And we have made ourselves living cesspools, and driven doctors to invent names for our diseases. ~ Plato
Last week, we learned there is no statistically significant mortality benefit to taking statins to prevent heart disease, especially if one is at low risk for cardiovascular disease. Yet, heart disease is the leading cause of death in the U.S. (CDC) For those of us at low risk, how else can we prevent it without resorting to pills?
Authors of this article in the New England Journal of Medicine analyzed data from 84,129 women collected in the Nurses’ Health Study. They concluded five factors significantly lower the risk for heart disease:*
- Not smoking
- Exercising moderately/vigorously for half an hour per day.
- Maintaining a healthful diet**
- Drinking alcohol in moderation (e.g., 2 glasses of wine per day)
- Keeping a healthy weight (BMI < 25)
Which echoes the findings of French cardiologist and researcher Michel de Lorgeril*** who believes that preserving our health depends on making five lifestyle choices:
- Don’t smoke.
- Exercise daily.
- Eat a Mediterranian (or equivalent) diet.
- Avoid/manage stress.
- Avoid toxic elements in our environment (including toxic drugs).
So there you go. If you’re at low risk for heart disease, you can still make lifestyle choices that further reduce your risk.† Indeed, whether you’re at low risk or not (or taking statins or not) these seem like common sense recommendations we’d all do well to consider.
By the way, how might you go about determining your risk level?
To help doctors and patients make an informed decision about medical care, The American Heart Association and the American College of Cardiology developed a Cardiovascular Risk calculator. If you’re between the ages of 40 and 79 and the calculator spits out a number that is less than 5 percent, it’s predicted your risk of having a cardiovascular event over the next 10 years is low. Of course, it goes without saying that the use of the calculator is meant to be a “starting point not as the final arbiter, for decision making.”
As to statins, as best as I can tell, the general consensus in the medical community is that the benefits outweigh the risks†. As noted in a recent Lancet review article that documented the benefits of statins and acknowledged some of the side effects:
Whereas the rare cases of myopathy and any muscle-related symptoms that are attributed to statin therapy generally resolve rapidly when treatment is stopped, the heart attacks or strokes that may occur if statin therapy is stopped unnecessarily can be devastating.
This underscores what many in the medical community decry: An “anti-statin trend” is putting lives at risk (CBS) and that “Dr. Google is a liar” (NYTimes). [Note, this isn’t an endorsement for/against statins. Further, equating the debate about statins to the debate about vaccines is utterly absurd.]
In any case, if you’re at a point in your life when you have started worrying about things like heart disease, consider including the items enumerated above and the calculator in your discussions with your primary care physician/cardiologist.
On that note, perhaps a good time for me to wipe the donut crumbs and cigarette ashes off my PJs and do a few jumping jacks before I head to work. Before I do though, how about some music for our Spotify playlist?
Been waiting for a good time to introduce you to the band Hiss Golden Messenger. Headed by the talented and laconic M.C. Taylor, the band has its roots in Durham, North Carolina and is best known for songs that suggest ways to “find and express joy when the world is crumbling all around you.” (Pitchfork). The song I’m leaving you with, “Heart Like a Levee” is off an album of the same name – hope you like it as much as I do.
Cheers…xian
*These women had an incidence of coronary events that was more than 80 percent lower than that in the rest of the population.
**From the article: “Diet low in trans fat and glycemic load (which reflects the extent to which diet raises blood glucose levels), high in cereal fiber, marine n–3 fatty acids, and folate, and with a high ratio of polyunsaturated to saturated fat.”
*** From Lorgeril’s book about cholesterol and statins which is written in English.
†This should not be construed as medical advice.
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