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Value of Cholesterol Targets Is Disputed
NY Times ^ | October 17, 2006 | RONI RABIN

Posted on 10/16/2006 9:15:45 PM PDT by neverdem

A provocative review paper published this month has raised questions about the aggressive cholesterol-lowering recommendations made two years ago by a government panel.

The panel, the National Cholesterol Education Program, urged patients at risk for heart disease to reduce sharply their harmful LDL cholesterol and to try to reach specific, very low levels.

Though the authors of the new paper, published in the Oct. 3 issue of Annals of Internal Medicine, endorse the use of cholesterol-lowering statins, they say there is not enough solid scientific evidence to support the target numbers for LDL cholesterol set forth by the government panel.

The authors’ argument challenges mainstream medical thinking and the consensus among most cardiologists that the lower the cholesterol is, the better.

Until 2004, an LDL cholesterol level of less than 130 milligrams a deciliter was considered low enough. But the updated guidelines recommend that high-risk patients reduce their level even more — to less than 100 — while patients at very high risk are given “the option” of reducing LDL cholesterol to less than 70. Patients often have to take more than one cholesterol-lowering drug to achieve those targets.

“This paper is not arguing that there is strong evidence against the LDL targets, but rather that there’s no evidence for them,” said Dr. Rodney A. Hayward, a study author, adding that this was largely because of the way clinical trials had been devised and carried out.

“If you’re going to say, ‘Take two or three drugs to get to these levels,’ you need to know you’re doing more benefit than harm,” said Dr. Hayward, who is director of the Veterans Affairs Center for Health Services Research and Development and a professor at the University of Michigan Medical School. He said he was particularly concerned because there was little long-term safety...

(Excerpt) Read more at nytimes.com ...


TOPICS: Culture/Society; Government; News/Current Events
KEYWORDS: cad; cholesterol; health; medicine
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To: PeaceBeWithYou

Thanks for the links, but I was hoping for a source similar to the type I gave in comment# 16, i.e. an abstract or article from the professional literature.


21 posted on 10/16/2006 10:47:05 PM PDT by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: RichardW
My doctor prescribed a statin for me six months ago.

I looked it up on the web and did some studying on it.

I ended up throwing out the entire bottle, never opened, of the prescription, and changing my diet radically.

Statins may help because they have blood thinning and infection reducing side affects, rather like aspirin.

But they are dangerous, and lowering cholesterol is attacking a symptom, not the disease. They do substantially more harm than good.

For an overview of the problems with statins, see Dr. Joseph Mercola's The Truth About Cholesterol-Lowering Drugs (Statins), Cholesterol and Health.

Some quotes from some of the articles that Mercola links to:

Cholesterol is NOT the Cause of Heart Disease

Cholesterol is not the major culprit in heart disease or any disease. If it becomes oxidized it can irritate/inflame tissues in which it is lodged in, such as the endothelium (lining of the arteries). This would be one of numerous causes of chronic inflammation that can injure the lining of arteries. However, many good fats are easily oxidized such as omega-3 fatty acids, but it does not mean that you should avoid it at all costs.

Common sense would indicate that we should avoid the oxidation (rancidity) of cholesterol and fatty acids and not get rid of important life-giving molecules. Using the same conventional medical thinking that is being used for cholesterol would lead one to believe that doctors should reduce the risk of Alzheimer's disease by taking out everybody's brain.

In fact, cholesterol is being transported to tissues as part of an inflammatory response that is there to repair damage.

The fixation on cholesterol as a major cause of heart disease defies the last 15 years of science and deflects from real causes such as the damage (via glycation) that sugars such as glucose and fructose inflict on tissues, including the lining of arteries, causing chronic inflammation and resultant plaque.

Leptin: How Diabetes and Obesity Are Linked

Like two peas in a pod, the obesity and type 2 diabetes epidemics have joined forces in an attempt to ravage America's health ... and it's working, as hundreds of millions of people have been significantly affected by this deadly pair.

