nfulmer
10-08-2005, 07:17 PM
The National Heart, Lung, and Blood Institute (NHLBI) has established guidelines for the treatment and management of high cholesterol. These guidelines were put together by a panel of experts and are the standard of care in which the American Heart Association makes its recommendations for cholesterol management. The nhlbi guidelines look at cardiac risk factors in conjunction with cholesterol numbers. For example, my total cholesterol is 252, LDL 157, and HDL 62, but because I do not have ANY cardiac risk factors (I do not smoke, my blood pressure is normal, etc), my numbers are not that big of a concern. You can access a quick reference of these guidelines by going to the nhlbi website and clicking on "Heart/Vascular" and then on "information for health professionals" (listed on the left menu). Next click on "cholesterol", then on "ATP III AT-A-Glance: Quick Desk Reference". I urge anyone who has high cholesterol to read these guidelines before taking statins. Unfortunately, most physicians are not aquainted with the guidelines.
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Brendap
10-08-2005, 08:42 PM
Thanks for the directions to that quick reference guide. I downloaded the pdf file and find it very interesting.
Brenda
Brenda
NHone
10-09-2005, 04:39 AM
The National Education Program (NCEP) has indeed issued an update to the thrid Adult Treatment Panel (ATP III). Six of the nine panelists had either received grants from or were paid consulting or speakers' fees by some of the following companies Pfizer (lipitor), Bristol-Myers Squibb (Pravachol), Merck (Me****r) and AstraZeneca (crestor).
nfulmer
10-09-2005, 08:28 AM
Regardless if consulting or speaker fees were paid, the guidelines show that cardiac risk factors play a huge role in the development of heart disease, and cholesterol alone does not. The guidelines state that higher cholesterol numbers are not always an indication for statins. What would the makers of lipitor, etc., have to gain from this? It is the physicians who are prescribing these drugs who are paid by the drug companies. The drug reps take them out to fine restuarants and play golf with them. I am a health care professional and I know this for a fact. The ATP III guidelines are the standard of care for the management of cholesterol and as such should be followed.
Moxie75
10-09-2005, 08:34 AM
I think you should have your CRP and homocysteine checked before determining that you are ok with cholesterol levels being that high..Lisa
nfulmer
10-09-2005, 10:23 AM
Lisa,
Thanks for the advice. I will have my CRP and homocysteine levels checked.
Thanks for the advice. I will have my CRP and homocysteine levels checked.
NHone
10-09-2005, 03:30 PM
The ATP III guidelines encourage physicians to aggressively increase the use of statin drgus to lower cholesterol. The report , in particular, recommends that target LDL leverl be reduced. Additionally , patients, such as diabetics are now encouraged to take statins. (It has been shown that seriously ill diabetics taking statins face a much higher risk of stroke). The new guidelines would dramatically increase the number of patients on statin drugs. This is why the drug companies would win big time. THe ATP III guidelines are going to make many more people victims.
wyod501
10-09-2005, 10:34 PM
Regardless if consulting or speaker fees were paid... The ATP III guidelines are the standard of care for the management of cholesterol and as such should be followed.
Yes, I know I am taking you a bit (or a lot, if you prefer) out of context, and please accept my apologies if this offends you.
The point that I would like to highlight, however, is that the "Standard of Care" in ATP III is largely bogus because the very people that have recommended these guidelines were taking what amounts to payola. The reason most doctors won't take them seriously and follow them is because they are bogus. Patients like me--and I am handed a 'script for some statin or another everytime I go to the doctor, which I promptly throw in the trash because of past history--really don't know what to think or who's opinion to trust. You certainly cannot trust government agencies to look out for the welfare of the people anymore.
Yes, I know I am taking you a bit (or a lot, if you prefer) out of context, and please accept my apologies if this offends you.
The point that I would like to highlight, however, is that the "Standard of Care" in ATP III is largely bogus because the very people that have recommended these guidelines were taking what amounts to payola. The reason most doctors won't take them seriously and follow them is because they are bogus. Patients like me--and I am handed a 'script for some statin or another everytime I go to the doctor, which I promptly throw in the trash because of past history--really don't know what to think or who's opinion to trust. You certainly cannot trust government agencies to look out for the welfare of the people anymore.
NHone
10-10-2005, 01:30 AM
You also should have your Lp(a) checked. Lipitor has been known to raise this level.
HubbleRules
10-10-2005, 09:38 AM
Regardless if consulting or speaker fees were paid, the guidelines show that cardiac risk factors play a huge role in the development of heart disease, and cholesterol alone does not. The guidelines state that higher cholesterol numbers are not always an indication for statins. What would the makers of lipitor, etc., have to gain from this? It is the physicians who are prescribing these drugs who are paid by the drug companies. The drug reps take them out to fine restuarants and play golf with them. I am a health care professional and I know this for a fact. The ATP III guidelines are the standard of care for the management of cholesterol and as such should be followed.
nfulmer,
I think the main point is that there is a clear conflict-of-interest between those who create the cholesterol guidelines and the pharmaceuticals.
