Ticker: Don't die of heart disease • Hacker News Board

Re: Ticker: Don't die of heart disease

#51

Post by tananan » Sat, Nov 08, 2025, 5:22 PM UTC

tonymet wrote: post #16

jasonjmcghee wrote: post #10

Earlier quoted context omitted.

Managing stress shouldn't be overlooked

“Stress” is so abused and nebulous that it’s impossible to define. Nearly every condition is worsened by “stress” but there’s no way to measure it. And there’s no conclusive way to manage stress either. Medication, psychotropics, self medication, meditation. Nearly all of those are more broadly abused and yet stress “worsens”. One person may run an intense soup kitchen 15 hours a day and feel little stress, and anoth…

Fortunately, as you mention in your last sentence, stress is introspectable.

How exactly stress corresponds to biomarkers doesn’t matter if your desire is to lower it.

The issue is that many of us don’t pay attention to how we keep our body & mind throughout the day, or do so on a very superficial level. So strain on the body can accumulate for a long time.

“Stress management” is a lifetime skill. It doesn’t come in bulletpoints, it’s as broad as “living happily”.

Edit: That said, this can make the advice “be less stressed” a bit vacuous.

But people do get scared when random health issues flare up and become more conscious of how they deal with stress in life.

So it’s not bad to keep reminding people either :)

Re: Ticker: Don't die of heart disease

#52

Post by evantbyrne » Sat, Nov 08, 2025, 5:23 PM UTC

camel_gopher wrote: post #3

Tl;dr be affluent enough to be able to afford great medical care and have enough free time for preventative actions

90 day supply of Atorvastatin costs $10. Running costs a pair of shoes.

Re: Ticker: Don't die of heart disease

#53

Post by lisbbb » Sat, Nov 08, 2025, 5:23 PM UTC

Love the chart at the bottom--it really puts on display media bias and lack of integrity and using fear to push idiotic policies which area really just a way to put everyone in the pocket of government and keep them there permanently with zero real improvement to public health. Fear get eyeballs. the Covid mass hysteria proves that, too.

As far as heart disease goes, yes, it's the big killer and it's time people started waking up from the media haze, but to do that, you have to admit you were wrong, and for many, that is far too tall a hill to climb.

Re: Ticker: Don't die of heart disease

#54

Post by zamiang_brennan » Sat, Nov 08, 2025, 5:23 PM UTC

Great post but quite surprised there is no mention of cutting red meat. There is a lot of evidence that especially the American diet is dangerously high in red meat to the point of elevating Heart Disease risk.

Re: Ticker: Don't die of heart disease

#55

Post by throwaway89201 » Sat, Nov 08, 2025, 5:24 PM UTC

I'm not sure that non-medically indicated CT scans are a great idea, as you're at least doubling your yearly dose of radiation in the year of the CT scan. Perhaps it's warranted, but the article doesn't seem to balance that at all against doing a CT scan "every 1-5 years".

Re: Ticker: Don't die of heart disease

#56

Post by carbocation » Sat, Nov 08, 2025, 5:24 PM UTC

    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 statement that is meant to last the test of time: it may well be the case that these tests are valuable for a broader population, but the data haven't really caught up to this viewpoint yet.

Re: Ticker: Don't die of heart disease

#57

Post by lisbbb » Sat, Nov 08, 2025, 5:24 PM UTC

hshdhdhehd wrote: post #7

camel_gopher wrote: post #3

Tl;dr be affluent enough to be able to afford great medical care and have enough free time for preventative actions

I think the point is it is cheap to prevent. The weird tip is doing a different test to the standard one, which costs little for typical HNers (but admit every $ counts for many people esp. with current inflation, poverty, bad governance) but sounds like on par with a dentist doing anything beyond a checkup.

A colleague of mine was a vegan, took care of himself, still died of pancreatic cancer. It is what it is.

Re: Ticker: Don't die of heart disease

#58

Post by Buttons840 » Sat, Nov 08, 2025, 5:25 PM UTC

I am not a statin skeptic--or rather, I don't want to be a statin skeptic. I've done the research and it makes sense to me, but I still feel some social and psychological pressures to reject statins.

When I see that it is widely accepted that ApoB is better to measure than LDL-C, but the industry continues to measure LDL-C, but not ApoB, I wonder why. It makes me skeptical.

When I see that the purpose of statins is to reduce plaque buildup in the arteries, and that we have the ability to measure these plaque buildups with scans, but the scans are rarely done, I wonder why. Like, we will see a high LDL-C number (which, again, we should be looking at ApoB instead), and so we get worried about arterial plaque, and we have the ability to directly measure arterial plaque, but we don't, and instead just prescribe a statin. We're worried about X, and have the ability to measure X, but we don't measure X, and instead just prescribe a pill based on proxy indicator Y. It makes me skeptical.

In the end statins reduce the chance of heart attack by like 30% I think. Not bad, but if you have a heart attack without statins, you probably (70%) would have had a heart attack with statins too. That's what a 30% risk reduction means, right?

As you can see, I'm worried about cholesterol and statins.

Re: Ticker: Don't die of heart disease

#59

Post by lisbbb » Sat, Nov 08, 2025, 5:26 PM UTC

pstuart wrote: post #21

A key takeaway is: don't be afraid of taking statins if you need them. I fell for the "statins are bad" BS for years and have paid the price.

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.

Re: Ticker: Don't die of heart disease

#60

Post by captainkrtek » Sat, Nov 08, 2025, 5:27 PM UTC

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 work up (calcium scan) because she now has early atherosclerosis. She eats super healthy and is a former olympic sprinter..

Bonus anecdote: In my free time I do shifts as an EMT with my fire dept (911), that is a big wake up call to wanting to be as healthy as can be. The number of patients I see who are 50+, nearly all are on 5-10+ meds, few are just one 0, 1, or 2. At that age I see type 2 diabetes, hypertension, high cholesterol, and more.