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    Ultralow LDL-C Still Predicts Early Subclinical Atherosclerosis

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    graham64
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    Ultralow LDL-C Still Predicts Early Subclinical Atherosclerosis

    Post by graham64 on Thu Dec 21 2017, 22:32

    The PESA risk-factor-free cohort averaged 45 in age and 50.3% were women. They were evaluated at baseline for carotid, iliofemoral, and abdominal aortic plaques by ultrasound and coronary artery calcification by CT, and for a range of serum biomarkers and lifestyle measures.

    Subclinical atherosclerosis, indicated by plaques or coronary calcification, was identified in 49.7% of the group and in more than one arterial system in 30%. The relationships between LDL-C and atherosclerosis presence and extent were seen in all arterial systems, Sanz said.

    After the field's long-time success of statin therapy for primary and secondary prevention, the addition of drugs like ezetimibe and the PCSK9 inhibitors that can push LDL-C to below 50 mg/dL have shaken up traditional views of how contemporary drug therapy should be used for prevention of atherosclerotic cardiovascular disease (ASCVD), according to an editorial accompanying the report[2].

    "In this context, the current analysis by Fernández-Friera et al is highly relevant and now raises the question of what the optimal cholesterol level may be in the primordial and primary prevention of ASCVD," write Dr Vijay Nambi (Baylor College of Medicine, Houston, TX) and Dr Deepak L Bhatt (Brigham and Women's Hospital, Boston, MA).

    They speculate that "arterial imaging at an early age," perhaps supplemented by biomarker and genetic screening, "would help further refine and personalize risk assessment prior to the establishment of atherosclerosis and/or ASCVD." But there are no appropriate trials supporting that approach, they add.

    Meanwhile, they write, "physicians should consider avoiding the term 'normal' and instead inform their patients of their current cholesterol, blood pressure, or blood glucose values and discuss what preventive efforts may be needed given their level of risk."

    More here:    https://www.medscape.com/viewarticle/890261#vp_2


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    chris c
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    Re: Ultralow LDL-C Still Predicts Early Subclinical Atherosclerosis

    Post by chris c on Fri Dec 22 2017, 23:53

    In Other News, LDL has f-all to do with CVD. Trigs/HDL does, an indicator for Insulin Resistance (said in an Ivor Cummins accent).

    Too low LDL is a risk factor for death from many other causes. Gosh you'd almost think the body made it for a reason rather than just to deliberately kill us.

    My current theory, based in part on Dave Feldman's research, is that when LDL is high because it is being used to transport fats (either dietary or body fat) for metabolising it is a Good Thing. When it is high because the body is overwhelmed with carbs and the fat doesn't get metabolised so the LDLs stack up in the blood it is Not A Good Thing.

    Likewise manipulating trigs and especially HDL with drugs has been an Epic Fail. Manipulating them with a sensible diet, completely different.

    Root Causes (also in an Ivor Cummins accent)
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    graham64
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    Re: Ultralow LDL-C Still Predicts Early Subclinical Atherosclerosis

    Post by graham64 on Sat Dec 23 2017, 22:35

    @chris c wrote:Likewise manipulating trigs and especially HDL with drugs has been an Epic Fail. Manipulating them with a sensible diet, completely different.

    Agreed Big Pharma decided if drugs don't work then it's because raising HDL and lowering trigs don't have any benefit  Rolling Eyes


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    I'm a skinny T2 diagnosed 4/4/2008, a high calorie LCHF diet and one metformin a day A1c 6.2 and no complications.

    Proving the LowCarb sceptics wrong for over nine years,

    Not all cherubs are Angels  Wink nor all diabetics Bonkers  Rolling Eyes

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    Re: Ultralow LDL-C Still Predicts Early Subclinical Atherosclerosis

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