But how are these two epidemics intertwined? Popular belief is that if one eats too much sugar, they'll get fat and develop diabetes; and, if they don't get diabetes it's merely because their body is producing enough insulin to keep up with the sugar. However, researchers have discovered evidence that there's more to the obesity-diabetes connection than this classic way of thinking: The missing link? Leptin.

Mice Studies Shed Light on the Subject

Research on mice has suggested that leptin is the key, as it regulates blood sugar through two different brain-body passageways:

  • One: Responsible for controlling appetite and fat storage
  • Two: Responsible for telling the liver what to do with its stored glucose

While it was previously found that disrupting the appetite-controlling passageway leads to obesity (which significantly increases the risk of diabetes), results of the study indicated that it likely takes disruptions in both of leptin's passageways to trigger full-blown diabetes.


22 posted on 10/16/2006 10:54:08 PM PDT by ThePythonicCow (We are but Seekers of Truth, not the Source.)
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To: RichardW; neverdem

So what is Zetia....generic of Zocor?

Hmm,...just checked the label,,...says Merck/Schering....


23 posted on 10/16/2006 10:55:59 PM PDT by Ernest_at_the_Beach (History is soon Forgotten,)
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To: neverdem
For research links on "statins, myopathy, myalgia and rhabdomyolysis", type that phrase in the search box at PubMed.com, and click the GO box, to search PubMed.

The first link that shows up is this one.

1: "Expert opinion on drug safety", Expert Opin Drug Saf. 2006 Sep;5(5):651-66.

Statins and myotoxicity: a therapeutic limitation.

Ranbaxy Research Laboratories, Metabolic & Urology Group, New Drug Discovery Research, Gurgaon-122001, Haryana, India. atul_tri@rediffmail.com

Hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors represent the most successful class of drugs for the treatment of hypercholesterolaemia and dyslipidaemia implicated in the pathogenesis of coronary heart disease and atherosclerosis. However, the popular profile of statins in terms of efficacy has been maligned by its adverse events. The myotoxicity, ranging from mild myopathy to serious rhabdomyolysis, associated with HMG-CoA reductase inhibitors, during treatment of hypercholesterolaemia is of paramount importance. Rhabdomyolysis is a rare but idiosyncratic muscle wasting disorder of different etiologies. Statin-associated rhabdomyolysis causes skeletal muscle injury by self-perpetuating events leading to fatal irreversible renal damage through a series of biochemical reactions.


24 posted on 10/16/2006 11:01:30 PM PDT by ThePythonicCow (We are but Seekers of Truth, not the Source.)
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To: traviskicks

How long has Touro University's College of Osteopathic Medicine been there?


25 posted on 10/16/2006 11:03:27 PM PDT by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: Ernest_at_the_Beach
So what is Zetia....generic of Zocor?

No, just plug tradenames into the PubMed link at comment# 16, you'll get the generic names. Zetia interferes with absorbing cholesterol from the diet in the intestines, IIRC.

26 posted on 10/16/2006 11:11:22 PM PDT by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: RichardW
I'm on a statin and I'm nearly 63 and have never had any indication of artery clogging but medical protocol dictates my cholesterol should be lower. What I do know for a certain fact is that it causes weird dreams; and I mean really weird dreams. There has to be a reason for that and I doubt it is necessarily good.

Cholesterol is produced by the body and is used for, among other things, the manufacture and maintanence of cell membranes. However, cholesterol (whether from diet or body manufacture) is too large to pass the blood brain barrier, and as a result, the brain also produces its own supply.

The problem with the statins, such as Lipitor, is: that the drug CAN pass through the blood brain barrier, thereby lowering the cholesterol levels in the brain. This has been reported by a number of people who have had memory and other cognative problems that manifested after starting on the drug. You might be experiencing some sort of affect from the statins and it a playing around with your dream state.

You might want to fire up google and look around for info on statins, Lipitor, and others. I know there is a web site by a former astronaut & AF Flight Surgeon (can't recall the name off hand), who has discussed the side affects he's had (loss of memory) after starting on Lipitor. I think it will also point you to other sites with forums where people have been discussing such matters.

