Joshi

@ Joshi @aussie.zone

Posts

48
Comments

160
Joined

2 yr. ago

Clean hands, Cool head, Warm heart.
GP, Gardener, Radical progressive

Moderating

[MIGRATED TO DIFFERENT INSTANCE CHECK PIN POST] Stardew Valley lemm.ee

1y ago

What is the best way to take your blood pressure to get the most accurate results?
Jump
Joshi @aussie.zone 1y ago
I have taken my own BP manually, it ain't easy

1y ago

Replaced old non standard electrical plugs with MC4s

The guy at Jaycar reckons he's never seen anything other than MC4 and it was difficult to find anything different online

Okay, I've been happily ignoring your little idee fixee on LDL aside from one gentle comment but I feel the need to comment here again.

This article is utterly disingenuous and sets up a complete strawman to knock down. It sets out to disprove a notion of cholesterol that was last current decades ago. Right in the first paragraph and throughout the article LDL is referred to as “the” major cause of atherosclerosis which to my knowledge even the Framingham authors wouldn't have been comfortable with, it is however a significant contributing factor.

It is well known that some people with elevated LDL or total cholesterol are at low risk(this is the reason for weak or negative results in whole population studies), atherosclerosis is a complex disease with multifactorial causes, no practising doctor I know thinks it is “the” major cause, or even the most important contributing factor.

That being said it is thoroughly established that statin use in select patients reduces the risk of MI and CVA, especially in those with established atherosclerosis, but also those with other substantial risk factors (high BP, family history, smoking, diabetes etc.). This is totally uncontroversial and the pathogenic mechanisms, while complex, are increasingly well understood.

I have been a doctor for over a decade and I consider myself diligent in keeping up with research, and although the selection of patients for statin therapy is an ongoing and regularly changing area of research on which experts can disagree, the fact that select patients will have substantially lower risk of coronary events due to statin therapy is uncontroversial.

Here is an article written by people who payed attention in stats class and have bothered to make their case with evidence rather than knocking down strawmen

Efficacy and safety of long-term treatment with statins for coronary heart disease: A Bayesian network meta-analysis (2016)

Or for a more succinct and easy to read summary here is the Cochrane conclusion

"Of 1000 people treated with a statin for five years, 18 would avoid a major CVD event which compares well with other treatments used for preventing cardiovascular disease."

Statins for the primary prevention of cardiovascular disease