Breaking down the numbers on the recent trial of the statin alternative nexletol. In terms of relative risk, there was a 23% reduction in heart attacks. In absolute terms, the control group had an incidence of 4.8% compared with 3.7% of the treatment group, for an absolute difference of 1.1%.
No difference in overall mortality rates at 6.2 vs 6.0%.
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If it causes an increase in Urate/Uric Acid then it is not surprising (if Perlmetter is right) that there is no real mortality difference. I intend studying Urate a bit once I have last week’s blood test results.
The argument appears to be that increased Urate drives metabolic syndrome to some extent.
But it does not include the study you posted though. The three included studies in meta analysis were done with obese, hypertensive and dyslipidaemic patients. Yours states healthy volunteers. But yes, it sounded too good to be true. 
Ahh, I didn’t check the meta analysis in detail and assumed they included it. I wonder why they didn’t. So maybe it does work, only in healthy people? One would need to try it, test and see.
With all the cross over and washout periods, that would be one heck of an anomaly, as long as the data aren’t made up.
I have regularly tested my lipids for years and adding Brazil nuts to my diet daily has done nothing for me. N of 1
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Apologies if this has been posted already. But this pilot is incredible fish oil tablets + metformin reduces apob by 40%
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Very nice results if they can be extrapolated to the general population. Is there any other research in this area?
I found this…
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It can’t since they had metabolic syndrome with hypertriglyceridemia, with a small sample size.
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Sadly the general population has metabolic syndrome to quite an astonishing degree. Metabolic Syndrome - What Is Metabolic Syndrome? | NHLBI, NIH.
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Coronary CT calcium evaluation/ score better than genetics in assessing cardiac risk.
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Has anyone done or looked into Peter Thiel backed Cleerly Health type of cardiovascular imaging
Seems to be even better than normal CT/CAC as it can also see soft plaque/ongoing calcification and not just past processes that had become solidified plaque.
Currently, conventional measures of risk-factor levels, such as blood pressure and cholesterol, are used by doctors to determine a person’s likelihood of developing coronary heart disease or blockages of the arteries in the heart. But some people may experience a heart attack, or related heart problem, without one of those conventional factors picking it up.
Because your thresholds of ldl cholesterol for treatment is too high. Lower LDL needs to be treated earlier.
Completely clueless doctors, it’s not a meme, it’s reality & parody.
I watched Dr. Aseem Malhotra on Joe Rogan. Are you a doctor? Do you see both sides of this? Have you looked at the studies that the other side sites?
Also I think he mentions in this interview that 11% of oncology studies are repeatable. Science is broken. I think before you reach the level of certitude that you apparently have, you need to do the studies yourself. Pharma wants to sell statins, so they buy the studies necessary. It’s happening.
Also rivasp12 is not a regular mainstream doctor (if there is such a thing). He reads widely and practices what he does. What do you actually do for a living?
As a farmer, sales people come to me and want to sell based on plots. They cheat like crazy. If you don’t do your own science you will get it wrong. Not might, will. The system will bury anybody not doing their own work. Also some people can’t even do their own work because of bias.
Good luck with your godlike certitude.
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Yes, you are correct.
Repeating myself, posted more than one time.
All should watch and remember;
The pursuit of ignorance
Stuart Firestein
Everyone knows, the point is to understand.
Shamelessly plagiarized from;
Albert Einstein — ‘Any fool can know. The point is to understand.’
In the medical field especially, decisions are based on benefit/ risk analysis. I’m neither pro nor anti statin, it all boils down to risk assessment.
In the low risk individual with a CAC of zero, the 10 year prognosis is extremely good, and the CV mortality risk is very low, so the gain in aggressive management is also very low.
I’ve previously posted a cardiologist’s recommendation for interventions based on different levels of CAC scores. This is a very reasonable way to assess your risk and determine the course of action.
I am seeing some impressive lipid lowering results with citrus bergamot at 1000 mg per day. Some additional benefits can be had with pantothene 600 mg per day.
In the high risk person, with high CAC scores, combinations of statins and PCSK9’s are warranted.
My main concerns with statins are the risk for developing diabetes and the cognitive/ memory issues that I’ve seen ( occasionally). There are reports of serious global amnesia episodes and a Mendelian randomization study did find impaired cognition with statins, but not with the PCSK 9 inhibitors.
Under I fully understand what’s going on in the brain with statins, I’m going to try other interventions first, unless the person is high risk for CVD. This is still not settled and I’ll probably change my mind as newer data emerges.
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So your concern is that the studies on LDL can’t be repeated? It does, over and over.
Statins are literally dirt cheap because they are generic, and for the aware consumer a much lower dosage than what’s sold is still effective. I am agnostic about statins, but they are inexpensive and very low risk, meaning most people do not get side effects.
“Intervening”, if you can call it that, after advanced disease has already developed isn’t good, it isn’t prevention at least.
The ideal approach would be to get a CAC at a young age and to begin interventions than if indicated by the score. Of course, most studies reveal the greatest gains come from secondary, not primary, prevention, and that’s because they are the ones at greatest risk.
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Still, you are only treating people who have advanced ASCVD, rather than preventing it. It isn’t preventative medicine. It is standard mainstream medicine.