Who knew chatGPT could be so political? Great summary even if chat seems to be purposely shooting straight down the middle.
Cronos posted a study in another thread that had a .46 RR for neurodegenerative diseases with statin exposure. Congruent with other studies but with a significantly lower RR. ChatGPT doesn’t mention this part of the argument.
Imaging for significant stenosis in cardiac vessels is good but imaging to predict neurodegenerative diseases has a much lower predictive value.
I err on the side that personalized medicine is not really data driven. Or at least not study driven. It is saying that I am different. My risk is different because of X. Now X may seem very reasonable and logical. But it isn’t reproduced by a study. Some of it is of course, I don’t smoke so my risk is lower than a cohort that smokes. Personalized medicine goes further than that of course and makes inferences and educated guesses not supported by literature.
Nothing wrong with people doing their own thing. But every individual does their own thing and most are wrong. Each argument may get better than the last and people with medical or biologic background spend their lives working on it probably have a better chance of getting it right. But the vast majority will probably make incorrect decisions.
I made a mistake. I had high LDL and had some trouble with simvastatin in my early 40s. So I stopped it. I exercise and eat well. My father was in exceptional shape with the same LDL profile. And didn’t take a statin. I figured my cardiac risk was low - my BP was 100/60, HR upper 30s (still is just with the help of telmisartan). I “personalized” my way to accepting a higher than ideal LDL. I suspect I have clean vessles. But the dementia data doesn’t care that your imaging is fine. My LDL has been below 70 for awhile now. I actually don’t see the need for cardiac imaging because I would take a statin either way.
Now my mistake is not the same as others - and many other decisions are not mistakes. But I am have seen the same mistake over and over again in various people. Todd doesn’t see it as a mistake. He makes a decent argument on the cardiac imaging side but has neglected the neuro side. And the microscopic vascular disease side.
Is there a respected health influencer or MD that allows their LDL to ride high because their imaging is ok? And I get that the word respected is going to be open to interpretation. What I see among experts in practice is go as low as you can.
