Re: Which cheap generic statin? Simvastatin vs Pravastatin vs Lovastatin?

x-no-archive: yes

me@xxxxxxxxxxx wrote:
Susan <nevermind@xxxxxxxxxx> wrote:


I don't think your statin use is giving you the risk lowering you seek, first of all. Your ratios are poor due to the lowering of your HDL and your comparatively high TGL. TGL will rapidly plummet if you stop eating starches and sugar.


I have NOT been taking my prescribed dose (40 mg)
....instead I was taking half of it(20 mg)

I understand, but your lipids are very low, yet their ratios have you at a high risk. That's because it's lowering your HDL and that and your diet are making your LDL lean toward the damaging VLDL type.


The experiment is not working so need to go back to 40
mg

I don't think so. Your diet is so atherogenic, you can't overcome its effects with a pill or a number on a chart.



In fact, since you eat such a carby diet, you have a LOT of improvement to get without spending a penny on drugs by dietary modification.


Agree..... but I still need cheap source for
statins.... and local Walmart four dollar list only has
lovastatin and pravastain.... NO simvastatin which is
what I am taking.

Read this stuff and see if you still think you need a statin; HINT: low carb causes triglycerides and blood glucose to drop:

Int J Cardiol. 2006 Mar 22;108(1):89-95. Epub 2005 Aug 8.
Related Articles, Links


Plasma triglycerides, an independent predictor of cardiovascular disease in men: a prospective study based on a population with prevalent metabolic syndrome.

Onat A, Sari I, Yazici M, Can G, Hergenc G, Avci GS.

Turkish Society of Cardiology, Istanbul, Turkey. tkd@xxxxxxxxxx

BACKGROUND AND METHODS: We aimed to assess whether fasting plasma triglycerides independently predicted future fatal and nonfatal cardiovascular disease (CVD) in a population having a high prevalence of the metabolic syndrome. In the Turkish Adult Risk Factor Study, a population-based survey, 2682 men and women 20 years of age or over with fasting triglyceride values available and free of CVD at baseline examination in 1990, were prospectively followed up till 2003/04. Triglyceride concentrations were measured by the enzymatic dry chemistry method and stratified into sex-specific quintiles. Information on the mode of death was obtained from first-degree relatives and/or health personnel of local health office. Diagnosis of coronary heart disease and stroke among survivors was based on history, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms. A total of 120 fatal and 221 new nonfatal CVD occurred among adults (mean age 43+/-14) during a mean 9.3 years of follow-up. RESULTS: CVD was significantly and independently predicted by the top versus the bottom fasting triglyceride quintile in logistic regression analyses when adjusted for age, sex, BMI, systolic blood pressure, total cholesterol, lipid-lowering medication, status of smoking and of glucose regulation (relative risk [RR] in men and all adults 2.38 and 1.79, respectively, p both <0.02). This corresponded to hazard ratios (HR) of 1.43 in men and 1.28 in men and women combined. Adjustment for HDL-cholesterol instead of total cholesterol in the same model gave also significant HRs corresponding to 1.42 in men and 1.32 in sexes combined. CONCLUSIONS: Fasting triglycerides are predictive of future CVD among men with an HR of 1.4, independent of age, diabetes, lipid-lowering medication, traditional risk factors including total cholesterol or HDL-C, in a population in which metabolic syndrome prevails. A modest independent risk increment in women did not reach significance.

PMID: 16085325 [PubMed - in process]
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A new study suggests that level of triglyceride in the blood may help
predict heart attack risk as well as other more well-known blood fats
such as LDL and HDL cholesterol. High triglycerides alone increased
the risk of heart attack nearly three-fold, according to a report in
the current issue of Circulation. And people with the highest ratio of
triglycerides to HDL -- the "good" cholesterol -- had 16 times the
risk of heart attack as those with the lowest ratio of triglycerides
to HDL in the study of 340 heart attack patients and 340 of their
healthy, same age counterparts. The ratio of triglycerides to HDL was
the strongest predictor of a heart attack, even more accurate than the
LDL/HDL ratio," reported Harvard lead study author.
Triglycerides, a mixture of fatty acids and glycerol that make up the
principle fats in the blood, bind to carrier proteins, forming
compounds known as lipoproteins. Other types of lipoproteins that
carry cholesterol, such as LDL and HDL, are known to be related to the
risk of heart disease because of their propensity to deposit -- or not
deposit -- fat in coronary arteries. However, it has not been clear if
triglyceride level could predict heart attack risk, despite years of
research." Circulation (1997;96:2520-2525)

