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Ticker: Don't die of heart disease

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Re: Ticker: Don't die of heart disease

#381

I’m sensing a potentially significant misallocation of resources. My mental model is that there’s a hypothetical quantification of not just your time and money, but your anxiety, attention bandwidth, mental energy, etc. I think, in some ways, the trick is being able to short circuit the entire journey represented by this website in favour of some form of, “I’m 40. I should be more mindful of heart disease. I should a…

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Re: Ticker: Don't die of heart disease

#382
post #340

Earlier quoted context omitted.

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…

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

If it's 30-60% heritable, that leaves 70-40% to split between personal decisions and environment. It does not guarantee that personal decisions matter much at all...

Re: Ticker: Don't die of heart disease

#383

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…

We went through this with Oprah in 2007. She did a show about her CT scan and how wonderful it was.

Here's what the New York Times had to say about it the following year: https://www.nytimes.com/2008/06/29/business/29scan.html

The bottom line is these tests aren't some sort of one-size-fits-all panacea, and nor can they perfectly predict the future. In fact Oprah herself backtracked on it, via an article by Dr. Oz in her magazine in 2011: https://www.oprah.com/health/are-x-rays-and-ct-scans-safe-ra...

A good rule of thumb is don't take medical advice from Oprah or Dr. Oz. But in the case of the latter article, he wasn't wrong.

Re: Ticker: Don't die of heart disease

#384
post #69

Earlier quoted context omitted.

> 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)

And our canines?

My genes gave me pretty big ones.

Re: Ticker: Don't die of heart disease

#385

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…

The old adage "You can lead a horse to water but you can't make it drink" applies here.

Re: Ticker: Don't die of heart disease

#387
post #59

Earlier quoted context omitted.

My dad would disagree--he's 84, was on statins for years and they did terrible things to his body. I'm sure the drugs kept him alive, but the side effects, as he describes them, particularly to his legs and kidneys, were pretty severe. He only got better when he stopped taking them.

I believe statins reduce risk by about 30%, so there's a roughly 30% chance the statins have done good things for your dad. (I think that's what the stats mean, right? I'm open to correction on this. I do believe the statin studies, I'm not a science denier. I think what I've said matches the science, as far as I understand.)

The risk reduction is relative risk not absolute

Re: Ticker: Don't die of heart disease

#388

"This means regular exercise (both strength training, ideally 3x per week, and cardio training that helps to improve V02 max like Zone 2 training)" Actually, V02 max is best improved through High Intensity Interval Training (HIIT) like doing 400m sprints 8x with a couple minutes rest inbetween. V02 max is famous for being one of the best predictors of longevity. Zone 2 training (light jogging) is important in tandem…

Is V02 max still the best predictor in people optimizing for it specifically above everything else, or only in people that train generally and have a high V02 max as a side effect?

My guess is the latter

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