tag:blogger.com,1999:blog-6745824333843276309.post6129562939947065011..comments2023-08-10T03:46:17.650-07:00Comments on Just JoeP: Mortality & Cholesterol - not what most Americans thinkJustJoePhttp://www.blogger.com/profile/02882794348703779345noreply@blogger.comBlogger13125tag:blogger.com,1999:blog-6745824333843276309.post-1168634457441513692009-09-24T03:57:29.751-07:002009-09-24T03:57:29.751-07:00Cool -- the midlife cholesterol & dementia stu...Cool -- the midlife cholesterol & dementia study is available for <a href="http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=000231980&Ausgabe=250346&ProduktNr=224226&filename=000231980.pdf" rel="nofollow">free</a>. The hazard ratios still make me yawn, but it's interesting to note that higher TC levels are associated with higher AD incidence but <i>lower</i> VaD incidence. I also appreciated the discussion, especially <i>"No relationship between midlife serum total cholesterol<br />and the risk of AD was found in the HAAS study"</i> and, even better, <i>"As the CAIDE and HAAS studies<br />have shown, the pattern of change in cholesterol levels<br />after midlife is also important; a <b>decline</b> in serum total<br />cholesterol after midlife may be associated with early<br />stages in the development of dementia"</i> [emphasis mine]<br /><br />In general my points are: observational studies are useful for generating hypotheses but do not show causation. Nor do risk factors show causation. If you base treatment solely on reduction of risk associations from observational studies, you could very well be treating a symptom and not a cause.pykerhttps://www.blogger.com/profile/06845984235403387118noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-49756239785072898092009-09-24T00:44:18.364-07:002009-09-24T00:44:18.364-07:00Your physician is not acting on hard science, but ...Your physician is not acting on hard science, but rather on the guidance of drug company reps (even ostensibly impartial "public" orgs have <a href="http://wholehealthsource.blogspot.com/2008/08/conflict-of-interest.html" rel="nofollow">massive conflicts of interest</a>).<br /><br />Of the guys I like to read, one of the more moderate is a practicing cardiologist who is much more skeptical of red meat and saturated fat than I am, and does prescribe statins, but only sparingly for specific reasons. Rather than bombard you with statin-haters, here are a couple of reasonable posts:<br /><a href="http://heartscanblog.blogspot.com/2007/10/which-is-better.html" rel="nofollow">http://heartscanblog.blogspot.com/2007/10/which-is-better.html</a><br /><a href="http://heartscanblog.blogspot.com/2008/12/statin-drug-revolt.html" rel="nofollow">http://heartscanblog.blogspot.com/2008/12/statin-drug-revolt.html</a>pykerhttps://www.blogger.com/profile/06845984235403387118noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-23192378246263922452009-09-23T21:24:49.318-07:002009-09-23T21:24:49.318-07:00i was just reading some positive press on choleste...i was just reading some positive press on cholesterol.<br /><br /><a href="http://www.cholesterol-and-health.com/Memory-And-Cholesterol.html" rel="nofollow">link</a><br /><br />statins scare the hell out of me. <a href="http://high-fat-nutrition.blogspot.com/2009/08/cholesterol-statins-and-oxldl.html" rel="nofollow">This</a> piece on oxLDL especially.zimhttps://www.blogger.com/profile/05072367389475963710noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-51440022687964781242009-09-23T20:33:12.430-07:002009-09-23T20:33:12.430-07:00I'm on statins at the advice of my physician a...I'm on statins at the advice of my physician after a 10 year long upward trend in LDL and triglycerides. (even though my HDL is very good). Family history for CVD is not on my side. I think there are enough studies to show an association with cholesterol and dementia to show there is something going on. But maybe that something is insulin resistance with high cholesterol--I agree that laying off the sugar and simple starch is health, and therefore, neuroprotective. (i'm very protective of my brain) But still the biggest risk factor for AD is age.dr. desert flowerhttps://www.blogger.com/profile/15642598635191893408noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-44820921379900154392009-09-23T14:10:06.246-07:002009-09-23T14:10:06.246-07:00Despite the language in the writeup, the hazard ra...Despite the language in the writeup, the hazard ratios in the study you cite are fairly mild (HR or RR of less than 2 generally doesn't get my attention). This seems a little more worrying: <a href="http://www.neurology.org/cgi/content/abstract/01.wnl.0000306313.89165.efv1?