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I thought it was strange when she circled the total cholesterol number in read and told me I would die (when??) if I didn't take statins.
When I got home I went straight to Dr. Google, and found out my risk of heart disease, based on the ratio, was ZERO.
But some doctors believe it's the total cholesterol number that counts.
And aside from all that -- in most cases, high cholesterol (LDL and triglycerides) is a SIGN of heart disease, NOT a cause!! So taking statins to lower cholesterol makes no sense. Unless you have the specific genetic disorder where cholesterol is extremely high and blocks arteries.
Statins are anti-inflammatory, and that is why they have been shown to have a slight benefit in some research. But if you want to get rid of chronic inflammation, decrease carbohydrates and increase exercise!!!!
You are just as one sided as the drs you criticize. Im no fan of the medical profession, ive seen too many serious mistakes and too much reliance on big pharma propaganda but your post OP isnt any better. How nice that exercise and diet will help SOME, but it wont help all. No different than the drs. Just as bad.
You are just as one sided as the drs you criticize. Im no fan of the medical profession, ive seen too many serious mistakes and too much reliance on big pharma propaganda but your post OP isnt any better. How nice that exercise and diet will help SOME, but it wont help all. No different than the drs. Just as bad.
I SAID that some heart disease patients need statins. But MOST do not. Statins are a giant money maker and have been promoted relentlessly.
MDs are not scientists, are not necessarily trained in statistical analysis. And their patients mostly are not. I know that SOME MDs are telling their patients disease is all genetic so don't bother improving lifestyle. Take the drugs.
Since you know the MDs, maybe you should report these MDs to the local medical board.
Have you spoken with their patients who told you about their MDs advice not to bother with lifestyle changes? What was their reactions?
It is irresponsible to let these MDs continue to dispense bad advice since there is evidence to the contrary.
You always say that, and it is ridiculous. If a doctor says "You should improve your lifestyle, eat less salt cholesterol, and fat, exercise 20 minutes 3 times a week. However, if that fails it's ok there are medications that will do the same thing" OF COURSE they either will ignore it or follow it and find it does not work.
Low salt, low cholesterol, low fat diets have no effect on most heart disease. Exercising 20 minutes 3 times a week is not nearly enough.
And even if they gave the correct lifestyle advice, framing it with "But don't worry you can take medications if that doesn't work" makes patients think the drugs are as good as lifestyle changes.
I had an experience with a doctor who told me I need statin drugs because my HDL number was high. She was very obese, and never asked me about my lifestyle.
I generally avoid doctors -- I had only gone because of a horrible allergy, which it turned out I had to figure out myself, doctors were no help.
Friends I know who see MDs have the same kind of experience as I had. But they trusted the doctors and are on drugs. Getting terrible muscle pains and cataracts, etc., which of course have nothing to do with statins.
You cannot extrapolate from your experience with one doctor or those of your friends, who may not be willing to share that they are ignoring their doctors recommendations for lifestyle changes. Doctors get fed up with noncompliant patients and stop giving advice they know will not be accepted.
# 1 In all individuals, emphasize heart-healthy lifestyle across the life-course
"A healthy lifestyle reduces atherosclerotic cardiovascular disease (ASCVD) risk at all ages. In younger individuals, healthy lifestyle can reduce development of risk factors and is the foundation of ASCVD risk reduction. In young adults 20 to 39 years of age, an assessment of lifetime risk facilitates the clinician–patient risk discussion (see #6) and emphasizes intensive lifestyle efforts. In all age groups, lifestyle therapy is the primary intervention for metabolic syndrome."
"The benefits of treatment of hypertension in preventing important health outcomes such as stroke, heart failure, and coronary heart disease events are well documented.11 Treatment can include lifestyle changes, pharmacotherapy, or both. Selection of treatment can vary depending on severity of blood pressure elevation, age, and other risk factors."
That has not at all been my experience with the doctors I see, or have seen throughout the years. They've always encouraged healthy lifestyle practices and diets as a primary and important step in maintaining my health. They have prescribed medications judiciously and as needed.
Well, the OP's last thread was closed. Funny, this discussion is a rehash of his last one. Waiting for it to be closed again.
Quote:
Originally Posted by Good4Nothin
You always say that, and it is ridiculous. If a doctor says "You should improve your lifestyle, eat less salt cholesterol, and fat, exercise 20 minutes 3 times a week. However, if that fails it's ok there are medications that will do the same thing" OF COURSE they either will ignore it or follow it and find it does not work.
Friends I know who see MDs have the same kind of experience as I had. But they trusted the doctors and are on drugs. Getting terrible muscle pains and cataracts, etc., which of course have nothing to do with statins.
