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From a Prominent Death, Some Painful Truths
NY Times ^ | June 24, 2008 | DENISE GRADY

Posted on 06/24/2008 9:33:46 PM PDT by neverdem

Apart from its sadness, Tim Russert’s death this month at 58 was deeply unsettling to many people who, like him, had been earnestly following their doctors’ advice on drugs, diet and exercise in hopes of avoiding a heart attack.

Mr. Russert, the moderator of “Meet the Press” on NBC News, took blood pressure and cholesterol pills and aspirin, rode an exercise bike, had yearly stress tests and other exams and was dutifully trying to lose weight. But he died of a heart attack anyway.

An article in The New York Times last week about his medical care led to e-mail from dozens of readers insisting that something must have been missed, that if only he had been given this test or that, his doctors would have realized how sick he was and prescribed more medicine or recommended bypass surgery.

Clearly, there was sorrow for Mr. Russert’s passing, but also nervous indignation. Many people are in the same boat he was in, struggling with weight, blood pressure and other risk factors — 16 million Americans have coronary artery disease — and his death threatened the collective sense of well-being. People are not supposed to die this way anymore, especially not smart, well-educated professionals under the care of doctors.

Mr. Russert’s fate underlines some painful truths. A doctor’s care is not a protective bubble, and cardiology is not the exact science that many people wish it to be. A person’s risk of a heart attack can only be estimated, and although drugs, diet and exercise may lower that risk, they cannot eliminate it entirely. True, the death rate from heart disease has declined, but it is still the leading cause of death in the United States, killing 650,000 people a year. About 300,000 die suddenly, and about half, like Mr. Russert, have...

(Excerpt) Read more at nytimes.com ...


TOPICS: Culture/Society; News/Current Events
KEYWORDS: apob; cad; cardiology; health; heart; medicine
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Apolipoproteins as markers and managers of coronary risk. ApoB, etc., check 'Related Articles' in the upper right. It's a FReebie.
1 posted on 06/24/2008 9:33:46 PM PDT by neverdem
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To: neverdem
A doctor’s care is not a protective bubble, and cardiology is not the exact science that many people wish it to be. A person’s risk of a heart attack can only be estimated, and although drugs, diet and exercise may lower that risk, they cannot eliminate it entirely

I remind my doc of this when he wants to double my blood pressure medicine and put me on the anti-cholesterol pills. There is no way in H E double hockey sticks I will ever be his "Statin Doll."

2 posted on 06/24/2008 9:46:45 PM PDT by HerrBlucher (Drill drill drill for oil offshore and on land merrily merrily merrily merrily environuts be damned)
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To: HerrBlucher

What do you have against statins?


3 posted on 06/24/2008 9:50:45 PM PDT by iowamark
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To: El Gato; Ernest_at_the_Beach; Robert A. Cook, PE; lepton; LadyDoc; jb6; tiamat; PGalt; Dianna; ...
The cancer biomarker problem

Doctors Say Medication Is Overused in Dementia

Follow the Silt

FReepmail me if you want on or off my health and science ping list.

4 posted on 06/24/2008 9:53:52 PM PDT by neverdem (I'm praying for a Divine Intervention.)
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To: neverdem

Here is how you can know just exactly how healthy you are. Apply for a life insurance policy. The insurer will give you a medical examination and if there is any hint you will die for any reason, the insurer will not insure you. Insurance companies are in the business of collecting premiums, not making claim payments.


5 posted on 06/24/2008 9:55:09 PM PDT by svxdave (Life is too short to wear a fake Rolex.)
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To: iowamark
Potential side effects vs benefits to be gained. Its a judgement call on my part....I make the final call not him. Plus, you can take all these medicines and still croak, just like Russert. Finally, my previous doctor was ok with my stats.....i.e. bp, cholesterol, triglycerides, and didn't recommend statins, the new doc is actually a nurse practitioner and I think in over his head.
6 posted on 06/24/2008 9:55:46 PM PDT by HerrBlucher (Drill drill drill for oil offshore and on land merrily merrily merrily merrily environuts be damned)
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Comment #7 Removed by Moderator

To: neverdem

Statins have done wonders to reduce LDL cholesterol levels and the accompanying atherosclerosis. The newest statin, rosuvastatin, is apparently the first to actually reverse atherosclerosis - in 10 or 20 years time what happened to Russert might be considered a problem of the past.


8 posted on 06/24/2008 10:06:12 PM PDT by AnotherUnixGeek
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To: neverdem

Medicine, like lawyering, is a “practice”.

No results guaranteed!
Eye of newt actually works, sometimes. Not much, but sometimes!


9 posted on 06/24/2008 10:08:40 PM PDT by djf (I don't believe in perpetual motion. Perpetual mutton, that's another thing entirely!)
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While Russert’s death is tragic: one should not forget that despite trying to lose weight -he was STILL overweight. He just came back from a long trip to Europe -which is stressful under the best of times & whose to say what role his medication played as drugs are not safe. Who could forget the Vioxx scandal which led to tens of thousands of fatalities. The drug industry is notorious for advancing unsafe drugs.


