Posted on 06/24/2008 9:33:46 PM PDT by neverdem
Apart from its sadness, Tim Russert’s death this month at 58 was deeply unsettling to many people who, like him, had been earnestly following their doctors’ advice on drugs, diet and exercise in hopes of avoiding a heart attack.
Mr. Russert, the moderator of “Meet the Press” on NBC News, took blood pressure and cholesterol pills and aspirin, rode an exercise bike, had yearly stress tests and other exams and was dutifully trying to lose weight. But he died of a heart attack anyway.
An article in The New York Times last week about his medical care led to e-mail from dozens of readers insisting that something must have been missed, that if only he had been given this test or that, his doctors would have realized how sick he was and prescribed more medicine or recommended bypass surgery.
Clearly, there was sorrow for Mr. Russert’s passing, but also nervous indignation. Many people are in the same boat he was in, struggling with weight, blood pressure and other risk factors — 16 million Americans have coronary artery disease — and his death threatened the collective sense of well-being. People are not supposed to die this way anymore, especially not smart, well-educated professionals under the care of doctors.
Mr. Russert’s fate underlines some painful truths. A doctor’s care is not a protective bubble, and cardiology is not the exact science that many people wish it to be. A person’s risk of a heart attack can only be estimated, and although drugs, diet and exercise may lower that risk, they cannot eliminate it entirely. True, the death rate from heart disease has declined, but it is still the leading cause of death in the United States, killing 650,000 people a year. About 300,000 die suddenly, and about half, like Mr. Russert, have...
(Excerpt) Read more at nytimes.com ...
I remind my doc of this when he wants to double my blood pressure medicine and put me on the anti-cholesterol pills. There is no way in H E double hockey sticks I will ever be his "Statin Doll."
What do you have against statins?
Doctors Say Medication Is Overused in Dementia
FReepmail me if you want on or off my health and science ping list.
Here is how you can know just exactly how healthy you are. Apply for a life insurance policy. The insurer will give you a medical examination and if there is any hint you will die for any reason, the insurer will not insure you. Insurance companies are in the business of collecting premiums, not making claim payments.
Statins have done wonders to reduce LDL cholesterol levels and the accompanying atherosclerosis. The newest statin, rosuvastatin, is apparently the first to actually reverse atherosclerosis - in 10 or 20 years time what happened to Russert might be considered a problem of the past.
Medicine, like lawyering, is a “practice”.
No results guaranteed!
Eye of newt actually works, sometimes. Not much, but sometimes!
While Russert’s death is tragic: one should not forget that despite trying to lose weight -he was STILL overweight. He just came back from a long trip to Europe -which is stressful under the best of times & whose to say what role his medication played as drugs are not safe. Who could forget the Vioxx scandal which led to tens of thousands of fatalities. The drug industry is notorious for advancing unsafe drugs.
FR bookmark , .. and thanks neverdem
I have a different take on it. I think that the vocal minority groups push the FDA to approve drugs before they have been thoroughly vetted. Many of the AIDS drugs were put on the market too early due to pressure from the Gay lobby. May be the same here.
I’m very conflicted when it comes to doctors. I have benefited tremendously from medical care, but as I age, I resist the idea of becoming a sheep in the medicated herd. Rather die? Rather die? One doesn’t want to die, but one resists the idea of giving up ones soul for the uncertain promise of an increased probability of longevity.
...there is no data published..
Actually, there is.
But detailed analysis shows it is not very convincing.
Here is what I heard and understand, if I am wrong, somebody please correct me and I will take my lumps.
Imagine there is a control group that does not get statins. Then there is the group that does get it.
Control group has 3 sudden cardiac death events. Statin group has two.
Statin vendors correctly and legitimately claim that statins reduce the risk of sudden cardiac events by 50%.
Trouble is, there is another index conveniently left out. That index is the NNT, or Number Needed to Treat.
If our group size is ten, then we have effectively lowered the risk by the one out of ten... but... in the statin studies that have had published results, the NNT is 100.
So 3/2 is statistically significant if that’s all you’re measuring, but 1/100 is nowheres near a statistically significant reduction.
And 100 people had to take statins, with all the costs and attendent side effects, to stop a single cardiac event.
Whether the medical establishment wants to admit it or not, very close to 50% of the sudden cardiac events in our country happen in people who have normal or less than normal cholesterol levels.
We all need to use good judgement and only trust the doc to a certain extent, after all they make mistakes too. I actually filled a presciption for Statins and was about to start taking them then just as it got near my mouth something inside me said....no. I then investigated potential side effects, which the doc didn't inform me.....that was it for me.
Of course he has noted all that in my file for protection and I don't blame him. That is another thing, maybe he is just covering his bases to protect himself from malpractice.
I work in the pharmaceutical industry. You're more on track than you know.
I believe the goal should be to raise HDL vs. lowering LDL.
I think about the television chef Justin Wilson who died at age 87. Must have been all that exercise from stirring pots of crawdads and hot sauce that kept him alim and trim.
It may not be just lowering cholesterol. Statins are also suspected of having an anti-inflammatory efect. I'm not crazy about the LDL and total cholesterol hypothesis, but for cardiovascular as well as cerebrovascular morbidity and mortality, the better numbers are found with those taking statins. They are not for everybody. IIRC, 3% get serious liver toxicity, and 1% get serious muscle pathology.
CONCLUSIONS: The benefit of early initiation of statin therapy during acute coronary syndromes slowly accrues over time so that a survival advantage is seen around 24 months. Relatively few patients need to be treated to prevent one death over this time period. Furthermore, this approach significantly reduces unstable angina and the need for revascularization.
Enter CAD and statins, mortality into the query box at PubMed. CAD means coronary artey disease. I'd start with review articles.
Do I have that right?
FMCDH(BITS)
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