Guided_by_Voices
Well-Known Member
Here at Excelmale there are frequent posts discussing the pros and cons of statins, and one in particular several weeks ago where a position paper was cited where the assumption was that statins are not only a viable option but should be the first line of defense against heart disease. As I have stated elsewhere, the best evidence seems to be that from a risk/reward perspective, statins may provide a rounding-error level of benefit for some people but come with potentially catastrophic risks. Rather than rehash that here, this post takes a different perspective by compiling a list of things that everyone can and likely should be doing to create good cardiovascular health which are likely to have a much better risk/reward than statins. My criteria for this list included:
- Little or no risk or side effects
- Multiple independent forms of supporting evidence
- Benefits on other non-CVD aspects of health
- Somewhat controllable
- Clearly better risk/reward than statins (based on TheNNT.com risk/reward as well as other confirming studies) based on around 90 people needing to be treated with statins for one to benefit
- Addresses a root cause, not just a symptom
- Almost never recommended by mainstream medicine (therefore not smoking, duh, is not included)
I will leave it up to each person to investigate the evidence for each of these and come to their own conclusions, however all of them are supported by easily findable combinations of data and logic. The purpose of this is not to give precise guidance but rather to give perspective on many of the things that are far more beneficial than even the best case for statins. These could also serve as a way for you to assess the quality of the medical guidance you are being given. The fewer of these that are recommended by your medical advisors before they jump straight to statins, the worse your medical guidance is likely to be. So here goes...
1. Maximize sleep quality and ensure sufficient sleep quantity. Ensure sleep apnea or other sleep disturbances are eliminated. Optimize circadian rhythms.
2. Keep fasting insulin below 5. There are different recommendation as to what should be the goal here, but 5 is Dr. Bredesen's number so I'll use that one.
3. Get a moderate amount of mid-day sunshine several times per week when the sun angle is above 50 degrees. While this has cardiovascular benefits, it is also especially relevant to optimize immune function via production of Vitamin D and its anti-microbial metabolites.
4. Avoid chronic stress and chronic sympathetic nervous system activation. Reduce known stressors such as barbell training to failure and any form of chronic overtraining. Especially avoid self-imposed stress such as taking on unnecessary debt.
5. Ensure healthy thyroid levels. Low thyroid is a strong predictor of heart issues.
6. Ensure healthy nutrient status, especially magnesium, and vitamins D,K2 and C.
7. Ensure iron overload is not present
8. Minimize risk of food sensitivities leading to chronic inflammation. Be especially suspicious of wheat and whey protein.
9. Take a low-dose PDE5i. As Dr Kendrick has referenced here, (What causes heart disease part XXVIII) this class of drug appears to have a much greater CV benefit and certainly fewer downsides than statins.
10. Adhere to the Maffetone method of cardiovascular training. Avoid exercising at a higher level than your cardiac conditioning can easily support.
11. Do 10-20 pushups, a 1 minute stationary bike sprint or a 10 minute walk before and after every meal, especially higher-carb meals. This is primarily to minimize blood sugar spikes but also has other benefits.
12. Go for a 2-3 hour walk at least once a week
13. Eat within an 8-hour window at least 5 days a week. Do a 24 hour fast once a week.
14. Avoid seed oils, especially corn and soybean oil and especially avoid seed oils in a heated state.
15. Get at least 40 minutes of sauna time per week.
16. Eliminate any form of mid-section bloat which may indicate organ (visceral) fat and/or digestive issues.
17. Avoid chronically inflamed gums. Poor oral health is strongly associated with CVD, although cause and effect may be unproven.
18. Include high-nitrate foods in your diet such as beets. These are nitric oxide pre-cursors.
19. Reduce trigs to below 100.
20. Increase the extra virgin olive oil in your diet
Honorable mentions:
And here are few things that have a bit less evidence or are indirectly helpful but which have little or no downside and which may also help:
- Supplement with NAC. It may lower homocysteine which may be a risk factor and it does lots of other good things such as being a pre-cursor to glutathione (another aspect of immune function.)