The way the pharmaceuticals benefit is that when the recommended levels for cholesterol are lowered, that results in a huge increase in the number of people who will be pushed to be on statins. It is a win-win situation for the guideline panel and the pharmaceuticals. The members of the board continue to get more paybacks from the pharmaceuticals for stroking their backs, and the pharmaceuticals get huge additional profits by having millions of additional patients-for-life.
Follow the money - the system is stinking full of it....
HubbleRules
:cool:
nfulmer,
I think the main point is that there is a clear conflict-of-interest between those who create the cholesterol guidelines and the pharmaceuticals.
The way the pharmaceuticals benefit is that when the recommended levels for cholesterol are lowered, that results in a huge increase in the number of people who will be pushed to be on statins. It is a win-win situation for the guideline panel and the pharmaceuticals. The members of the board continue to get more paybacks from the pharmaceuticals for stroking their backs, and the pharmaceuticals get huge additional profits by having millions of additional patients-for-life.
Follow the money - the system is stinking full of it....
HubbleRules
:cool:
nfulmer
10-10-2005, 03:02 PM
I disagree with you about the ATP III guidelines. I agree with you that the drug companies are politically powerful and that they throw their weight around.
The point I would like to make is that physicians are prescribing statins for cholesterol levels that are only slightly elevated. Why is this?? Many don't even encourage diet and exercise. I have a problem with this, big time! At least the ATP guidelines state that diet and exercise, depending on your cholesterol levels, should be attempted before statins are prescribed. If you have not taken the time to throughly read the guidelines, I suggest you do before putting them down.
The point I would like to make is that physicians are prescribing statins for cholesterol levels that are only slightly elevated. Why is this?? Many don't even encourage diet and exercise. I have a problem with this, big time! At least the ATP guidelines state that diet and exercise, depending on your cholesterol levels, should be attempted before statins are prescribed. If you have not taken the time to throughly read the guidelines, I suggest you do before putting them down.
HubbleRules
10-10-2005, 09:04 PM
I disagree with you about the ATP III guidelines. I agree with you that the drug companies are politically powerful and that they throw their weight around.
The point I would like to make is that physicians are prescribing statins for cholesterol levels that are only slightly elevated. Why is this?? Many don't even encourage diet and exercise. I have a problem with this, big time! At least the ATP guidelines state that diet and exercise, depending on your cholesterol levels, should be attempted before statins are prescribed. If you have not taken the time to throughly read the guidelines, I suggest you do before putting them down.
nfulmer,
That the physicians are prescribing statins for mildly elevated cholesterol levels plays right into my argument that the medical profession has a strong conflict of interest with the monetary incentives offered it by the pharmaceuticals, and that their clinical diagnosis and treatment of patients has been negatively influenced as a result.
I have read the guidelines. I have a Framingham Study score of 12, which gives me a 10year risk of CHD of 10%. I have 2+ risk factors (Total Chol > 200, a family member with CHD under age 55, and I am over 45 years old).
I should be treated with a) therapeutic lifestyle changes, and if after 3 months my LDL is not < 130, then I should be treated with LDL lowering drugs.
I understand the above, but I DO NOT TRUST THE RECOMMENDED LDL LEVELS (<130 for me) because of the flagrant conflict of intestest between those who determined the guidelines and the pharmaceutical companies who reap huge additional profits by the lowering of the LDL guidelines. THIS IS MY MAJOR POINT...
Let's just respectfully agree to disagree about the guidelines.
HubbleRules
:cool:
The point I would like to make is that physicians are prescribing statins for cholesterol levels that are only slightly elevated. Why is this?? Many don't even encourage diet and exercise. I have a problem with this, big time! At least the ATP guidelines state that diet and exercise, depending on your cholesterol levels, should be attempted before statins are prescribed. If you have not taken the time to throughly read the guidelines, I suggest you do before putting them down.
nfulmer,
That the physicians are prescribing statins for mildly elevated cholesterol levels plays right into my argument that the medical profession has a strong conflict of interest with the monetary incentives offered it by the pharmaceuticals, and that their clinical diagnosis and treatment of patients has been negatively influenced as a result.
I have read the guidelines. I have a Framingham Study score of 12, which gives me a 10year risk of CHD of 10%. I have 2+ risk factors (Total Chol > 200, a family member with CHD under age 55, and I am over 45 years old).
I should be treated with a) therapeutic lifestyle changes, and if after 3 months my LDL is not < 130, then I should be treated with LDL lowering drugs.
I understand the above, but I DO NOT TRUST THE RECOMMENDED LDL LEVELS (<130 for me) because of the flagrant conflict of intestest between those who determined the guidelines and the pharmaceutical companies who reap huge additional profits by the lowering of the LDL guidelines. THIS IS MY MAJOR POINT...
Let's just respectfully agree to disagree about the guidelines.