27 posted on 10/16/2006 11:13:04 PM PDT by AFreeBird (If American "cowboy diplomacy" did not exist, it would be necessary to invent it.)
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To: neverdem

Good, I told the Doc I liked French Fries,...but I would work on learning to love salads....


28 posted on 10/16/2006 11:15:19 PM PDT by Ernest_at_the_Beach (History is soon Forgotten,)
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To: neverdem; Abram; albertp; AlexandriaDuke; Alexander Rubin; Allosaurs_r_us; Americanwolf; ...
"A provocative review paper published this month has raised questions about the aggressive cholesterol-lowering recommendations made two years ago by a government panel."

But... shouldn't we believe the government panel? /s





Libertarian ping! To be added or removed from my ping list freepmail me or post a message here.
29 posted on 10/16/2006 11:18:29 PM PDT by traviskicks (http://www.neoperspectives.com/Amnesty_From_Government.htm)
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To: traviskicks
There is an astonishing load of crap floating around out there regarding statins, Lipitor in particular. It is so widely prescribed and has been around long enough that if the absurd claims that are made about it were true - we'd have plenty of evidence. obviously any single drug is not the answer for everyone. In some people statins do produce some rather negative side effects - which is why the standard protocol is for a series of liver function tests before beginning a statin and then typically 30 days after. My sense is that the statin issue is like a large Rorschach test for detecting people who are paranoid about pharmaceuticals.
30 posted on 10/16/2006 11:28:50 PM PDT by Wally_Kalbacken
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To: Wally_Kalbacken
I'm reading and hearing more and more about inflammation being the cause of plaque build up. When a doctor tells you it's an anomaly that some patients live longer with high cholesterol and others die young with low cholesterol, if it's 50-50, then cholesterol is probably not the main factor.
31 posted on 10/16/2006 11:36:58 PM PDT by chuckles
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To: neverdem

I will tell you something that is even more idiotic.... I see and care for patients in a NH....Very government regulated places... Just to show you how stupid governement can be the NH has to pay for Pharmacist to consult every month. They look at charts not patients. They write up little notes that I have to address. They say we must check A lipid panel on all patients every 6 months and recommed I start so and so on lipid lowering medication.. I have to use my time writing to them why I do not feel it necessary to start John Doe on statin drugs as he is tube feed, does not walk or verbalize and does not know who or where he is but the government thinks lowering his cholesterol is of upmost importance. Never mind he is 85 years old. JUst like they tell me I need to start a female patient with the same medical condition on calicum with Vit D. Oh really. That is the problem with government paper pushers and regulators.


32 posted on 10/16/2006 11:40:31 PM PDT by therut
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To: ThePythonicCow
Thanks for the partial abstract. Here's a later portion:

"Although statin-associated myotoxicity affects compliance, quality of life of patient and discontinuation rate, yet the low incidence of myotoxicty including rhabdomyolysis and less severity of commonly occurring myopathy and myalgia do not raise doubts about the clinical efficacy and tolerability of statins."

Even the part that you quoted stated that it's rare:

"Rhabdomyolysis is a rare but idiosyncratic muscle wasting disorder of different etiologies. Statin-associated rhabdomyolysis causes skeletal muscle injury by self-perpetuating events leading to fatal irreversible renal damage through a series of biochemical reactions."

No drug is always benign. They all can have adverse effects. Numerous studies have shown that for folks with coronary artery disease using statins decreases the incidence of more coronary artery disease morbidity and mortality. If a patient starts having unexplained muscle pain or weakness, stop the statin.

33 posted on 10/17/2006 12:00:49 AM PDT by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: therut
I will tell you something that is even more idiotic.... I see and care for patients in a NH....

Great, even if I hijack my own thread. I worked at a nursing homes too. I hope you can be there on Election Day to report that the staff helps the patients with dementia to vote. I wasn't aware that they voted a straight dem ticket, but I was told by the nurses that the staff helps the patients with voting at Kings Harbor NH, Bronx, NY, Nov. 2001. My jaw hit the floor.

