Re: Statins for the primary prevention of cardiovascular disease
The elephant in this room is the fact this patient is overweight. While mentioned in the introduction, it is ignored thereafter in the narrowly focused attempts to find out which drug treatments may best compensate for the poor fellow's unhealthy lifestyle.
As a GP without a special interest in anything in particular, I have found, in cases like this, that advice to stop adding sugar to hot drinks, to stop eating sugary drinks and sugared products, to stop, or reduce, the consumption of biscuits buns cakes and confectionery, and if this is not enough, to reduce the consumption of starches, results in an average weight loss of about 7% (and counting). I have noticed some pretty remarkable improvements in patients biochemistry, but that is not all.
By removing sugar from the diet, patients avoid eating trans fats in particular and excessive saturated fats as a side effect. A low sugar diet is a low junk food diet! With weight loss, they feel better, can exercise more, and reduce the multitude of problems associated with obesity and gain control over their own lives.
Advising patients to take statins to reduce their theoretical risk of disease at best makes them feel no better but often makes them feel physically worse. Benefits are theoretical and taken on faith, while side effects are real and current. Also, prescribing statins can side-line the possibility of helping them control their own risk factors for themselves.
Too much lip service is given to dietary advice, which is central to the pathologies concerned. To prescribe statins in primary prevention without having put energy and resources into improving a patient's diet, particularly by reducing sugar intake from its present high levels, is bad medicine.
Rapid Response:
Re: Statins for the primary prevention of cardiovascular disease
The elephant in this room is the fact this patient is overweight. While mentioned in the introduction, it is ignored thereafter in the narrowly focused attempts to find out which drug treatments may best compensate for the poor fellow's unhealthy lifestyle.
As a GP without a special interest in anything in particular, I have found, in cases like this, that advice to stop adding sugar to hot drinks, to stop eating sugary drinks and sugared products, to stop, or reduce, the consumption of biscuits buns cakes and confectionery, and if this is not enough, to reduce the consumption of starches, results in an average weight loss of about 7% (and counting). I have noticed some pretty remarkable improvements in patients biochemistry, but that is not all.
By removing sugar from the diet, patients avoid eating trans fats in particular and excessive saturated fats as a side effect. A low sugar diet is a low junk food diet! With weight loss, they feel better, can exercise more, and reduce the multitude of problems associated with obesity and gain control over their own lives.
Advising patients to take statins to reduce their theoretical risk of disease at best makes them feel no better but often makes them feel physically worse. Benefits are theoretical and taken on faith, while side effects are real and current. Also, prescribing statins can side-line the possibility of helping them control their own risk factors for themselves.
Too much lip service is given to dietary advice, which is central to the pathologies concerned. To prescribe statins in primary prevention without having put energy and resources into improving a patient's diet, particularly by reducing sugar intake from its present high levels, is bad medicine.
Competing interests: No competing interests