After years of treating LDL to low targets, and failing in the REAL WORLD at preventing cardiac events, They changed the guidelines to LDL above 190.
That does not tell the whole story.
First the European's are still using the old target guidelines.
But the new US guidelines say that for those with existing disease to treat with HIGH statin doses without regard to to current LDL. Although it does allow for a dose reduction if it gets below 40. And a high dosage is expected reduce LDL by 50% or more.
The 190 LDL is for those that are don't have existing disease or other risk factors. They are to be started on a statin.
For others treatment is based on a risk calculation THAT INCLUDES TOTAL CHOLESTEROL AND HDL amount other parameters.
And diet and exercise are suggested for all.
But all of these are guidelines not commandments. There are too many different variations from person to person and situation to situation.
In my case I should be taking a high dose statin. But after discussing my history and how I am doing on my current moderate dose my cardiologist and I decided that there was no reason to change.View Thread
In most cases an heart attack is not caused by plaque breaking off. But rather "cracking open" forming a "wound" and the blood tries to plug the wound by clogging. Much like what happens if you cut the skin.
That is the reason that aspirin is taken is that helps keeps the blood from being as "sticky". Omega 3's (fish oil) have similar effects on the blood.
In most cases it is plaques that block 20-40% of the artery that are soft and vulnerable to rupture. Typcially as they grow larger the plaques become more stable and less likely to rupture.
However, if a plaque does not rupture people don't have symptoms until the blockage grows to 70% or more. That is when they start have angina, shortness of breath, and other symptoms.
I question the meaning of: "treatment" from the above quote: "...Luckily, the plaque components responsible for vulnerability (soft lipid and probably macrophages) are apparently most likely to regress with treatment. Do you think they mean taking statin drugs or exercising? Regards, One of "side effects" of statins is to help stabilize plaque.
But no amount of of the best medicine can overcome the worst diets and poor life styles.
Likewise you have probably heard the phases "food is medicine" and "exercise is medicine".
The best is to optimum amounts of good food, exercise, and medicines.View Thread
An effective and inexpensive way of reducing venous pressure and cardiac output is by using drugs that reduce blood volume . These drugs (diuretics ) act on the kidney to enhance sodium and water excretion. Reducing blood volume not only reduces central venous pressure, but even more importantly, reduces cardiac output by the Frank-Starling mechanism due to the reduction in ventricular preload .