I believe for the majority of society, you are correct… All causes of mortality would go down significantly if people consume less processed food, ate a balanced diet and exercised consistently.
Genetics is a factor. My whole life I’ve been a athlete and ate very clean. I’ve weighed all my food for over two decades. Since I was 20s my LDL was high normal and my HDL was extremely low. Continue refinement of diet only had very marginal impact. A large number of men in my family all died before the age of 60. (7 of them)
I believe a calcium CT score is the gold standard for artery health as it actually measures whether there’s a buildup of plaque in the artery. I’ve had the test done every five years for the last 20 years. The first three tests had zero plaque, even though my cholesterol numbers were less than ideal. The last test, four years ago, showed a build up of plaque in the Widowmaker artery. So i will take every % increase in reduced risk i can get and to-date i have had zero measurable sides from a very low dosage statin.
completely agree. This is how medicine should be done.
Prioritize individual assessments over one-size-fits-all guidelines. If doctors just follow generic protocols, why have them at all?
Tests like CAC scores or CIMT are far better for identifying actual artery disease, allowing treatment only for those with plaque buildup.
The challenge with socialized healthcare is cost. CAC and CIMT scans are expensive ($100–$400 each), so it’s cheaper to put everyone on statins than to test individually.
If a heart attack costs the system $50,000, medicating a few hundred people with statins to prevent one event is more cost-effective than scanning hundreds of people.
But this “herd” approach risks overmedicating healthy people, ignoring individual factors like insulin sensitivity, where high ApoB is less risky.
Fundamentally, we're relying on the side effects being benign or subclinical in the majority of people to be justifiably ignored for the benefits to the few that truly do benefit from statin use.
Statins also have a clear risk of causing type 2 diabetes, and several other pleotropic effects.
Lipitor for example caused reversible dementia in test subjects. (when they stopped taking it the dementia went away). So how much subclinical dementia is acceptable to people ?
Genetics do matter, and family history is important.
looks like you've already gone after the lowest hanging fruit, insulin sensitivity is biggest by far,
you can't pick your parents,
so makes sense for you to go to the next step.
Unfortunately, that one % benefit is an average for the general population.
As a metabolicly healthy guy you're out on the tail of the bell curve, so benefits would be maybe only 0.3–0.5%.
It's been a while since I read this stuff, so my numbers might be off. I'm open to correction if I'm misremembering or something new has come up.
