131–140 of 197 posts
Before getting a CAC scan, I'd probably do these tests first: * ApoB - about 20% of people with normal cholesterol results will have abnormal ApoB, and be at risk of heart disease. * Lp(a) - the strongest hereditary risk factor for heart disease. * hs-CRP - inflammation roughly doubles your risk of heart disease * HbA1c - insulin resistance is a risk factor for just about everything. * eGFR - estimates the volume of…
Given the low side effect rate and limited overall impact, shouldn't the bar for deciding to take statins be near-zero? Like, the articles say if there's a 5% chance of a heart attack in the next 10 years there's no reason to take a statin, but if the statin changes that 5% to 4% (that's speculation on my part) then given the limited side effects it would likely be worth it, right?
The current guidelines for prescribing statins are based on your risk of a major cardiac event in the next 10 years (forecasted using a statistical model). But given that plaque builds up in your arteries over your lifetime, there's a strong argument for using a 30-year or lifelong time horizon.
“20% risk means we need to without a doubt medicate people for the rest of their life!” This really says something to me about American medicine. Something is going to get you at some point. Is something that has a 80% risk of not happening really justify medication which comes with it own cost and risk? Another article on this topic was posted a few weeks ago and prompted the same reaction in me.
https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate...
One thing I’ve wondered is why getting a diagnostic test done out of pocket in the US of your own volition (without a doc prescription) isn’t possible. Why does it need to be controlled by a doc and insurance? In India this is common. They probably use the same expensive machines for x rays and MRIs but anyone can walk in, and pay for a diagnostic test and get numbers (well, not everyone can afford it, but generally…
Its not impossible to get diagnostic tests done outside the scope of a GP. It's generally very expensive.
Before getting a CAC scan, I'd probably do these tests first: * ApoB - about 20% of people with normal cholesterol results will have abnormal ApoB, and be at risk of heart disease. * Lp(a) - the strongest hereditary risk factor for heart disease. * hs-CRP - inflammation roughly doubles your risk of heart disease * HbA1c - insulin resistance is a risk factor for just about everything. * eGFR - estimates the volume of…
Given the low side effect rate and limited overall impact, shouldn't the bar for deciding to take statins be near-zero? Like, the articles say if there's a 5% chance of a heart attack in the next 10 years there's no reason to take a statin, but if the statin changes that 5% to 4% (that's speculation on my part) then given the limited side effects it would likely be worth it, right?
The rate of serious side effects is quite low (e.g. brain fog), but the reported rate for muscle weakness is non-trivial.
Earlier quoted context omitted.
I think, politely, this perspective misses the forest for the trees (or maybe the trees for the forest). Out of the approx. 250 million adult americans, a large cross section do manage their health. While average outcome might be better in the UK, it's useless to lump the 60% (150 million) of americans who are not obese in with the 40% (100 million) who are obese. And while this is easily the most major, it is just o…
As an anecdote, I saw just this morning plastic adirondack chairs for sale outside a grocery store, and they had a large sticker on them proclaiming in 4-inch lettering that they are rated for 350 pounds(!). That says something sad about the U.S.
That a lot of couples like to share the same chair??
One thing I’ve wondered is why getting a diagnostic test done out of pocket in the US of your own volition (without a doc prescription) isn’t possible. Why does it need to be controlled by a doc and insurance? In India this is common. They probably use the same expensive machines for x rays and MRIs but anyone can walk in, and pay for a diagnostic test and get numbers (well, not everyone can afford it, but generally…
This test is also being heavily misused and misinterpreted in some online communities. There are a lot of people posting CAC scan results after something like a year of keto dieting in their 20s or 30s and using that to conclude that the saturated fat connection to atherosclerosis is a myth or that high cholesterol is fine. These tests don’t have perfect accuracy and resolution, so low or zero results don’t mean that…
Earlier quoted context omitted.
I wonder if all symptoms would show on an EKG though. Would reduced coronary blood flow alter electrical signals ?
That’s a stress test. Attach an EKG, have the patient ride a bike with significant exertion. If there is a lack of blood flow, it will show up in the EKG as alteration of the electrical signals through the heart.