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=whitmer&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT" rel="nofollow">http://www.neurology.org/cgi/content/abstract/01.wnl.0000306313.89165.efv1?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=whitmer&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT</a>. So dementia is associated with obesity, diabetes, big ol' gut, and insulin resistance. I'd say lay off the sugar and starch!<br /><br />The sad thing is, as zim points out, TC is pretty much a useless measure. Would have been wonderful if we could see midlife LDL-P, trigs, HDL, associations with later dementia. If you eat a ton of fructose and not much in the way of good fats, you'll have sky-high trigs and low HDL (and you'll set yourself up nicely for round middle and insulin resistance). Someone with a similar TC but low trigs and high HDL correlates with much happier outcomes.pykerhttps://www.blogger.com/profile/06845984235403387118noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-12524205468197134542009-09-23T14:04:18.637-07:002009-09-23T14:04:18.637-07:00Wow, you're on statins? That is shocking. Ser...Wow, you're on statins? That is shocking. Seriously. Not a single controlled study has EVER shown a mortality benefit to <b>women</b> of any age. There is no good evidence that statins help women at all.pykerhttps://www.blogger.com/profile/06845984235403387118noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-83794137294697587022009-09-23T13:37:45.130-07:002009-09-23T13:37:45.130-07:00uht oh... let the comment retorts begin to fly......uht oh... let the comment retorts begin to fly... 4... 3... 2... 1... (hunkering down in a bunker, closing the blast doors, knowing what will likely be incoming from Chicago, London, and elsewhere... zoiks!)JustJoePhttps://www.blogger.com/profile/02882794348703779345noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-7438753614154783232009-09-23T13:30:39.012-07:002009-09-23T13:30:39.012-07:00I'm not ready to give up my statin just yet: h...I'm not ready to give up my statin just yet: http://www.ncbi.nlm.nih.gov/pubmed/18448847<br /><br />While high TC may not be associated with early mortality<br />There is an association between high MIDLIFE TC and later dementia. There is some evidence that this is also associated with APOE4 status.dr. desert flowerhttps://www.blogger.com/profile/15642598635191893408noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-18484583055178345432009-09-23T06:12:58.128-07:002009-09-23T06:12:58.128-07:00if that 95% is accurate, that's depressing. if...if that 95% is accurate, that's depressing. if they're behind the curve on TC vs HDL/LDL/tri's, how long until they understand that total calculated LDL is also useless?<br /><br />perhaps once the statin patents wear out?zimhttps://www.blogger.com/profile/05072367389475963710noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-26201399323985469892009-09-22T23:13:03.795-07:002009-09-22T23:13:03.795-07:00Another nice graph, showing cholesterol & mort...Another nice graph, showing cholesterol & mortality by age: <a href="http://4.bp.blogspot.com/_zULJExxrW54/SmaBHOF3S5I/AAAAAAAAAh4/Q72JhytoYaE/s1600-h/Oku+Framingham+chol+mortality.jpg" rel="nofollow">http://4.bp.blogspot.com/_zULJExxrW54/SmaBHOF3S5I/AAAAAAAAAh4/Q72JhytoYaE/s1600-h/Oku+Framingham+chol+mortality.jpg</a><br /><br />As <a href="http://wholehealthsource.blogspot.com/2009/07/diet-heart-hypothesis-little.html" rel="nofollow">Stephan says</a>, "If you're 80 or older, and you have low cholesterol, it's time to get your affairs in order."pykerhttps://www.blogger.com/profile/06845984235403387118noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-402107173070581852009-09-22T23:06:33.492-07:002009-09-22T23:06:33.492-07:00Zim, congratulations, you have a more sophisticate...Zim, congratulations, you have a more sophisticated understanding of cholesterol than 95% of all primary-care physicians. Basically almost anyone with TC over 200 in the US these days will walk out of their doctor's office, confused and scared, with a prescription for the statins.pykerhttps://www.blogger.com/profile/06845984235403387118noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-24823853380053592612009-09-22T20:35:27.849-07:002009-09-22T20:35:27.849-07:00i'm always wary of looking only at total chole...i'm always wary of looking only at total cholesterol. i have to think that the benefit comes from high HDL and low tri's, and not just any "configuration" adding up to that total.zimhttps://www.blogger.com/profile/05072367389475963710noreply@blogger.comtag:blogger.com,1999:blog-6745824333843276309.post-55585463192980527422009-09-22T17:54:32.023-07:002009-09-22T17:54:32.023-07:00I do love data =)I do love data =)JustJoePhttps://www.blogger.com/profile/02882794348703779345noreply@blogger.com