New Study Suggests Statins For Those at Low Risk

A new study published in March 2016 by McGill University’s George Thanassoulis, MD in the Circulation journal of the American Heart Association suggests that many identified as ‘Low Risk’ by the latest cholesterol treatment guidelines should be taking cholesterol-lowering statins.

The current guidelines for treating cholesterol, published with much fanfare and controversy in November 2013, moved away from targeting treatment to reach a specific cholesterol level and instead include a ‘calculator’ that measures risk. If a person’s risk is lower than 7.5% chance of heart disease in 10 years, statins are NOT recommended. (Details, including a link to the calculator, found in my post: The NEW Guidelines for Cholesterol-Lowering Statin Meds.)

Personally, I fall into the ‘do not take statins’ pool using this calculator as:  a) I do not already have cardiovascular disease; b) my LDL (bad) cholesterol is less than 190; c) I do not have diabetes; and d) my 10-year risk is lower than 7.5%.

But according to this NEW March 2016 study, “Individualized Statin Benefit for Determining Statin Eligibility in the Primary Prevention of Cardiovascular Disease,” I might be one of the many at ‘low risk’ who should be taking statins!

Yikes.

The new study recommends “an INDIVIDUALIZED statin benefit approach” rather than relying on the calculator; using this approach, thousands who are currently at ‘low risk’ and not treated with statins would instead be treated with statins. According to the study authors, “Statin treatment in this group would be expected to prevent an additional 266,508 cardiovascular events over 10 years.”

Yikes times two.

And it was a large study. The study, “included 2134 participants representing 71.8 million American residents potentially eligible for statins in primary prevention from the National Health and Nutrition Examination Survey for the years 2005 to 2010.”  The study “compared statin eligibilities using 2 separate approaches: a 10-year risk-based approach (≥7.5% 10-year risk) and an individualized benefit approach (ie, based on predicted absolute risk reduction over 10 years [ARR10] ≥2.3% from randomized, controlled trial data).”

The risk-based approach (the ‘new’ 2013 guidelines that doctors are currently using) identified 15.0 million Americans who should take statins, versus 24.6 million Americans who should take statins according to the benefit-based approach. Thus, “the benefit-based approach identified 9.5 million lower-risk (<7.5% 10-year risk) Americans not currently eligible for statin treatment who had the same or greater expected benefit from statins (≥2.3% ARR10) compared with higher-risk individuals.

That’s 10 million Americans who should be taking statins who right now are not.

And I’m probably one of them!  Because the study goes on to say, “This lower-risk/acceptable-benefit group includes younger individuals (mean age, 55.2 versus 62.5 years) with higher low-density lipoprotein cholesterol (140 versus 133 mg/dL). Statin treatment in this group would be expected to prevent an additional 266,508 cardiovascular events over 10 years.

Yikes times three!  As this describes me: I’m under 55 and my LDL is 145.

I guess it’s time to put in a call to my cardiologist and ask what he thinks of this study.  I do not want to go on a statin medication, but I do want to understand his thoughts on both this study and what an “individualized benefit approach” to treating my high cholesterol looks like.

 

Share

Tangy, Healthy, Homemade Yogurt

Two things happened mid-February that messed with my decade-long half-bagel with smidge of cream cheese and slice of lox breakfast habit.

  1. My fabulous local delicatessen can no longer get the nirvana-like H&H bagels from NYC (yes, I know the real H&H closed years ago but the ‘other’ H&H bagels are great too). And I despise their CT-made replacement bagels. DESPISE.
  2. In the NYT, I read a Melissa Clark article about making homemade yogurt and became obsessed – especially because there was a kitchen gadget I could buy.

I tried to be more open — to embrace change and learn to love the new bagels. I could not. I then bought a dozen bagels from a deli in NYC and brought them home on the train. Nope. Tasted right but they are the size of a softball and I hate that.

Yes, I am picky. I know I am not flexible. It’s sad but I’m just not. I’d say I’m working on it, but at least food-wise, it’d be a lie.