34 posted on 10/17/2006 12:17:49 AM PDT by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: garyhope

Bush's fault.

I wonder if Atkins was on to something when he
suspected excessive carboydrates to heart disease.
Why do diabetics run a greater risk of coronary
dysfuntion? Any corollation or just fad bad science?


35 posted on 10/17/2006 12:42:27 AM PDT by ChiMark
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To: neverdem
True - drug side affects are dosage dependent and typically rare, or least claimed to be rare in research studies ultimately funded by drug manufacturers.

And the essential difference between a food and a drug is that there is a wider safety range with the food, within which it is providing benefits without much risk of dosage related harmful side affects.

I can't back up my position with references to research articles, so you would be advised to discredit it. But I am living my life now under the conclusion that statins do more harm than good, and that while they may lower cholesterol, they do not significantly improve mortality rates, and they do long term damage to the body that is undesirable.

A few of the many dietary alternatives are much healthier, in my view, and by my choice. My current recommendations are at the bottom of my Freeper home page:

Nutrition, Health, and Medicine
I recommend Swanson Vitamins and The Blaylock Wellness Report. I've just ordered Health and Nutrition Secrets That Can Save Your Life by Russell L. Blaylock. It looks like it should be a good book. Other worthwhile sites on health and nutrition, perhaps a bit strong on their over zealousness, include Articles by Karl Loren and Mike Adam's NewsTarget.com. Also check out Dr. Joseph Mercola, at Mercola.com. Mercola is obviously selling stuff, but at least he's selling healthy stuff.

36 posted on 10/17/2006 12:47:57 AM PDT by ThePythonicCow (We are but Seekers of Truth, not the Source.)
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To: neverdem

"I worked at a nursing homes too. I hope you can be there on Election Day to report that the staff helps the patients with dementia to vote."


===

I remember this mentioned on FoxNews some time ago, maybe after the last election.

The Dems perpetrate voter fraud everywhere. I vaguely remember that they were so brazen, they even filled out ballots in advance and got people in nursing homes to sign, when they had no idea what they were doing.


37 posted on 10/17/2006 12:48:59 AM PDT by FairOpinion (Dem Foreign Policy: SURRENDER to our enemies. Real conservatives don't help Dems get elected.)
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To: Wally_Kalbacken
That's a nice moderate sensible sounding position.

My "moderate" nephew (just graduated from U.Calif.Berkeley, and thought it was a moderate place) says the same thing about those who find the current leadership of the Democrat party to be a bunch of Marxists, Socialists, Communists, Thugs, Crooks, Leftists and Fellow Travelers.

I am proud to pass both his and your tests for being a raving paranoid nutcase.

Sometimes the s*it really is as bad, or worse, than it seems.

38 posted on 10/17/2006 12:55:08 AM PDT by ThePythonicCow (We are but Seekers of Truth, not the Source.)
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To: garyhope

I feel the best way to combat heart disease is to get rid of all processed foods and eat a natural diet. This doesn't mean raw or vegitarian at all. It just means you eat like people did 100 years ago. Also throw in some moderate exercise, sunlight, reduce stress, and get plenty of sleep.


39 posted on 10/17/2006 1:02:58 AM PDT by LukeL (Never let the enemy pick the battle site. (Gen. George S. Patton))
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To: garyhope
The way to deal with cholesterol is to wash everything down and out with a nice glass of good red wine. It's like deglazing a pan, the alcohol and acid just break down the fat and grease and wash it right out of your body.

...never heard it put that way, but that's what we do here in our house.
I admit to a certain amount of cynacism about all this. Some people are making a lot of money off the manufacture and sale of drugs that are designed to adjust cholesterol levels. My MD is all over me with this and I hate it.

40 posted on 10/17/2006 1:05:58 AM PDT by Banjoguy (The words "Democrat" and democratic are not interchangable.)
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