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Cholesterol/statins with history of heart attack
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<blockquote data-quote="oldgreymare" data-source="post: 2333590" data-attributes="member: 20373"><p>[USER=533553]@andbreath[/USER] Congratulations on your weight loss and great HBAc1. Definitely hear you re concerns over knee jerk prescription of statins (I consistently refuse). Statins will lower LDL levels, but I decline because I am not convinced that preventive taking of them has a material benefit in terms of subsequent improved CVD mortality for older women. That said, I think the evidence may be different for individuals who already have a CVD history - so it's a tough call. </p><p></p><p>If you're up for some biochemistry reading, then PeterAttiaMD.com is pretty critical and in particular his podcasts with Thomas Dayspring. </p><p></p><p><a href="https://peterattiamd.com/tomdayspring6/" target="_blank">https://peterattiamd.com/tomdayspring6/</a></p><p></p><p>Listening to these and also other resources, I've decided I will use the following metrics to discuss my CVD risk with my health team -</p><p>HBAc1 & time in range (from my Dexcom G6);</p><p>Lipo (a) test result : mine was low normal - as this is a genetic marker the test only needs doing once (Did you have this measured as part of your heart attack workup?);</p><p>Triglycerides - ideally below 0.7 mmol/L - pretty much mirrors my carb intake;</p><p>Apo B - a more relevant LDL CVD marker than the outdated derived LDL-C estimate which is still common. Unfortunately usually not available to GPs, but an endo can order (not that expensive, so NHS NICE just very slow to modernise?);</p><p>CT CAC screen - provides estimate of cardiac arterial plaques/damage. I'm self referring to get a baseline value. Annoying as only costs $50-100 in USA, I'll have to pay £350. But unless looking high risk this only needs repeating every 5 years. First results next week;</p><p>Also blood pressure, liver function and kidney function markers. </p><p></p><p>Hope this gives you some ideas of some info you may want to ask for/obtain in order to make your mind up on your approach to statins and for discussion with health team generally.</p></blockquote><p></p>
[QUOTE="oldgreymare, post: 2333590, member: 20373"] [USER=533553]@andbreath[/USER] Congratulations on your weight loss and great HBAc1. Definitely hear you re concerns over knee jerk prescription of statins (I consistently refuse). Statins will lower LDL levels, but I decline because I am not convinced that preventive taking of them has a material benefit in terms of subsequent improved CVD mortality for older women. That said, I think the evidence may be different for individuals who already have a CVD history - so it's a tough call. If you're up for some biochemistry reading, then PeterAttiaMD.com is pretty critical and in particular his podcasts with Thomas Dayspring. [URL]https://peterattiamd.com/tomdayspring6/[/URL] Listening to these and also other resources, I've decided I will use the following metrics to discuss my CVD risk with my health team - HBAc1 & time in range (from my Dexcom G6); Lipo (a) test result : mine was low normal - as this is a genetic marker the test only needs doing once (Did you have this measured as part of your heart attack workup?); Triglycerides - ideally below 0.7 mmol/L - pretty much mirrors my carb intake; Apo B - a more relevant LDL CVD marker than the outdated derived LDL-C estimate which is still common. Unfortunately usually not available to GPs, but an endo can order (not that expensive, so NHS NICE just very slow to modernise?); CT CAC screen - provides estimate of cardiac arterial plaques/damage. I'm self referring to get a baseline value. Annoying as only costs $50-100 in USA, I'll have to pay £350. But unless looking high risk this only needs repeating every 5 years. First results next week; Also blood pressure, liver function and kidney function markers. Hope this gives you some ideas of some info you may want to ask for/obtain in order to make your mind up on your approach to statins and for discussion with health team generally. [/QUOTE]
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