So what’s a non-food-flexible girl to do? Well, that’s the upshot of the story because Melissa Clark’s homemade yogurt recipe was a revelation.

When I read How to Make Yogurt at Home, I was immediately intrigued by her statement that it’s both simple to make and delicious – far more delicious than store-bought and since I’m not a huge fan of yogurt I thought I should try it. And bonus: my doctor wants me to consume more calcium and, um, ice cream is not on the lo-co calcium list.

Then it got fun. As I re-read Ms. Clark’s article, I realized she inserted a mystery into her story. And who doesn’t love a good mystery:

“I fell in love with a whole-milk yogurt that was so smooth, thick and milky tasting that it blew away anything I’d had before. Naturally, it was made by a Brooklyn artisan, it cost a fortune, and it was in such high demand that the fancy shop where it was sold was often out of stock.”

Finding out what yogurt she was obsessed with became my obsession.

After a ridiculous number of hours reading yogurt reviews and searching online, I did not know the answer but narrowed it down to either The White Moustache or Sohha Savory Yogurt.  In NYC for the weekend, I could not find Sohha but did find The White Moustache, so I bought one of the single-serve jars for a whopping $6.

Then I re-read the ‘simple’ recipe and started laughing. Sure, it’s simple, if you have a lot of patience. But I’m neither flexible nor patient (at least I know my faults, right?)  Her two “tips” about how easy it was to make yogurt were what prompted me to immediately buy a yogurt maker.  To me, these did not sound easy:

Tip #1: “…rub an ice cube over the inside bottom of the pot before adding the milk. This keeps it from scorching as it heats.” (For me, this reads like a guarantee of a scorched pot and is thus to be avoided at all costs.)

Tip #2: “I’ve tried placing it in a turned-off oven with the oven light on, in a corner swathed in a heating pad, on the countertop wrapped in a big towel, and tucked on the top of the fridge. They all worked, though the warmer the spot, the more quickly the milk fermented.” (OMG…too many options / too many ways I could go wrong, so, um, no.)

When I told my sister what I was going to do, she said, “Oh, making yogurt at home is easy, you just cook it and leave it somewhere warm.”  Or something to that effect.  So I guess these ‘tips’ would act as ‘tips’ for some (most?) people, but for me it led me straight to the internet.

Where I realized there was one final challenge with making yogurt: timing. The entire process takes at least 18 hours. While none of it’s hard (except for that scorched pot part) and none of that time is actually active work, it does mean you need to plan out exactly when you start or you’ll need to get up at 3am to jam it into the refrigerator. And that’s a big no for me. Armed now with information, I searched on Amazon.

Cuisinart Electronic Yogurt MakerFirst I bought an “InstantPot”. Too many issues to enumerate so let me say, “just don’t believe the reviews; it’s not good as a yogurt maker.” I immediately returned it and bought the fabulous Cuisinart Electronic Yogurt Maker with Automatic Cooling.  At $99 it was not a small purchase but I’ve been thrilled with it – you just mix 2 cups of organic 2% milk (for lo-co yogurt I’m using 2%) with 3-4 TB of the White Moustache plain yogurt, turn it on for 12 hours and when it’s done, it then keeps it cool for 12 more hours – so at any normal time of day, you can remove it to the refrigerator. To me, that’s worth the cost of the pretty slim, nice-looking appliance!

Not only is this truly easy, but it makes yogurt that’s rich, creamy and tangy. With NO sugar, that tangy taste takes a bit of getting used to, but I’m trying (look at me, being flexible after all!)  I add fresh berries and mash them up to give the yogurt a bit of color and also a handful of granola for some crunch and texture.

The only problem is – I am eating it for lunch, not breakfast. Turns out I really crave hot (or at least, not cold) for breakfast.  So I’m still eating the last of my NYC frozen bagels (can’t let them go to waste, right?) and trying to gear myself up to try yogurt for breakfast.

If you are more flexible than me (a low bar indeed) and/or like yogurt for breakfast but would prefer a tangier, no-sugar option at a fraction of the cost of buying individual serve yogurts, give Melissa Clark’s recipe a whirl.

Share