HubbleRules
:cool:
ARIZONA73
10-10-2005, 09:37 PM
I understand the above, but I DO NOT TRUST THE RECOMMENDED LDL LEVELS (<130 for me) because of the flagrant conflict of intestest between those who determined the guidelines and the pharmaceutical companies who reap huge additional profits by the lowering of the LDL guidelines. THIS IS MY MAJOR POINT...
I think the drug companies have a great racket going. If they wish to increase profits, all they have to do is stack the deck in favor of lower guidelines. It's no accident that the so-called "panel of experts" often have strong financial ties to big pharma. Have you also noticed that they've been going the same route with blood pressure readings? Just tweak the guidelines, and they end up with billions of more dollars in their pockets. Wow, what a racket! I wish I can make money so easily!
I think the drug companies have a great racket going. If they wish to increase profits, all they have to do is stack the deck in favor of lower guidelines. It's no accident that the so-called "panel of experts" often have strong financial ties to big pharma. Have you also noticed that they've been going the same route with blood pressure readings? Just tweak the guidelines, and they end up with billions of more dollars in their pockets. Wow, what a racket! I wish I can make money so easily!
HubbleRules
10-10-2005, 09:53 PM
I think the drug companies have a great racket going. If they wish to increase profits, all they have to do is stack the deck in favor of lower guidelines. It's no accident that the so-called "panel of experts" often have strong financial ties to big pharma. Have you also noticed that they've been going the same route with blood pressure readings? Just tweak the guidelines, and they end up with billions of more dollars in their pockets. Wow, what a racket! I wish I can make money so easily!
Arizona,
I couldn't agree more....
What's scary also is that investigative reporting by the major media (like 60 Minutes, The New York Times, et al...) has completely dropped the ball on informing the public about the dangerous influence of the pharmaceutacls - and for a very logical reason.
Over 40% of the advertising revenue in this country is spent by the pharmaceuticals.
What do you think the chance is of a major network being critical of one of it's biggest advertisers and exposing the harm they are posing to the general public? Somewhere between slim and none???
HubbleRules
:cool:
Arizona,
I couldn't agree more....
What's scary also is that investigative reporting by the major media (like 60 Minutes, The New York Times, et al...) has completely dropped the ball on informing the public about the dangerous influence of the pharmaceutacls - and for a very logical reason.
Over 40% of the advertising revenue in this country is spent by the pharmaceuticals.
What do you think the chance is of a major network being critical of one of it's biggest advertisers and exposing the harm they are posing to the general public? Somewhere between slim and none???
HubbleRules
:cool:
Uff-Da!
10-10-2005, 11:03 PM
Well, my doctor sure isn't going by these guidelines. Going by the Farmington charts, I get a ten-year risk of 1% (10 points for age of 64, 2 points for cholesterol of 239 on last test, -1 point for an HDL of 85, and 1 point for an unmedicated SBP of 126. This equals 12 points for a risk of 1% on the female chart.) Going by the sliding calculator on the NHLBI website, my risk is 2% in the next ten years. Now granted, I think my risk should be considered higher than that because of the results of some of the emerging risk factors, but not enough to put me in a "high risk" category.
But my doctor wants me to bring my non-HDL down to under 130 and my LDL down to under 100. "And 70 is better." :rolleyes: Is it any wonder my SBP was up to 181 when the nurse took it just after I left the doctor's office?
But my doctor wants me to bring my non-HDL down to under 130 and my LDL down to under 100. "And 70 is better." :rolleyes: Is it any wonder my SBP was up to 181 when the nurse took it just after I left the doctor's office?
Lenin
10-15-2005, 10:14 AM
Is one to assume that a great deal of money isn't made by the anti cholesterol treatment people like the Mercolas, the Raths, the Enigs and the "Uwe's"? Can we assume that the vitamin and supplement industries do their "work" out of the goodness of their little hearts?
Do you think the diet purveyors like Atkins or the meat lobbyists like Weston Price arent WELL rewarded for espousing their ideas? Their books make money, their spinoff organizations can make BILLIONS if the marketing is right.
Anyone looking for another Mother Theresa or Albert Schweitzer when dealing with any aspect of health care, especially in the U.S., is going to have a long fruitless time of it. Altruism is in very short supply.
Do you think the diet purveyors like Atkins or the meat lobbyists like Weston Price arent WELL rewarded for espousing their ideas? Their books make money, their spinoff organizations can make BILLIONS if the marketing is right.
Anyone looking for another Mother Theresa or Albert Schweitzer when dealing with any aspect of health care, especially in the U.S., is going to have a long fruitless time of it. Altruism is in very short supply.
NHone
10-17-2005, 11:19 PM
You know maybe people aren't having storkes from the medications..Could be that doctors are just so arrogant, and under-informed that it makes our blood boil. If they would just listen, instead of always asking, "are you a doctor?", I wouldn't get so irratated. My blood pressure is usually 92/62...but after talking to my mother's doctor it went 188/78. Also on mercola and it rest of the "anti" cholesterol people, I guess they do make money. But supplements are not patented, and you have numerous suppliers of each type.