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Ticker: Don't die of heart disease

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Re: Ticker: Don't die of heart disease

#331

Post by bluGill »

zzzeek wrote: post #290
btilly wrote: post #235

Earlier quoted context omitted.

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…

> Sure, it is absolutely true that better lifestyle and diet has a huge effect. not for me. My cholesterol was hovering in the high 200's, then finally hit 300 and I completely freaked out, radically changed my diet, and lost 22 pounds (from 180 to 158). What did my high cholesterol do ? It did absolutely nothing. ticked down to like, 280. So I'm on the statins. my total cholesterol went from high 200's to about 150…

i think diet an exercise can get you 20 points lower but you needed 150 or so and no diet claims that.

i don't know how to source that but I recall a few 20 points lower diets making the news over the years

Re: Ticker: Don't die of heart disease

#332

Post by recursive »

getnormality wrote: post #300
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 you're communicating here, perhaps unintentionally, is that what matters is not results, but blame. If the doctor said what to do but the patient didn't do it, all that matters is the patient is to blame. You've communicated that by ignoring or dismissing the question of whether better outcomes are possible through other means than demanding that everyone follow doctors' orders and blaming them if they don't. "W…

It's hard to help someone that doesn't want to be helped.

Re: Ticker: Don't die of heart disease

#333

Post by bluGill »

ekianjo wrote: post #128
Aurornis wrote: post #122

Earlier quoted context omitted.

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.

> There have been a lot of studies on statins Financed by who?

Lots of people. Statins are fairly cheap and a lot of people are on them. Cholesterol is also cheap to measure. As a result the two are commonly studied. Even if your goal isn't the above it is probably in the study data.

Re: Ticker: Don't die of heart disease

#334

Post by agiacalone »

sn9 wrote: post #296
zzzeek wrote: post #290

Earlier quoted context omitted.

> Sure, it is absolutely true that better lifestyle and diet has a huge effect. not for me. My cholesterol was hovering in the high 200's, then finally hit 300 and I completely freaked out, radically changed my diet, and lost 22 pounds (from 180 to 158). What did my high cholesterol do ? It did absolutely nothing. ticked down to like, 280. So I'm on the statins. my total cholesterol went from high 200's to about 150…

> My cardiologist tells me that the conventional wisdom of "diet and exercise" is almost entirely disproven to have any meaningful effect on lipids these days (though i havent researched deeply). I would be immensely skeptical of this unless he was talking about something much more narrow, like how there's a fraction of people who have really unfortunate genetics and can only improve their blood lipids with medicatio…

> I would be immensely skeptical of this unless he was talking about something much more narrow, like how there's a fraction of people who have really unfortunate genetics and can only improve their blood lipids with medication.

I am one of those unfortunate genetic people, sadly, and have had high cholesterol numbers since my early 20s. Most of my older grandparents passed from heart disease. Now in my 40s, have a decent diet, and my numbers are The good news is that it's a pretty low dose with decently high effect.

Re: Ticker: Don't die of heart disease

#335

Post by btilly »

a1studmuffin wrote: post #282
btilly wrote: post #235

Earlier quoted context omitted.

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…

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.

If my health is my responsibility, then shouldn't the treatment that I receive be to the standard that I request?

In 2015, https://pubmed.ncbi.nlm.nih.gov/26551272/ showed that medicating all of the way to normal works out better than medicating down to stage 1 hypertension, then insisting on diet and exercise. And yet my request in 2018 to be medicated down to normal blood pressure was refused, because the professional guidelines followed by the experts was to only medicate down to stage 1 hypertension, then get the patient to engage with diet and exercise. The expert standard of care was literally the opposite of what research had shown that they should do.

I agree that experts should not be accountable for my laziness. But can you agree that experts should be accountable for following standard of care guidelines that are in direct conflict with medical research? And (as in my case) refusing the patient's request to be treated in a way that is consistent with what medical research says is optimal?

Re: Ticker: Don't die of heart disease

#336

Post by kelseyfrog »

nradov wrote: post #313
kelseyfrog wrote: post #284

Earlier quoted context omitted.

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?

Open to evidence either way. I haven't seen people improve it even with what seems to be terrible negative consequences associated with poor temporal discounting ability, but I'd love to read differing perspectives.

Re: Ticker: Don't die of heart disease

#337

Post by btilly »

zzzeek wrote: post #290
btilly wrote: post #235

Earlier quoted context omitted.

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…

> Sure, it is absolutely true that better lifestyle and diet has a huge effect. not for me. My cholesterol was hovering in the high 200's, then finally hit 300 and I completely freaked out, radically changed my diet, and lost 22 pounds (from 180 to 158). What did my high cholesterol do ? It did absolutely nothing. ticked down to like, 280. So I'm on the statins. my total cholesterol went from high 200's to about 150…

Your anecdotal report that diet and exercise did not have a huge effect on your cholesterol does not discount the mountain of evidence that we have showing that diet and exercise has a huge effect on health and lifespan.

These effects were first demonstrated in 1953. And has been confirmed over and over again since.

So don't discount the value of diet and exercise just because losing weight didn't fix your cholesterol.

Re: Ticker: Don't die of heart disease

#339

Post by bargainbin »

Anyone note where to get this full blood panel done in the UK? I’ve got issues with high blood pressure and swelling in the lower extremities. Blood tests and ECG showed nothing.

Both granddads died in their 50s from heart attacks. I’m convinced I have an issue with my circulation but the blood tests I had done doesn’t seem to cover everything stated here.

Re: Ticker: Don't die of heart disease

#340

Post by btilly »

kelseyfrog wrote: post #336
nradov wrote: post #313

Earlier quoted context omitted.

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

Open to evidence either way. I haven't seen people improve it even with what seems to be terrible negative consequences associated with poor temporal discounting ability, but I'd love to read differing perspectives.

Research on heritability have found that the amount of temporal discounting we do is moderately heritable. With twin studies ranging from 30-60% of our natural variability explained by genes.

This strongly suggests that genetics definitely slips a thumb on the scale, but ultimately we are able to also impact our personal behavior.

More importantly, research such as https://pubmed.ncbi.nlm.nih.gov/31270766/ shows that there are techniques (such as mindfulness practices) that have been demonstrated to improve our abilities in practice. I have personally seen these have an impact.

Of course if you have a condition such as severe ADHD, you might not be able to reach the same level as is possible for someone with good genetics. But you still have the ability to move the needle. If you have a condition such as traumatic brain injury, even your ability to move the needle may be lacking.

But most of us should be able to make a positive change.

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