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Ticker: Don't die of heart disease

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Re: Ticker: Don't die of heart disease

#171

Post by Flere-Imsaho »

toast0 wrote: post #167
Flere-Imsaho wrote: post #139

Earlier quoted context omitted.

I learnt a great trick about exercise: find a podcast or audio book that you really enjoy listening to. Here's the trick: you're only allowed to listen when you're exercising. Also with food and drink: place friction between the treat and yourself. The easiest example is to not have biscuits / alcohol in the house. Bonus tip: alcohol free beer is really good these days.

If you're exercising for cardio, and you're able to follow your book or podcast, you're probably not doing good cardio. OTOH, it's not a bad way to do interval training while watching sports, go hard when they're yammering, slow down when the sports are happening (or, if you're watching soccer, you can go hard most of the time and then slow down for the replay if anything happens, which is unlikely)

I lift weights, so there's lots of pauses between the sets!

However I can definitely listen to a podcast when using a static bike... As long as your heart rate is 75‰

Re: Ticker: Don't die of heart disease

#172

Post by bluGill »

reidrac wrote: post #94

There are some points on this post that confuse me. > In early 2023 during a routine skin check at my dermatologist [...] Are routine skin checks a thing? > [...] I’ve spoken with several of the world’s leading cardiologists and lipidologists [...] How come?

they are to me. I'm very light skinned and thus have had sigificant sunburn more than once, skin checks have found and removed somewhat likely to turn into cancer. Probably useless if you are 20, but by 50 they can find and prevent cancer and so should become common

Re: Ticker: Don't die of heart disease

#173

Post by fwip »

Apes wrote: post #114
safety1st wrote: post #83

Earlier quoted context omitted.

Right. Hang on a second. This guy is making a big big claim. The central point of his article is that he went to a doctor who followed the guidelines, tested him and found he wasn't at risk for heart disease. But then he went to another, very expensive concierge doctor, who did special extra tests, and discovered that he was likely to develop heart disease and have a heart attack. Therefore he is arguing that THE STA…

I strongly suspect the truth is both are "right", but they're both optimized answers to slightly different problems. Mainstream medicine is hyper optimized for the most common 80% of cases. At a glance it makes sense: optimize for the common case. Theres some flaws in this logic though - the most common 80% also conveniently overlaps heavily with the easiest 80%. If most of the problems in that 80% solve themselves,…

Part of providing good care is not burdening the patient with tests or treatments that are very unlikely to yield benefit. Put another way, the mission of healthcare is not "health at any cost."

Re: Ticker: Don't die of heart disease

#174

Post by GeoAtreides »

Aurornis wrote: post #122
sixtyj wrote: post #107

Earlier quoted context omitted.

https://jamanetwork.com/journals/jamainternalmedicine/fullar... Meta-analysis conclusion: This literature-based meta-analysis did not find evidence for the benefit of statin therapy on all-cause mortality in a high-risk primary prevention set-up.

A meta-analysis that only includes 11 studies on statins is immediately suspect. There have been a lot of studies on statins. If a meta-analysis comes along and only cherry picks a couple of them, something is up.

Have you read their methodology and understood how they did their selection? You could critique their actual methodology. Maybe their selection is backed by strong arguments, right? And if you think their methodology is weak, then please explain why.

Not just throw a two-line comment disparaging the work of experienced specialists in the field.

For the curious, here are the author affiliations for this study:

Department of Public Health and Primary Care, University of Cambridge, Cambridge, England (Drs Ray, Seshasai, and Erqou); Department of Cardiology, Addenbrooke's Hospital, Cambridge (Dr Ray); Department of Clinical Pharmacology and Therapeutics, Imperial College, and National Heart and Lung Institute, London, England (Dr Sever); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (Dr Jukema); and Department of Statistics (Dr Ford) and BHF Glasgow Cardiovascular Research Centre, Faculty of Medicine (Dr Sattar), University of Glasgow, Glasgow, Scotland.

Re: Ticker: Don't die of heart disease

#175

Post by GeoAtreides »

echelon wrote: post #69
dust42 wrote: post #63

Long story short care about your health. If you don't do already, maybe now is a good time to start. What you put into your body: no processed food, cook yourself, lots of variety of veggies and fruits, little meat, little alcohol. What you do with your body: regular exercise, low stress, enough sleep. What you do with your mind: good social environment, good relationships. And an apple a day keeps the doctor away!

