 STUPID 2PD OMER PLANS OLD FASHION. SUPER NOMER EATING PLAN BEST
On Jan 31, 8:48 pm, "Andrew B. Chung, MD/PhD"
<heartdo...@emorycardiology.com> wrote:
> "What's cholesterol got to do with it?" -- Gary Taubes.
>
> "The same as calories... the title of your book is meaningless, Gary."
> -- Andrew, in the Holy Spirit
>
> Be smarter than dear neighbor Gary by eating less, down to the right
> amount while ignoring calories, which are meaningless (neither good
> nor bad):
>
> http://HeartMDPhD.com/BeSmart
>
> Be hungry... be healthy... be hungrier... be blessed:
>
> http://TheWellnessFoundation.com/BeHealthy
>
> Prayerfully in the infinite power and might of the Holy Spirit,
>
> Andrew <><
> --
> Andrew B. Chung, MD/PhD
> Lawful steward ofhttp://EmoryCardiology.com
> Bondservant to the KING of kings and LORD of lords.
>
> Bill wrote:
> > Role of cholesterol in prevention and mortality benefit of statins
> > debated in media
>
> > January 30, 2008
>
> > Michael O'Riordan
> > New York, NY - There is no shortage of cholesterol news to begin the new
> > year, especially with questions deriving from the Effect of Combination
> > Ezetimibe and High-Dose Simvastatin vs Simvastatin Alone on the
> > Atherosclerotic Process in Patients with Heterozygous Familial
> > Hypercholesterolemia (ENHANCE) trial. Now, an editorial published over
> > the weekend in the New York Times questions the cholesterol hypothesis,
> > specifically that current medical practice is focusing inappropriately
> > on LDL cholesterol rather than on the lipoproteins that carry the "bad"
> > cholesterol. [1]
> > The opinion piece, titled "What's cholesterol got to do with it?" by
> > Gary Taubes, author of Good Calories, Bad Calories: Challenging the
> > Conventional Wisdom on Diet, Weight Control, and Disease, zeroes in on
> > the Vytorin (ezetimibe/simvastatin, Merck/Schering-Plough
> > Pharmaceuticals) storm, using the current controversy as a launching pad
> > to question the clinical importance of lowering LDL cholesterol.
>
> > "The idea that cholesterol plays a key role in heart disease is so
> > tightly woven into modern medical thinking that it is no longer
> > considered open to question," writes Taubes. "This is the message that
> > emerged all too clearly from the recent news that the drug Vytorin had
> > fared no better in clinical trials than the statin therapy it was meant
> > to supplant."
> > In light of these findings from the ENHANCE trial, many cardiologists,
> > writes Taubes, said that "the result implied nothing about their
> > assumption that LDL cholesterol is dangerous, only about whether it is
> > always medically effective to lower it.
>
> > "But this interpretation is based on a long-standing conceptual error
> > embedded in the very language we use to discuss heart disease," he
> > writes. "It confuses the cholesterol carried in the bloodstream with the
> > particles, known as lipoproteins, that shuttle that cholesterol around.
> > There is little doubt that certain of these lipoproteins pose dangers,
> > but whether cholesterol itself is a critical factor is a question that
> > the Vytorin trial has most definitely raised. It's a question that needs
> > to be acknowledged and addressed if we're going to make any more headway
> > in preventing heart disease."
>
> > Losing sight of abnormal lipoproteins
> > In his article, Taubes provides a brief history, noting that in the
> > 1950s researchers suspected that lipoproteins, carriers of cholesterol,
> > might play a bigger role in cardiovascular disease. However, measuring
> > these lipoproteins was difficult and expensive, while cholesterol
> > testing was relatively easy to order up for any doctor.
> > By the 1960s, scientists were able to measure the cholesterol inside the
> > different types of lipoproteins�high-density, low-density, and
> > very-low-density lipoproteins. Studies later showed that cholesterol in
> > LDL was a marginal risk factor, leading to the concept that LDL carries
> > bad cholesterol and HDL carries good cholesterol. HDL and LDL later
> > became "good" and "bad" cholesterol, losing sight of the idea that the
> > causal agent in cardiovascular disease might be abnormal lipoproteins,
> > writes Taubes.
> > The results with statin drugs, which lower LDL cholesterol and prevent
> > MI, have led many to believe that lowering LDL prevents heart disease.
> > However, statins have other pleiotropic effects, including lowering the
> > number of low-density and very-low-density lipoproteins in the blood,
> > including the smallest, densest, and most noxious form of LDL, writes
> > Taubes. Moreover, the ENHANCE study with Vytorin, as well as data on
> > estrogen therapy and torcetrapib, all of which lower LDL cholesterol,
> > have failed to show a benefit, he writes.
> > "If the evidence continues to challenge the role of cholesterol, then
> > rethink it, without preconceptions, and consider what these other
> > pathways in cardiovascular disease are implying about cause and
> > prevention," writes Taubes. "A different hypothesis may turn out to fit
> > the facts better and one day help prevent considerably more deaths."
