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Ticker: Don't die of heart disease

myticker.com

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Re: Ticker: Don't die of heart disease

#311

Post by sn9 »

hackama wrote: post #17

Very interesting, but do the numerous mentions of taking action in your 20s, 30s and 40s mean it's too late for someone in their 50s? Nitpick: he mentions LDL-C but the test results don't mention that at all. Only later do I see that is "LDL Cholesterol".

It's like time in the market.

In a real sense, you've spent decades likely increasing your risk unnecessarily when taking action early would have given you the greatest leverage to lower your lifetime risk.

But you can't change the past. If you didn't plant a tree 20 years ago, plant it today and you'll still get some benefit, minimizing any future increase in risk and maybe even lowering it.

You could realistically have almost half your life left before you, and you can still end up being fitter and healthier than you've ever been in your life if you adopt healthy habits around diet, strength training, and endurance training.

Re: Ticker: Don't die of heart disease

#312

Post by nradov »

btilly wrote: post #235
mac-mc wrote: post #82

Earlier quoted context omitted.

If you fix it without statins through better lifestyle and diet, that is the preferrable route. As to why medicine is like this, it's because it's conservative, usually about 17 years behind university research[0], and doctors are shackled to guidelines in most health systems or risk losing their licenses. It isn't a coincidence that the article author had his out-of-pocket concierge doctor tell him the more up-to-da…

I have an objection to the "better lifestyle and diet" approach. Sure, it is absolutely true that better lifestyle and diet has a huge effect. However it is absolutely certain that the vast majority of people who are told to improve their lifestyle and diet, won't. The result is doctors giving advice that they know won't be followed. And thereby transferring potential fault from the doctor to the patient, with no imp…

You're arguing against a strawman. The reality is that most doctors will tell the patient their options and let them pick. While statins have some significant side effects in many patients, there is no downside to a better diet and frequent hard exercise (assuming proper technique). So it usually makes sense to at least try lifestyle modification as the initial therapy. And if that doesn't work for whatever reason then prescribe the drugs.

Re: Ticker: Don't die of heart disease

#313

Post by nradov »

kelseyfrog wrote: post #284
a1studmuffin wrote: post #282

Earlier quoted context omitted.

Your health is ultimately your own responsibility - it's your body. You have free will, and your appetite for risk is yours alone. You can choose to ignore expert advice and refuse to wear a seatbelt, skip your rehabilitation exercises, invest all-in on crypto, or smoke cigarettes. None of this responsibility should fall on the expert if they communicated the risks clearly.

What if you have an intrinsically lower ability to perform temporal discounting?

Is that really something intrinsic and fixed or can you improve it over time with deliberate effort?

Re: Ticker: Don't die of heart disease

#314

Post by sn9 »

lateforwork wrote: post #40
DharmaPolice wrote: post #23

Earlier quoted context omitted.

Dementia seems a pretty awful outcome too. I hope my heart gives out before my brain.

Alzheimer's too.

If you made a Venn diagram for the non-genetic risk factors for heart disease and Alzheimer's, they'd basically be a circle.

Being worried about dementia but ignoring things like heart disease, diabetes, poor sleep, getting enough exercise, eating a health-promoting diet, etc. is like worrying about paying for retirement but refusing to save and invest.

There are a handful of high-impact habits that meaningfully lower your risk for the major killers people are worried about: https://www.barbellmedicine.com/blog/where-should-my-priorit...

Re: Ticker: Don't die of heart disease

#315

Post by nradov »

kryogen1c wrote: post #146
mac-mc wrote: post #82

Earlier quoted context omitted.

If you fix it without statins through better lifestyle and diet, that is the preferrable route. As to why medicine is like this, it's because it's conservative, usually about 17 years behind university research[0], and doctors are shackled to guidelines in most health systems or risk losing their licenses. It isn't a coincidence that the article author had his out-of-pocket concierge doctor tell him the more up-to-da…

>doctors are shackled to guidelines To expand, one of the coverage pillars of malpractice insurance (in the US) is the "standard of care". This is basically what most doctors and their associations consider acceptable, which by definition excludes new, better techniques. This is both a bug and a feature. A move fast and break things philosophy would cause more harm than good, but it also prevents rapid adoption of in…

You are conflating two different things. The standard of care in a malpractice lawsuit is not necessarily the same as clinical practice guidelines. In reality doctors are free to rapidly adopt incremental improvements, especially when they are evidence based.

