When to treat (or not treat) a high cholesterol | Hacker News Reader

When to treat (or not treat) a high cholesterol

sensible-med.com

2 pointsbrandonb3 comments

No evidence that High cholesterol causes Cardiovascular Disease

1. Dietary Cholesterol and the Lack of Evidence in Cardiovascular Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6024687/

Cardiovascular disease (CVD) is the leading cause of death in the United States. For years, dietary cholesterol was implicated in increasing blood cholesterol levels leading to the elevated risk of CVD. To date, extensive research did not show evidence to support a role of dietary cholesterol in the development of CVD.

2, Doubt cast on wisdom of targeting ‘bad’ cholesterol to curb heart disease risk

British Medical journal

  https://bmjgroup.com/doubt-cast-on-wisdom-of-targeting-bad-cholesterol-to-curb-heart-disease-risk/

Decades of research have failed to show consistent benefit for this approach, say researchers

Setting targets for ‘bad’ (LDL) cholesterol levels to ward off heart disease and death in those at risk might seem intuitive, but decades of research have failed to show any consistent benefit for this approach, reveals an analysis of the available data, published online in BMJ Evidence Based Medicine.

The cholesterol panic is great for big pharma and the millions they make prescibing Statins.

For 20 + years I have lived on a high fat diet with 70% of my calories from fats.

My cholesterol has been quite normal

The non-sequiter conclusion you make will hopefully make others dismiss your post, as they should. You have normal cholesterol, the atherogenic hypothesis applies to those with high ldl, or more precisely high apo b. The bmj editorial you link hints that ldl alone may not be a good reason to prescribe statins, but the alternative is not to ignore cholesterol but to consider other factors like CAC. You also seem to not grasp the limited value of anecdotal information, and don’t say how much of your diet is saturated fat. A high fat diet from olive oil is different than a high fat diet from butter.

The cost of atorvastatin is about $100/year. The value of avoiding a cardiac event might be in the millions of dollars, so 25% reduction of a 3% risk sounds like a good deal.

This analysis ignores the issue of negative side effects. The most serious, rhabdomyolysis, occurs in about 0.1% of those taking statins. Liver issues are more common, and the cost of monitoring that might affect the cost/benefit ratio.

It would be nice to have a next generation statin that didn't have the muscle side effect (which appears to be independent of the primary mode of action of statins.)

Reply on news.ycombinator.com