5 Steps to prevent Heart Disease

Sunday, March 27, 2016

Americans don't care about absolute risk, they want to know how to live to 100

My compliments to Doctor  Axel F Sigurdsson for a great blog.

Allow me to continue with Dr Braunwald’s American point of view.
Americans want and expect to live till 100 years of age in good health.
That’s the lottery and statins are the insurance to get there.
I am impressed by Dr Sigurdsson’s ability with math.  I have no such ability.
My I ask him to calculate the absolute risk from age 65 to 100
1-to prevent death and
2-to prevent stroke and
3-to prevent MI.

As to side effects, MD’s need to see the patient every 4 months and monitor for that.  
As to residual risk, if goals of LDLp or apoB, not LDLc are met I believe residual risk will be less.
In the end it is the decision of the patient.
Somehow we sell the 85 year old the bypass surgery, yet atorvastatin 20 mg with niacin 1,000 mg a day from age 60 is not worth it?
Americans got the message about smoking.
Americans got the message about carbs and IR before Endocrine society.
Americans got the message about statins and the results have been remarkable.

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