My cholesterol numbers were golden for many years before I had a heart attack. Cholesterol numbers don’t mean sh*t as far as I’m concerned.
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What do you mean by “golden”? 99mg/dL?
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Medicine doesn’t make decisions based on N=1. Just because in your case LDL didn’t track apoB doesn’t mean that it doesn’t for most people. I don’t think you knew your Lp(a), either. ApoB is superior to LDL and it should be used of course, as well as Lp(a) is important, that is a failure of the medical system. But LDL is pretty darn good, still. Much better than ignoring LDL altogether which would lead to an extreme increase in death rate and heart attacks.
It is also a failure of the medical system to not update that lower is better (and sooner).
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I would ask them what the stroke risk is with Afib and what they are doing for that and thinking long term.
Very sorry to hear about the situation. It’s so unfortunate that the medical system is so bad (except in treating acute situations, mostly).
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Has anyone mentioned stress and mental health yet?
“Golden” means that as a result of my annual lipid panel (total cholesterol well under 200), my PCP said, “you are great, keep doing what you’re doing” and did not recommend a statin or any diet change.
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I make decisions based on N=1 if I am the 1. They always told me the Total, Trig, HDL, VLDL, and LDL. Those numbers were always optimal, and the doc never said anything about any other tests. Indeed, to this day, he doesn’t give a sh*t about anything other than a standard lipid panel. His attitude is “take your statin and shut up”.
I think stress is more important than is commonly understood. In my own case I believe marital stress leading to divorce was the reason I had a heart attack.
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You can order online apoB & Lp(a) tests. Generally the medical system is not optimizing for maximum healthspan and longevity via latest evidence and preventative care, but they do recommend statins and SGLT2i which are both good.
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Agreed. But we need a much better way to measure it longitudinally.
We need a highly accurate stress-focused Fitbit like device (or have this feature integrated into existing fitness measuring wearables).
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I think it may be time to find a new doctor…
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Don’t you have concrete values?
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Terribly sorry to hear Chris. Thanks a lot for sharing / this can help remind us all of how crucial things are!
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I find it interesting (or common sense) that the countries in blue are the ones with socialized medicine.
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I wonder if the life expectancy thing is particularly income linked in each of the countries.
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There are many countries with life expectancies lower than the US but with socialized medicine:
The US is the only outlier in the world, spending more to get less:
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Yes - I think quality matters… (and per capita GDP).
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