intending to do a monthly subscription to listen to the full episodes of some exercise related teasers he’d sent in my email (purely out of the goodness of his heart, I’m sure😉) Became very apparent that a month would not be enough. Then I got to listening to some of his other guests…oftentimes academics specializing in lipidology, ASCVD etc, and the rest is history…
I’ve certainly escaped my mum’s fate…peripheral vascular disease, renal artery stenosis, stroke and ultimately congestive heart failure starting in her very early 60s.
Bottom line, there is no treatment without side effects and complications. Some are more easily seen than others. As far as statins and diabetes, I can see where it is hard to see the association because the 2 diseases being treated have overlapping lifestyles.
As an aside, cholesterol levels need to be viewed in association with a C reactive protein level (among other things). If CRP (a measure of inflammation) is normal, the chances of an elevated cholesterol causing issues is decreased.
Again, the whole picture needs to be looked at, not just one number.
Yes. My thoughts cannot pass TMFs profaniy censor…750!!! That was followed rapidly by an appointment with an intervention cardiologist and CTAngiogram with flow analysis. If you’re interested I’ll reproduce it here if I can remove any identifiers but basically I have 3 coronary arteries with greater than 75% blockage and a couple more ain’t much better. No symptoms whatsoever…I only did the CAC scan to put my mind at rest per the subject of a link I posted on the topic a while back. Goes to show you, right?
I have seen a cardiologist as of last year. He looked at a December 2019 calcium test literally bringing up the “video” of sorts from the archive. He fully thinks there is next to no plaque. The legs were done the prior year and there is no plague there either.
The issue is protection because I was 250 lbs. There is no standard of care for people who have properly lost 50 lbs and kept it off coming up in August for two years. There is not a sample large enough to run enough studies on two formulate a standard of care. I am taking minor doses of Metformim and Rosuvastatin to err on the side of caution.
Mom went on a statin around age 80. She was not happy to have to add it.
I am rethinking adding K2 MK7. Calcium studies are barely coming onto my radar. There are issues with calcium, aging and diet. These are related to blood and bone.
So my efforts to tease out what was goin on started with my physical last year when I initiated the discussion with my new PCP. As well as suggesting a CAC scan, I asked about measuring circulating insulin seeing as insulin resistance is but one driver of vascular disease. Normal fasting glucose and A1c but why wait till they get out of whack? Husband did a quick calculation on results and my HOMA-IR score was 1.25 so, apparently not too shabby at all. I know an OGTT would be the Gold Standard but even I don’t care to go that far.
Per the hs-CRP…never been higher than .8 so, you can see why I accepted the reassurances.
FWIW, I’ve become a bit miffed (says she, euphemistically) that Bad Habits have so taken over the narrative these days…both in lay circles and even within the community that ought to know better. Don’t get me wrong…folk with Bad Habits certainly need to be taken care of but not at the cost of assuming that a high Righteous Living Quotient can act like some sort of vaccine.
Well, I’m not going down that rabbit hole, Andy, TYVM but now that I think about it, on one of my past Peter Attia podcasts there was a bit of a discussion on all the genotypes that predispose to ASCVD and other maladies associated with “high cholesterol” if we live long enough and why they exist. The thinking is, apparently, that in the time of our ancestors when life was usually short and brutal thanks to trauma and infection, these genes that enabled a quick inflammatory response were very useful and conferred enough of an advantage that they’ve survived long enough to bite us in the coronaries. Especially if we give them an even better chance to wreak havoc with all the risk enhancers available to us…smoking, overeating, oversitting etc.
Correlation is not causation. As the study states:
But the participants in these studies were also ill during the first wave of Covid cases, when people were largely staying home.
There were “changes in behavior, including diet and lack of exercise” that could be a factor in the higher cholesterol levels, said Dr. Glenn Hirsch, chief of cardiology at National Jewish Health in Denver. He said his team has seen increases in the risk for many conditions following Covid, including diabetes, cardiovascular disease and kidney disease.
My hypothesis is that people who got Covid (and got it severe enough to have reported such) include a higher percentage of people than the general populace that are already predisposed to other health risks - especially among the cadre that refused to be vaccinated. The article doesn’t mention this fact but if you click the link at the bottom it states:
My guess would be that the vaccinated, by and large, have different results (also probably correlation).
I know what you mean VeeEnn, I hate conspiracy theories but… I just went to the doctor for my yearly checkup and had unusually high Cholesterol readings. So…I found this encouraging because now I can tell my doctor it wasn’t all the shrimp, cheese, beer, sausage, and partying I did over the holidays that increased my cholesterol. Oh no Doc, it was covid. So don’t worry let’s give it a year or two.