- Supplement Glycine. It appears to have anti-inflammatory properties;
- Increase Omega 3 as well as reducing seed oils;
- Supplement Hawthorn berry and/or a low-dose ACE inhibitor and/or ARB to maintain moderate blood pressure and for general anti-aging;
- Swap beer for red wine; and
- Follow Dr. Bredesen's anti-dementia protocol. You can't do the things above if you can't remember them.
Ok, please suggest others I may have missed.
- Little or no risk or side effects
- Multiple independent forms of supporting evidence
- Benefits on other non-CVD aspects of health
- Somewhat controllable
- Clearly better risk/reward than statins (based on TheNNT.com risk/reward as well as other confirming studies) based on around 90 people needing to be treated with statins for one to benefit
- Addresses a root cause, not just a symptom
- Almost never recommended by mainstream medicine (therefore not smoking, duh, is not included)
I will leave it up to each person to investigate the evidence for each of these and come to their own conclusions, however all of them are supported by easily findable combinations of data and logic. The purpose of this is not to give precise guidance but rather to give perspective on many of the things that are far more beneficial than even the best case for statins. These could also serve as a way for you to assess the quality of the medical guidance you are being given. The fewer of these that are recommended by your medical advisors before they jump straight to statins, the worse your medical guidance is likely to be. So here goes...
1. Maximize sleep quality and ensure sufficient sleep quantity. Ensure sleep apnea or other sleep disturbances are eliminated. Optimize circadian rhythms.
2. Keep fasting insulin below 5. There are different recommendation as to what should be the goal here, but 5 is Dr. Bredesen's number so I'll use that one.
3. Get a moderate amount of mid-day sunshine several times per week when the sun angle is above 50 degrees. While this has cardiovascular benefits, it is also especially relevant to optimize immune function via production of Vitamin D and its anti-microbial metabolites.
4. Avoid chronic stress and chronic sympathetic nervous system activation. Reduce known stressors such as barbell training to failure and any form of chronic overtraining. Especially avoid self-imposed stress such as taking on unnecessary debt.
5. Ensure healthy thyroid levels. Low thyroid is a strong predictor of heart issues.
6. Ensure healthy nutrient status, especially magnesium, and vitamins D,K2 and C.
7. Ensure iron overload is not present
8. Minimize risk of food sensitivities leading to chronic inflammation. Be especially suspicious of wheat and whey protein.
9. Take a low-dose PDE5i. As Dr Kendrick has referenced here, (What causes heart disease part XXVIII) this class of drug appears to have a much greater CV benefit and certainly fewer downsides than statins.
10. Adhere to the Maffetone method of cardiovascular training. Avoid exercising at a higher level than your cardiac conditioning can easily support.
11. Do 10-20 pushups, a 1 minute stationary bike sprint or a 10 minute walk before and after every meal, especially higher-carb meals. This is primarily to minimize blood sugar spikes but also has other benefits.
12. Go for a 2-3 hour walk at least once a week
13. Eat within an 8-hour window at least 5 days a week. Do a 24 hour fast once a week.
14. Avoid seed oils, especially corn and soybean oil and especially avoid seed oils in a heated state.
15. Get at least 40 minutes of sauna time per week.
16. Eliminate any form of mid-section bloat which may indicate organ (visceral) fat and/or digestive issues.
17. Avoid chronically inflamed gums. Poor oral health is strongly associated with CVD, although cause and effect may be unproven.
18. Include high-nitrate foods in your diet such as beets. These are nitric oxide pre-cursors.
19. Reduce trigs to below 100.
20. Increase the extra virgin olive oil in your diet
Honorable mentions:
And here are few things that have a bit less evidence or are indirectly helpful but which have little or no downside and which may also help:
- Supplement with NAC. It may lower homocysteine which may be a risk factor and it does lots of other good things such as being a pre-cursor to glutathione (another aspect of immune function.)
- Supplement Glycine. It appears to have anti-inflammatory properties;
- Increase Omega 3 as well as reducing seed oils;
- Supplement Hawthorn berry and/or a low-dose ACE inhibitor and/or ARB to maintain moderate blood pressure and for general anti-aging;
- Swap beer for red wine; and
- Follow Dr. Bredesen's anti-dementia protocol. You can't do the things above if you can't remember them.
Ok, please suggest others I may have missed.
Last edited:
