OT: More attacks upon conventional wisdom about heart disease

Thanks for posting this Bilybob. As you know this is a topic near and dear to my heart.
I had a discussion today with my Drs (PCP/Cardio) partner, I was there with my wife for her appointment. She had an abnormal nuclear stress test that showed blockages, and she does have moderately high cholesterol. But she had n angiogram last week that showed. Her arteries are completely clear and free of plaque, so they called the nuclear stress a false positive.
But back to the point, I on the other hand, NEVER had high cholesterol, and I have heavy plaque.

So o mentioned this to him and said that I had read a lot lately about cholesterol not being a primary cause.

He said I should be very skeptical about anyone who states that. Honestly I don't remember what he said, he went into a detailed explanation that had my head spinning.mbut at the time, it seems pretty convincing,

I really don't know what to believe any more. Every study that comes out has its supporters and also has detractors that find ways to invalidate the results.
I think nobody really knows.

halbert said...
Pratoman, you may be more right than you know. In that nobody knows anything....not quite. But that's how science works.

I'm pretty much on board with this. fwiw

The things that have pushed the averages up are probably penicillin, antibiotics, etc.

I believe I read somewhere where working out/running etc has virtually no effect at all longevity. It's all about the way one feels while living.

It's all in the genes....that molecular code deal the mapping...i lve forgotten what its called) may be where the real money is. It's controversial...but it wouldn't suprise me if someday all diseases are cured/ prevented, all of them...In the same way.

Until cancer, heart disease, etc is prevented from occurring or cured before one gets it...We're gonna keep swatting at flies.

Pratoman said...
Thanks for posting this Bilybob. As you know this is a topic near and dear to my heart.
I had a discussion today with my Drs (PCP/Cardio) partner, I was there with my wife for her appointment. She had an abnormal nuclear stress test that showed blockages, and she does have moderately high cholesterol. But she had n angiogram last week that showed. Her arteries are completely clear and free of plaque, so they called the nuclear stress a false positive.
But back to the point, I on the other hand, NEVER had high cholesterol, and I have heavy plaque.

So o mentioned this to him and said that I had read a lot lately about cholesterol not being a primary cause.

He said I should be very skeptical about anyone who states that. Honestly I don't remember what he said, he went into a detailed explanation that had my head spinning.mbut at the time, it seems pretty convincing,

I really don't know what to believe any more. Every study that comes out has its supporters and also has detractors that find ways to invalidate the results.
I think nobody really knows.

More comments on your post, Prat! First, when you said "a topic near and dear to my heart.", I'd say it is literally that!

And yes, it does give you/me a feeling that we don't now anything. But as one study after another comes out conflicting with one another, we do know this:
Your wife and I and no doubt at least a few others, have fairly high cholesterol numbers and have no apparent blockage, even with my docs wanting me on the statins at least until my test showed me with a zero score.

You, OTOH, NEVER had Hi C, but you say have a lot of plaque.

Though I don't know how valuable that test( calcium scoring ) is as far as predicting or diagnosing serious heart disease, I do THINK it is at least pretty valuable. Maybe a good bit more valuable than cholesterol numbers. If it is indeed quite valuable, telling us the bottom line about what we want to know, then I would say our little study of 3 confirms what this article is saying. Unfortunately, those tiny numbers are only anecdotal, and could be totally useless. Maybe. Or not. But we do know that the cholesterol numbers from the 3 of us do not seem to relate to actual plaque.

Post Edited (BillyBob@388) : 6/15/2016 8:52:23 AM (GMT-6)

BillyBob, the article was clear about the use of statins on patients over the age of 60. In other words, the way I read it, they are suggesting that statins don't extend the lives of patients who are over 60.

And, no, they probably aren't morons at the BMJ. What does happen, frequently, is a rush to publish before all the reviews are done....there is a strong desire to publish contrary or 'new' findings in the name of getting tenure...and the corrections are usually buried on an inside page and ignored by the popular press.

Note my cynicism related to the academic press.

I think this may be related to the above quoted/linked BMJ study, but I'm not sure and we will have to pay $ find out, although there is a free trial:

www.bmj.com/content/347/bmj.f6340?ijkey=ddce39b3e3c3eebabbefc4081b918ecce26b839b&keytype2=tf_ipsecsha

Somebody said...


This article has a correction. Please see:

Errata - May 15, 2014

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Aseem Malhotra, interventional cardiology specialist registrar, Croydon University Hospital, London

[email protected]

Scientists universally accept that trans fats—found in many fast foods, bakery products, and margarines—increase the risk of cardiovascular disease through inflammatory processes.1 But “saturated fat” is another story. The mantra that saturated fat must be removed to reduce the risk of cardiovascular disease has dominated dietary advice and guidelines for almost four decades.

Yet scientific evidence shows that this advice has, paradoxically, increased our cardiovascular risks. Furthermore, the government’s obsession with levels of total cholesterol, which has led to the overmedication of millions of people with statins, has diverted our attention from the more egregious risk factor of atherogenic dyslipidaemia.

Saturated fat has been demonised ever since Ancel Keys’s landmark “seven countries” study in 1970.2 This concluded that a correlation existed between the incidence of coronary heart disease and total cholesterol concentrations, which then correlated with the proportion of energy provided by saturated fat. But correlation is not causation. Nevertheless, we were advised to cut fat intake to 30% of total energy and saturated fat to 10%.”3 The aspect of dietary saturated fat that is believed to have the greatest influence on cardiovascular risk is elevated concentrations of low density lipoprotein (LDL) cholesterol. Yet the reduction in LDL cholesterol from reducing saturated fat intake seems to be specific to large, buoyant (type A) LDL particles, when in fact it is the small, dense (type B) particles (responsive …

I've mentioned this before. Read the book "The Big Fat Lie". Dispels the Ancel Keyes fat is bad theory. I dont restrict my fat intake anymore. But I'm pretty much every day, less than 80-100 grams of carbs. No bread, no rice, no pasta, no wheat or grain products.

BillyBob@388 said...

Pratoman said...
I've mentioned this before. Read the book "The Big Fat Lie". Dispels the Ancel Keyes fat is bad theory. I dont restrict my fat intake anymore. But I'm pretty much every day, less than 80-100 grams of carbs. No bread, no rice, no pasta, no wheat or grain products.

Does that seem to be working in your favor, far as you can tell?

At last bloos test, high wasn't in April, after being on very low carb, and semi high fat...
Cholesterol 83
LDL 33
Triglycerides 85 (was 208 in January, before starting low carb, and 359 with 3 meds 3-4 years ago before I started losing weight)
HDL 34 (still needs work)

There are many other blood tests I took, too numerous to mention.
I retest in a few weeks, will have results mid July.
Of course these are just blood tests and I don't know what's going on inside me. I am going to ask about retaking CAC, the Ct heart scan you mentioned, which to answer your question IS very valuable. It gave me a baseline score and also found my blockages, indicating angiogram required. But I don't know if the Drs will go along with it, as serial CTAngios is not protocol

Pratoman said...

BillyBob@388 said...

Pratoman said...
I've mentioned this before. Read the book "The Big Fat Lie". Dispels the Ancel Keyes fat is bad theory. I dont restrict my fat intake anymore. But I'm pretty much every day, less than 80-100 grams of carbs. No bread, no rice, no pasta, no wheat or grain products.

Does that seem to be working in your favor, far as you can tell?

At last bloos test, high wasn't in April, after being on very low carb, and semi high fat...
Cholesterol 83
LDL 33
Triglycerides 85 (was 208 in January, before starting low carb, and 359 with 3 meds 3-4 years ago before I started losing weight)
HDL 34 (still needs work)

There are many other blood tests I took, too numerous to mention.
I retest in a few weeks, will have results mid July.
Of course these are just blood tests and I don't know what's going on inside me. I am going to ask about retaking CAC, the Ct heart scan you mentioned, which to answer your question IS very valuable. It gave me a baseline score and also found my blockages, indicating angiogram required. But I don't know if the Drs will go along with it, as serial CTAngios is not protocol

about your HDL still needing some work: with such incredibly low TC and LDL numbers, it would be really difficult for you to get HDL much higher, though probably not impossible( more fat? ). You probably already know that some docs like to go by a ratio of either TC/HDL or simply the non-HDL level.
www.mayoclinic.org/cholesterol-ratio/expert-answers/faq-20058006

Your TC/HDL ratio or 83/34 is a spectacular 2.44. An optimal level is considered anything less than 3.5. It is going to be tough to get much better than that.

OTOH, your non-HDL level is 83-34= 49. An optimal number is < 130. Based solely on these numbers, I am truly on my death bed compared to you, though of course per CAC and lack of symptoms even while hiking up steep hills with a pack without frequent training(out of shape/over weight), it appears I have zero heart disease. But who the heck really knows, my doc wanted me on statins prior to the Calcium scoring test, then he stopped insisting. Still, I don't see how you could get your numbers much better and I do wonder how much benefit it would be to you if you could. But I'm sure there are some MDs who would disagree with me.

In fact, I can't help but wonder about the benefits of such extremely low numbers, considering the many bodily functions that cholesterol is essential for. But what do I know? Though there are some whacko MDs/alternative health practitioners out there who would agree with me. Pretty much the same guys who have said for years that low fat is BS and it is the carbs/sugar we need to pay more attention to. But most MDs/dieticians etc would strongly disagree with that, probably even some that would say not only are your extreme low TC/LDL numbers great, but you should try for even lower. There is probably some MD out there who even thinks zero is the goal. Not really, but maybe almost.

Post Edited (BillyBob@388) : 6/17/2016 8:14:20 AM (GMT-6)

@Billybob,
My cardiologist told me I probably won't be able to get my HDL much higher, just in my genes, but that it was ok, with my LDL as low as it is. Still I've stepped up my exercise, and I'm hoping to get my TG lower. I saw a lipidologist wh told me that as TG goes down, HDL tends to rise. And so far that's been the trend for me, my HDL was 27 at one point so it's up 20% since I brought TG down.

As far as plaque burden and calcium score, I'm hoping that stepping up the exercise and keeping my numbers low, will produce some reversal, or at least stop progression. Time will tell

I've read studies about cholesterol that's too low being a bad thing. I've seen enough studies that refute other studies in the last few years, to confuse anyone. So on this one, I'll trust my doc who says it's not a problem, and with my Coronary artery disease, I'm better of with LDL as low as it can go, and low. Total cholesterol, vs the risks of too low cholesterol

Thanks Tommy, before meds my cholesterol ran around 160, never high, LDL around 70


On the other front, I've got my PSA coming up in tw weeks, so there's that. I'm reasonably under control, but getting a bit apprehensive. Hopefully that will pass without any new developments