> lots of variety of veggies and fruits, little meat This is wrong. Our bodies evolved to rend flesh and eat meat. They are optimized by millions of years of evolution to process and run on meat. The biochemical pathways of carb-heavy diets put more oxidative stress on the body.

>Our bodies evolved to rend flesh and eat meat.

is that why we have flat molars? for eating meat?

(spoilers: no, the flat molars are not for eating meat)

Re: Ticker: Don't die of heart disease

#176

Post by AaronAPU »

captainkrtek wrote: post #60
AaronAPU wrote: post #32

I was planning to start getting scans ordered for specific risks like aneurysm or heart attack but what holds me back is the idea the scans will harm me worse than those things. It is very difficult to have any level of confidence with the medical industry so my current approach has been to eat as healthy as possible while staying as fit as I can without undue extreme stress.

A relevant anecdote. I’m very athletic and skinny, eat well, have a resting heart rate in the 40s, but was recently prescribed a statin at 30, due to my very high LDL cholesterol and lipoprotein A. My family has a history of cardiovascular disease despite us doing what we can w.r.t eating and exercise. I’d encourage you to get some tests at least. My mother similarly was put on statins and is getting a cardiovascular…

They have me on blood pressure meds and do the usual blood tests, the tests I considered have been elective and I requested them explicitly. Just haven’t followed through due to aforementioned hesitations. I’m very much aware heart issues run in the family and that I have symptoms.

But I would be very happy to do any elective non invasive tests. On the fence about going beyond that until/unless the Dr. flags it as needed.

Re: Ticker: Don't die of heart disease

#177

Post by k__ »

fullStackOasis wrote: post #50
k__ wrote: post #19

There doesn't seem to be any mention of hypertension on that page.

Actually, there is. You have to search for "pressure". For example, "Other Tests: There are some other things that are important to know as well. You must know your blood pressure".

Good point.

I've forgotten that blood pressure is another word for it, as all medical papers use hypertension.

Thanks!

Re: Ticker: Don't die of heart disease

#178

Post by rasse »

safety1st wrote: post #83
carbocation wrote: post #56

Key Takeaway: Get a CT or CTA scan, and if you can afford it go for the CTA with Cleerly. There is a reason that we don't recommend getting imaging for everyone, and that reason is uncertainty about the benefit vs the risks (cost, incidentalomas, radiation, etc, all generally minor). Most guidance recommends calcium scoring for people with intermediate risk who prefer to avoid taking statins. This is not a normative…

Right. Hang on a second. This guy is making a big big claim. The central point of his article is that he went to a doctor who followed the guidelines, tested him and found he wasn't at risk for heart disease. But then he went to another, very expensive concierge doctor, who did special extra tests, and discovered that he was likely to develop heart disease and have a heart attack. Therefore he is arguing that THE STA…

It's important to note that there's geographic variability in guidelines. Also, the article doesn't give enough information about the author's other risk factors. For a similar patient (based on the initial lab results), treated by a doctor adhering to the European guidelines, at least the following items would have been considered:

- Lipid lowering drugs

- ApoB testing

- Coronary CT (if the pre-test likelihood of obstructive coronary artery disease was estimated to be > 5%)

- Diabetes tests

- Kidney tests

Re: Ticker: Don't die of heart disease

#179

Post by rufus_foreman »

lateforwork wrote: post #5

The title of the article says "don't die of heart disease", but given that we all have to die at some point, if you could choose what natural cause to die of, wouldn't you pick heart disease? It is the best way to die. The worst is stroke. So once you cross a certain age, say 60, don't worry about heart disease, worry instead about stroke.

>> given that we all have to die at some point, if you could choose what natural cause to die of, wouldn't you pick heart disease?

Monty Python, "The Meaning of Life", Part VII.

Re: Ticker: Don't die of heart disease

#180

Post by guerby »

m_a_g wrote: post #161
lateforwork wrote: post #152

Earlier quoted context omitted.

There are plenty of statin skeptics and for good reasons; see prior discussion here: https://news.ycombinator.com/item?id=45430939

> and for good reasons That prior discussion gives no good reasons. The linked medium posts are, to be frank, trash. Statins are well-tolerated drugs with little to no noticeable side effects. You might have to try a few. You may need to combine ezetimibe to maintain a moderate statin dosage level, and that's it. (Like the author of this article) Source: Leading cardiologists worldwide, and doctors of the rich and fa…

What the BMJ has to say on this very topic of statins:

https://www.bmj.com/campaign/statins-open-data

So no settled science here.

Unless you consider the BMJ a trash journal of course.

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