>
> > Lifesaving role of statins called into question
> > Will taking a statin make you live longer? That's the question put forth
> > by another article in the New York Times [2]. In the fallout from the
> > ENHANCE trial, the paper notes that statins are excellent for reducing
> > LDL-cholesterol levels and reducing the risk of heart attack, but for
> > many users statins do not prolong life.
>
> > Middle-aged men with cardiovascular disease do derive significant
> > benefit from statins, science reporter Tara Parker-Pope writes, but many
> > statin users don't have heart disease, just elevated LDL-cholesterol
> > levels. "For healthy men, for women with or without heart disease, and
> > for people over 70, there is little evidence, if any, that taking a
> > statin will make a meaningful difference in how long they live," writes
> > Pope.
>
> > Dr Harlan Krumholz (Yale University School of Medicine, New Haven, CT)
> > agreed. "I do think that we do not disclose often enough to patients
> > where there is uncertainty," he told heartwire. "Statins are remarkable
> > drugs that have been shown to reduce risk in many populations and to be
> > particularly useful in high-risk populations. The magnitude of benefit
> > is smaller in lower-risk populations even if the relative risk is the
> > same, making it harder to show benefit and translating into more people
> > that need to be treated to produce a benefit."
> > Pope notes that the PROSPER study, published in the Lancet in 2002 and
> > reported by heartwire, found the drugs did not reduce mortality in
> > patients 70 years of age and older.
> > "In the oldest populations I have the greatest degree of uncertainty,"
> > agreed Krumholz. "I believe our best approach is to engage in shared
> > decision making, where the uncertainty is disclosed and the
> > recommendation is based on what evidence is available and the
> > preferences, values, and goals of the patients. There is still much to
> > learn."
> > One recent meta-analysis, also reported by heartwire, showed that
> > statins did translate into a 22% lower mortality risk for high-risk
> > patients 65 years of age and older who had a prior MI or established
> > cardiovascular disease. The number needed to treat (NNT) to save one
> > life in this analysis was 28, reported lead investigator Dr Jonathan
> > Afilalo (McGill University, Montreal, QC). "If a patient has had a heart
> > attack, they generally should be on a statin," he told the Times.
> > Pope also writes that treatment with a statin does not improve quality
> > of life and that the drugs do cause side effects, such as muscle pain.
> > To heartwire, Krumholz said there are many patient groups that remain
> > understudied, such as minorities, women, the elderly, and those with
> > renal dysfunction. While the results from trials are extrapolated to
> > these populations, where is less certainty, the mainstream opinion is
> > that statins are effective.
> > "The open debate is good, but we need to be sure that patients
> > understand the balance of benefits and risks with any medications, and
> > it would seem a shame if the recent publicity led high-risk patients to
> > discontinue statins because they incorrectly believe them to be
> > ineffective."
>
> > Debating whether or not lowering LDL cholesterol is enough
> > With questions surrounding the mortality benefits of statins and the
> > importance of lowering LDL cholesterol being asked in the media, some
> > high-profile cardiologists also get in on the act in the January 29,
> > 2008 issue of Circulation, with Drs H Robert Superko (St Joseph's
> > Translational Research Institute, Atlanta, GA) and Spencer King III
> > (Emory University School of Medicine, Atlanta, GA) [3] debating the
> > effectiveness of lowering LDL to reduce cardiovascular risk and
> > suggesting that new strategies are necessary. Taking an opposing stand
> > is Dr Scott Grundy (University of Texas Southwestern Medical Center,
> > Dallas), who argues for the promise of LDL-lowering therapy in primary
> > and secondary prevention [4].
> > According to Superko and King, a danger for the future health of
> > patients lies in assumptions that cholesterol reduction alone can stem
> > the tide of coronary heart disease. They argue that "this is not enough"
> > and state that the "well-meaning focus on LDL-cholesterol reduction has
> > deflected interest in other therapeutic aspects of lipoprotein treatment
> > that provide equal or greater benefit."
> > They also point to the many clinical trials with monotherapy showing a
> > consistent 25% reduction in cardiovascular events. This relative risk
> > reduction, they suggest, obscures the fact that 25% is simply
> > insufficient.
> > To support their argument, Superko and King point to the PROVE-IT trial,
> > a comparison of high-dose atorvastatin vs pravastatin 40 mg, suggesting
> > that while the relative 16% reduction in clinical events is laudable,
> > 22.4% of patients treated with atorvastatin 80 mg still experienced a
> > clinical event. These events occurred despite LDL cholesterol being
> > lowered to 62 mg/dL. The NNT also remains too high in monotherapy
> > trials, write Superko and King, but combining LDL lowering with
> > therapies to raise HDL cholesterol could
>
> ...
>
> read more »
Amazing Dr. Benton Q. Ningning MD,PhD,SAT Time Traveller and All
Around Great Fellow give coming notice of Fabulous NOMER Eatery Plan!
How it work...
God give hunger
Devil say hunger bad
Eat until Devil ignored
Hey ho now you got it !
Throw away weigh scales and Live Free!
Benton.  |
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