#1

My doctor just recommended this calculator, so I thought I’d share.

https://tools.acc.org/ldl/ascvd_risk_estimator/#!/calulate/estimator/

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#3

Good point, but it may not be possible. I’ve just gotten a prescription for Gemfibrozil but the doctor said it was only 30-50% as effective as a statin but much milder side effects.

I hope the dementia reduction of 60% is accurate!

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#4

It’s possible but expensive.

150 mg praluent every month and another or two cholesterol med.

#5

Here is an easy to understand chart about CVD risk from the European guidelines.
Divide by 38.67 to convert from mg/dl to mmol/l.
Basically the best ways to lower the CVD risk are

  1. Don’t smoke
  2. Stay young
  3. Low blood pressure.
  4. Be a woman
  5. Low cholesterol

In fact it’s the high blood pressure plus high cholesterol combination that is deadly.

The full guidelines are here 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk
They are very much worth reading in full.

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#6

Right after my heart attack, I used a bunch of online “risk calculators” and plugged in the numbers from the physical I had two months before the attack. They all said “your cardiac health is great, you have super-low risk of a heart disease!” That made me skeptical of such calculators.

Using that red/yellow/green chart there, I was “green” before my heart attack, which goes to show that even if you are a non-smoker with golden cholesterol numbers and BP, you are not immune from danger.

I wish I’d known about the CAC scan then, because I’d certainly have gotten one.

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#7

I am skeptical of all health calculators.

So, if you had gotten a CAC scan, what would you have done differently?
After your heart attack, what interventions did you follow?

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#8

I totally agree. These are statistical tools and they give the averages but on those matters there is a huge individual variation that’s why all the discussions about say LDL-C are not very useful. People who really want to know need to do a CAC score, or much better a CT angiogram, and MNR lipid tests.

Those calculators are mostly useful at population levels not at an individual level.

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#10

@Dexter_Scott

As Desert shoes asks:
If you had gotten a CAC scan, what would you have done differently?
After your heart attack, what interventions did you follow?

Current studdies are saying that preventative stenting except for LAD lesions probably doesn’t help.

#11

Most of you seem rather narrow minded in your approach to cardiovascular disease. Everyone has their own unique situation. You can’t dismiss any one risk factor because it doesn’t apply to you.
And i know Cardiologist who are great doctors and whom I’d trust.

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#12

So besides statins and fibrates, what would your cardiologist friends recommend to reduce high LDL and ApoB? Diet and exercise are also a given.

#13

So, if you had gotten a CAC scan, what would you have done differently?

The real question is how much of the plaque accumulated as a result of stress - had the heart attack after I got divorced and the three years before that hadn’t been great. Really no way to avoid that stress.

But I suspect a lot of it built up over the years as a result of bad diet. Kind of like smoking - one cigarette won’t kill you, but decades of smoking will add up. So how far back would I have to stop eating fried food? Probably long before I got the CAC. But I stopped eating fried food or anything with seed oils in it since the heart attack, so there’s that. Would certainly have paid much closer attention to my diet as a result of an alarming CAC scan.

I would have been inclined to try some of the “Hail Mary” treatments like high-dose Nattokinase or EDTA chelation. Maybe I should still try those. I’m taking “some” Natto daily but not a high dose.

After your heart attack, what interventions did you follow?

As I said, dialed in the diet. No more junk food ever. Very low carb. Nothing ultraprocessed, I buy the ingredients and make it at home.

Meds are carvedilol, lisinopril, and tadalafil (daily for cardioprotective effect).

Vitamin C, D3, K2, magnesium, aspirin, Natto, citrulline, lysine, chondroitin sulfate, proline, glucosamine sulfate, whey protein, creatine.

Frequent intense exercise.

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#14

We don’t talk about it much on this forum, but emotional stress is a killer for many reasons and I am sure that there is an inverse correlation between stress and lifespan.

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#15

Obviously PCSK9. I think there are 9 or 10 classes of cholesterol lowering drugs.

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#16

Unfortunately, PCSK9 is a bit overkill for marginally high LDL. I’d like to lower it, but just not at that price tag.

I am really bummed that statins caused me to have myopathy. Does anyone know if ezetimibe would do the same? Or do I just have to try it and find out?

#17

Fish oil, niacin, colestipol, Zetia, Bempadoic acid?

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#18

Ezetimibe gave me zero side effects.

#19

I take fish oil and NMN (niacin-like)

I am considering Zetia or Bempedoic acid.

I just don’t want any myopathy.

#20

I am fortunate to not get any side effects from Rosuvastatin.

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#21

Yes, my doctor said myopathy from statins are very rare.

I always knew I was 1 in a million. But I always thought it would be for something else.

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#22

Move along, nothing to see here.

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