10 posted on 06/24/2008 10:15:51 PM PDT by Republic_of_Secession.
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To: neverdem

FR bookmark , .. and thanks neverdem


11 posted on 06/24/2008 10:19:13 PM PDT by Dad yer funny (FoxNews is morphing , and not for the better ,... internal struggle? Its hard to watch)
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To: Republic_of_Secession.

I have a different take on it. I think that the vocal minority groups push the FDA to approve drugs before they have been thoroughly vetted. Many of the AIDS drugs were put on the market too early due to pressure from the Gay lobby. May be the same here.


12 posted on 06/24/2008 10:24:10 PM PDT by originalbuckeye
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To: HerrBlucher

I’m very conflicted when it comes to doctors. I have benefited tremendously from medical care, but as I age, I resist the idea of becoming a sheep in the medicated herd. Rather die? Rather die? One doesn’t want to die, but one resists the idea of giving up ones soul for the uncertain promise of an increased probability of longevity.


13 posted on 06/24/2008 10:25:43 PM PDT by dr_lew
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To: tallank

...there is no data published..

Actually, there is.
But detailed analysis shows it is not very convincing.

Here is what I heard and understand, if I am wrong, somebody please correct me and I will take my lumps.

Imagine there is a control group that does not get statins. Then there is the group that does get it.

Control group has 3 sudden cardiac death events. Statin group has two.

Statin vendors correctly and legitimately claim that statins reduce the risk of sudden cardiac events by 50%.

Trouble is, there is another index conveniently left out. That index is the NNT, or Number Needed to Treat.

If our group size is ten, then we have effectively lowered the risk by the one out of ten... but... in the statin studies that have had published results, the NNT is 100.

So 3/2 is statistically significant if that’s all you’re measuring, but 1/100 is nowheres near a statistically significant reduction.

And 100 people had to take statins, with all the costs and attendent side effects, to stop a single cardiac event.

Whether the medical establishment wants to admit it or not, very close to 50% of the sudden cardiac events in our country happen in people who have normal or less than normal cholesterol levels.


14 posted on 06/24/2008 10:31:04 PM PDT by djf (I don't believe in perpetual motion. Perpetual mutton, that's another thing entirely!)
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To: dr_lew
I resist the idea of becoming a sheep in the medicated herd

We all need to use good judgement and only trust the doc to a certain extent, after all they make mistakes too. I actually filled a presciption for Statins and was about to start taking them then just as it got near my mouth something inside me said....no. I then investigated potential side effects, which the doc didn't inform me.....that was it for me.

Of course he has noted all that in my file for protection and I don't blame him. That is another thing, maybe he is just covering his bases to protect himself from malpractice.

15 posted on 06/24/2008 10:37:54 PM PDT by HerrBlucher (Drill drill drill for oil offshore and on land merrily merrily merrily merrily environuts be damned)
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To: originalbuckeye
I have a different take on it. I think that the vocal minority groups push the FDA to approve drugs before they have been thoroughly vetted. Many of the AIDS drugs were put on the market too early due to pressure from the Gay lobby. May be the same here.

I work in the pharmaceutical industry. You're more on track than you know.

16 posted on 06/24/2008 10:43:26 PM PDT by buccaneer81 (Bob Taft has soiled the family name for the next century.)
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To: HerrBlucher

I believe the goal should be to raise HDL vs. lowering LDL.


17 posted on 06/24/2008 10:46:45 PM PDT by buccaneer81 (Bob Taft has soiled the family name for the next century.)
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To: neverdem

I think about the television chef Justin Wilson who died at age 87. Must have been all that exercise from stirring pots of crawdads and hot sauce that kept him alim and trim.


18 posted on 06/24/2008 10:54:22 PM PDT by count-your-change (you don't have to be brilliant, not being stupid is enough.)
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To: tallank; HerrBlucher; iowamark; djf; dr_lew
There is plenty wrong with Statins. First off, there is no data published that shows a decrease in heart disease by artificially lowering cholesterol with statins.

It may not be just lowering cholesterol. Statins are also suspected of having an anti-inflammatory efect. I'm not crazy about the LDL and total cholesterol hypothesis, but for cardiovascular as well as cerebrovascular morbidity and mortality, the better numbers are found with those taking statins. They are not for everybody. IIRC, 3% get serious liver toxicity, and 1% get serious muscle pathology.

Long-term benefit of statin therapy initiated during hospitalization for an acute coronary syndrome: a systematic review of randomized trials.

CONCLUSIONS: The benefit of early initiation of statin therapy during acute coronary syndromes slowly accrues over time so that a survival advantage is seen around 24 months. Relatively few patients need to be treated to prevent one death over this time period. Furthermore, this approach significantly reduces unstable angina and the need for revascularization.

Enter CAD and statins, mortality into the query box at PubMed. CAD means coronary artey disease. I'd start with review articles.

19 posted on 06/24/2008 10:55:26 PM PDT by neverdem (I'm praying for a Divine Intervention.)
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To: neverdem
Nobody is supposed to die anymore.

Do I have that right?

FMCDH(BITS)

20 posted on 06/24/2008 10:56:08 PM PDT by nothingnew (I fear for my Republic due to marxist influence in our government. Open eyes/see)
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