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Re: Some sceptiscism is good, but remember to
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Posted by AdamB [Email] (#3) [Profile/Gallery] (more from AdamB) on Tue, 3 Aug 2004 15:41:09 Share Post by Email
In Reply to: Re: Some sceptiscism is good, but remember to, AlexP, Tue, 3 Aug 2004 11:31:51
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I'm not a Dr., I'm a med. student and there is no need to feel upset or be sarcastic just because we don't agree.

The cholesterol issue is being argued by 2 groups of researchers. I have no vested interest in either side, I just go were the evidence is. So far the majority of evidence is on the side of the group claiming a benefit of statins. If that changes, then so does my opinion on the issue. As a person in the medical business I'm only interested in what is best for the patients. When the majority of trials show statins to be beneficial then it will be used by doctors. You can't practice medicine based only on theories (no matter how elegant and logical they may be), as most people in the business will tell you, there is a large gap between theory and practice. Drugs that work in a specific way in the lab, can easily have completely different effects in the real world.

The prevailing theory at the moment (simplified) is that a high serum LDL level leads to a buildup of LDL in the intima of blood vessels' endothelium. This leads to atheriosclerosis and hence a higher risk of myocardial infarction. As for evidence for the relationship between levels of serum cholesterol and coronary disease there are some gargantuan studies showing this. For example the "Multiple Risk Factor Intervention Trial" (Stamler J, Wentworth D, Neaton JD, 1986) which had 361,000 men in it. It showed a clear correlation of serum cholesterol level and coronary artery disease. Statins are also thought to have another beneficial action other than the LDL lowering and HDL raising ones. It is thought to be anti-inflammatory, and it's being investigated, but there is no conclusive evidence yet.

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