Re: Ticker: Don't die of heart disease

#316

Post by sixtyj »

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.

How many studies is enough? There were approx. 60k+ participants in them. If I got it right…

Re: Ticker: Don't die of heart disease

#317

Post by jodrellblank »

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.

> "wouldn't you pick heart disease? It is the best way to die."

Dick Cheney (former USA Vice President) died a few days ago. Let's recap his publically known health:

- 1978 heart attack, age 37

- 1984 heart attack

- 1988 heart attack

- 1988 quadruple bypass surgery

- 2000 heart attack

- 2000 stent

- 2001 balloon angioplasty

- 2001 implantable defibrillator

- 2005 atery repair vascular surgery, stents behind the knees

- 2006 shortness of breath, hospitalized, blood clot

- 2006 travels everywhere with an ambulance standing by. Accidentally shoots friend. Friend has heart attack.

- 2007 deep vein thrombosis treatment, atrial fibrillation

- 2008 minor heartbeat irregularity

- 2010 January heart attack

- 2010 July Left-Ventricular Assist Device (LVAD) surgery for worsening congestive heart failure.

- 2012 heart transplant, cardiologist said "it would not be unreasonable for an otherwise healthy 71-year-old man to expect to live another 10 years".

- 2025 death, age 84, from complications of pneumonia and cardiac and vascular disease.

Or President Dwight Eisenhower:

- 1955 heart attack

- ? heart attack

- ? heart attack

- 1968 heart attack, heart attack, heart attack, heart attack

- 1968 cardiac arrest, cardiac arrest, cardiac arrest, cardiac arrest, cardiac arrest, cardiac arrest, cardiac arrest, cardiac arrest, cardiac arrest, cardiac arrest, cardiac arrest, cardiac arrest, cardiac arrest, cardiac arrest

- 1969 death from heart disease

Definitely not the best way to die. Heart disease is palpitations, fibrillation, chest pain, back pain, angina. It's leg swelling, breathlessness, dizziness, fatigue, slow wound healing. It's statins, beta blockers, stents, pacemakers, defibrillators, coronary bypasses, valve replacements, open heart maze scarring, angioplasty. It's not all widowmakers and sudden death. I would pick one of those "fell alseep and didn't wake up" things.

Re: Ticker: Don't die of heart disease

#318

Post by nradov »

hshdhdhj4444 wrote: post #253
mac-mc wrote: post #82

Earlier quoted context omitted.

If you fix it without statins through better lifestyle and diet, that is the preferrable route. As to why medicine is like this, it's because it's conservative, usually about 17 years behind university research[0], and doctors are shackled to guidelines in most health systems or risk losing their licenses. It isn't a coincidence that the article author had his out-of-pocket concierge doctor tell him the more up-to-da…

Licensing but also insurance. I think only recently have insurance companies started covering APoB testing in your annual exams (or that may just be my insurance…).

Many commercial health plans will only cover an ApoB blood test for patients with certain conditions or risk factors. But if you want it you can pay out of pocket for like $70.

Re: Ticker: Don't die of heart disease

#319

Post by Fire-Dragon-DoL »

ponector wrote: post #307
Fire-Dragon-DoL wrote: post #252

Earlier quoted context omitted.

We don't know how to treat obesity 100% though

Are you joking? We do know how to treat eating disorders. Same as we know how to treat opioid addiction or alcoholism.

No I'm not, as far as I'm aware "diet" is one of the "drugs" with highest failure rate ever

Re: Ticker: Don't die of heart disease

#320

Post by OutOfHere »

floundy wrote: post #309
OutOfHere wrote: post #198

Earlier quoted context omitted.

Please strictly cease and desist from accusing material of being written by an LLM, whether on this site or on any other site. If you want to criticize the material, do so under the good faith assumption that it is written by a human.

Genuinely, why? More people than ever are using LLMs to flood the internet with textual slop far faster than humans who have respect for the craft of writing can generate their own text. I checked Jared Hecht (the author of this piece’s blog) at jared.xyz and the oldest piece is from March 2023. Why should we give someone who has no evidence of writing anything before the release of ChatGPT the benefit of the doubt t…

Because the signs are only in your head. There is no hard evidence. It is a disingenuous and false way to attempt to discredit someone. Anyone can be accused of it for writing anything at all. The argument that the writing started after the invention of ChatGPT is simply horrible because everyone starts sometime.

It's like calling someone a witch in historical times. By the way, your comment looks to be AI generated, so please do us a favor and stop generating more slop.

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