Cholesterol and Statins

bulkbiker

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This seems to be a new one on sat fats etc. Not directly statin connected, but cholesterol related
A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease.
https://www.ncbi.nlm.nih.gov/pubmed/19364995
Are they saying that a "Mediterranean Diet" is associated with increased risk of CHD?
Seems a bit unclear from the last sentence in the "results" section...
 

BrianTheElder

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Are they saying that a "Mediterranean Diet" is associated with increased risk of CHD?
Seems a bit unclear from the last sentence in the "results" section...
Yes, very poor that they didn't spell out the direction of the association in each case.
 

Oldvatr

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Are they saying that a "Mediterranean Diet" is associated with increased risk of CHD?
Seems a bit unclear from the last sentence in the "results" section...
Here is the published report in JAMA
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1108492

<<<<snip>>>>>>
and increased Mediterranean (0.63 [0.53-0.72]) and high-quality diet patterns (0.63 [0.45-0.81]) were each associated with a significantly lower risk of CHD. Conversely, an increased consumption of trans–fatty acids (RR, 1.32 [95% CI, 1.16-1.48]) and foods with a high glycemic index (1.32 [1.10-1.54]) were associated with a significantly higher risk of CHD (Table 2).<<<<<< endsnip<<<<<
 
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bulkbiker

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Here is the published report in JAMA
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1108492

<<<<snip>>>>>>
and increased Mediterranean (0.63 [0.53-0.72]) and high-quality diet patterns (0.63 [0.45-0.81]) were each associated with a significantly lower risk of CHD. Conversely, an increased consumption of trans–fatty acids (RR, 1.32 [95% CI, 1.16-1.48]) and foods with a high glycemic index (1.32 [1.10-1.54]) were associated with a significantly higher risk of CHD (Table 2).<<<<<< endsnip<<<<<
Thanks
 

bulkbiker

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Oops! Atorvastatin increases arterial calcification.. ! Yes you read that right..

https://pubmed.ncbi.nlm.nih.gov/164...ring-treatment-a-randomised-controlled-trial/

Screenshot 2020-01-31 at 17.11.01.png
 
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Mr_Pot

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Oops! Atorvastatin increases arterial calcification.. ! Yes you read that right..

https://pubmed.ncbi.nlm.nih.gov/164...ring-treatment-a-randomised-controlled-trial/

View attachment 38274
I can't remember enough about statistical significance to be sure about the figures but the conclusion says:
Conclusion: In contrast to previous observational studies, this randomised controlled trial has shown that, despite reducing systemic inflammation and halving serum low density lipoprotein cholesterol concentrations, statin treatment does not have a major effect on the rate of progression of coronary artery calcification.
It appears statins don't make any difference to calcification, to say it makes it worse is a bit of a stretch.
 

bulkbiker

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I can't remember enough about statistical significance to be sure about the figures but the conclusion says:
Conclusion: In contrast to previous observational studies, this randomised controlled trial has shown that, despite reducing systemic inflammation and halving serum low density lipoprotein cholesterol concentrations, statin treatment does not have a major effect on the rate of progression of coronary artery calcification.
It appears statins don't make any difference to calcification, to say it makes it worse is a bit of a stretch.

Capable...?
Screenshot 2020-02-03 at 12.07.02.png
 

Oldvatr

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I can't remember enough about statistical significance to be sure about the figures but the conclusion says:
Conclusion: In contrast to previous observational studies, this randomised controlled trial has shown that, despite reducing systemic inflammation and halving serum low density lipoprotein cholesterol concentrations, statin treatment does not have a major effect on the rate of progression of coronary artery calcification.
It appears statins don't make any difference to calcification, to say it makes it worse is a bit of a stretch.
Although it is an RCT, The test method does not give any indication of how long the groups were exposed to the test conditions. Since the aetiology of calcification is generally a long term process, then duration will be a prime requirement to be controlled and will have significant effect on the outcome. All the participants were chosen because they already had calcification, so again this distorts the analysis.

I am drawn to the Conflicts of Interest declaration in that RCT where Pfizer was funding the study and the staff making the decisions. The Key Issues at the end of the review is also worth taking into account.

These two commentaries show that this is a review of a previous study, and there seems to be no date mentioned for when the RCT was actually conducted. The 2015 date refers to when the Review took place and not when the RCT took place If it was before 2005 then it is highly suspect since many trials performed before 2004 used very dubious statistical methods and were open to misrepresentation, as discussed in Key Issues. The standards for medical studies were tightened in 2005 to clean up the actions of certain pharma companies. Most statin trials took place before 2004 and are considered to be open to self interest.
 

Oldvatr

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You are assuming that "lowering cholesterol" is beneficial..
No. I merely question if the same RCT had been performed using a natural statin or stanol whether it would agree with the Pfizer RCT. Or is there something in the processing into a pill that removes or changes the active ingredients.

There are some here who have a big distrust in big pharma. So would they benefit by using natures own statins instead?
 

Indy51

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An epic 2 part debate on the Fat Emperor podcast - Dr Malcolm Kendrick and Dr Scott Murray - 2 Scotsmen & an Irishman walk into a ....

Ep54 1 PART ONE of "Should you get a Calcium Scan???" - The Big Debate Kendrick Murray Cummins:


Ep54 2 PART TWO of Should you get a Calcium Scan The Big Debate Kendrick Murray Cummins:


 
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