MDs are not scientists, are not necessarily trained in statistical analysis. And their patients mostly are not. I know that SOME MDs are telling their patients disease is all genetic so don't bother improving lifestyle. Take the drugs.
Here's the process and I am sure you have heard it before. It does not require every doctor to be a scientist or to do clinical studies.
There is basic research in the sciences that can have application or no application for the real world. There is translational research that looks at the basic science and then tries to make something out of it. After that stage comes the applied clinical research where clinical researchers use whatever is learned on patients to see what happens. That is called clinical research. There is what we call clinical practice. One can not perform research in patients without their consent so clinical practice is different from research. Once the clinical research is published then others usually follow up and further vet the research. The specialists in the field then review all of the studies and then recommend to doctors who are in clinical practice to change the guidelines and they should now start to do that in clinical research. It is no longer considered clinical research but accepted clinical practice. Accepted clinical practice becomes the standard of care.
MD's don't have to learn or do research and don't have to be statisticians. They all must follow the standard of care or be sued or possibly lose their license.
I don't believe in gross generalizations by taking exceptions of low occurrences and then smearing all doctors. The reality of the situation is as I stated above. They have to follow the standard of care whether they think it is right or not. Those doctors who don't follow the standard of care are the exceptions.
SOME MDs are telling their patients disease is all genetic so don't bother improving lifestyle.
Sorry but I just don't believe you with that statement. If a person has a poor lifestyle regardless of the condition one is talking about, all doctors promote healthy lifestyles. Sounds like you are trying to misquote out of context. People can have a genetic disorder for which a change in lifestyle has not altered outcomes. It depends on the genetic mutation. It is difficult to study outcomes with regard to changes in "lifestyle". Most people are unable to maintain a healthy lifestyle just look at all of the obesity out there. The more strict the lifestyle the less likely they are to maintain it. What is a doctor to do? Continue promoting something that the patient is not compliant with?
What's the best diet out there? One that the person is able to maintain the longest.
And, by the way, doctors should be allowed to use their clinical experience. Now they are robots, forced to follow the consensus of the moment. Medical research very often is not replicated, turns out to be defective. During covid, especially, the consensus about the vaccines was political and authoritarian. MDs could NOT express any skepticism to their patients.
So you don't want any standard of care and want doctors to do anything they want including doing research with patients without their permission under the guise of clinical experience. That's the flaw of clinical experience is that they don't take into account severe complications from deviations of care.
A surgeon doesn't have to wash his hands or wear gloves because most of the time nothing happens to a patient if he doesn't. Before germ theory came about doctors did fine with amputations etc. The deaths were accepted as a part of clinical experience. Those things happen.
The whole point is to reduce deviations of care that result in poor outcomes. Clinical experience based medicine says that we have always done it this way and will live with poor outcomes. Experience based medicine looks and compares practices based on experience and modifications of such practices to see which is better. If proven that one way is better than another based on outcomes then screw the experience based practice and follow the proven studied practice and make that the standard of care.
Doctors should look at the clinical studies and inform patients based on those studies.
So you don't want any standard of care and want doctors to do anything they want including doing research with patients without their permission under the guise of clinical experience. That's the flaw of clinical experience is that they don't take into account severe complications from deviations of care.
A surgeon doesn't have to wash his hands or wear gloves because most of the time nothing happens to a patient if he doesn't. Before germ theory came about doctors did fine with amputations etc. The deaths were accepted as a part of clinical experience. Those things happen.
The whole point is to reduce deviations of care that result in poor outcomes. Clinical experience based medicine says that we have always done it this way and will live with poor outcomes. Experience based medicine looks and compares practices based on experience and modifications of such practices to see which is better. If proven that one way is better than another based on outcomes then screw the experience based practice and follow the proven studied practice and make that the standard of care.
Doctors should look at the clinical studies and inform patients based on those studies.
We still need “experienced” based medicine. Not just evidence based medicine.
I’m a huge huge fan of evidence based medicine and its reliance on RCT to answer important questions. But the truth is the patient in front of you is a unique individual who may not fit neatly the “average” profile of the subjects in the clinical trials. But even if they do….
Take this example. You run a RCT (would actually be a cluster randomized trial!) on which teaching method is more effective in 1st graders. Phonics or whole language instruction. Let’s say, in my made example, Phonics won and test scores in reading improved more dramatically than Whole Language instruction. But not so fast. If we drill into the data more we see that some students benefited more from Whole Language instruction, just more benefited from Phonics.
As a short cut, if you’re teaching an entire class, you’d opt for teaching Phonics. But if you’re a private tutor you’d use your experience to decide whether Phonics or Whole Language instruction works best for your student.
Medicine is really just as much an art as it’s data. If medicine just came down to SOC decided by clinical trials, we might as well get rid of doctors and just have the patient talk to a computer.
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