Triglycerides and TG-HDL Ratio Help Identify Insulin Resistance in
Overweight Patients


Laurie Barclay, MD


Nov. 20, 2003 - Triglycerides and triglyceride-high-density lipoprotein
(HDL) ratio are good surrogate markers for identifying insulin resistance in
overweight patients, according to the results of a cross-sectional study
published in the Nov. 18 issue of the Annals of Internal Medicine.

"Insulin resistance is more common in overweight individuals and is
associated with increased risk for type 2 diabetes mellitus and
cardiovascular disease," write Tracey McLaughlin, MD, and colleagues from
Stanford University School of Medicine in Stanford, California. "Given the
current epidemic of obesity and the fact that lifestyle interventions, such
as weight loss and exercise, decrease insulin resistance, a relatively
simple means to identify overweight individuals who are insulin resistant
would be clinically useful."

The investigators measured body mass index (BMI), fasting glucose, insulin,
lipid and lipoprotein concentrations, and insulin-mediated glucose disposal
as determined by the steady-state plasma glucose concentration during the
insulin suppression test in 258 nondiabetic, overweight volunteers with BMI
of 25 kg/m2 or greater.

The most useful metabolic markers for insulin-resistance, defined as being
in the top tertile of steady-state plasma glucose concentrations, were
plasma triglyceride concentration, ratio of triglyceride to HDL cholesterol
concentrations, and insulin concentration.

Based on receiver-operating characteristic curve analysis, the optimal
cut-points were 1.47 mmol/L (130 mg/dL) for triglyceride, 1.8 in SI units
(3.0 in traditional units) for the triglyceride-HDL cholesterol ratio, and
109 pmol/L for insulin. These cut-points achieved a sensitivity of 67%, 57%,
and 68%, and specificity of 64%, 71%, and 85%, respectively.

The ability of these markers to identify insulin-resistance was similar to
that of the criteria proposed by the Adult Treatment Panel III to diagnose
the metabolic syndrome, which had a sensitivity of 52% and specificity of
85%.

Study limitations include primarily white study sample precluding
generalization of the findings to other ethnic groups, and limited
sensitivity and specificity of the markers studied.

"Three relatively simple metabolic markers can help identify overweight
individuals who are sufficiently insulin resistant to be at increased risk
for various adverse outcomes," the authors write. "In the absence of a
standardized insulin assay, we suggest that the most practical approach to
identify overweight individuals who are insulin resistant is to use the
cut-points for either triglyceride concentration or the triglyceride-HDL
cholesterol concentration ratio.... Early identification of high-risk
patients might lead to earlier, more successful interventions, such as
weight loss or prevention of further weight gain."

The National Institutes of Health supported this study. The authors report
no potential financial conflicts of interest.

Ann Intern Med. 2003;139:802-809

Blood Glucose Concentration Linked to>Cardiovascular Risk in Nondiabetic Men>
----------------------------------------------------------------------------

WESTPORT,>CT (Reuters Health) Jan 04 - Increased glycated hemoglobin
(HbA1c)>concentrations are predictive of cardiovascular mortality among
all men,>not only those with diabetes, according to a report in the
British>Medical Journal for January 6.

Dr. Kay-Tee Khaw and colleagues, from>the University of Cambridge
School of Clinical Medicine, UK, collected>data on all-cause mortality
and cardiovascular mortality in 4662 men, 45>to 79 years of age, who
participated in the Norfolk UK cohort of the>European Prospective
Investigation into Cancer and Nutrition>(EPIC-Norfolk). At baseline,
from 1995 to 1997, HbA1c was measured and>the subjects were followed
until December 1999.

As expected, Dr.>Khaw's group found that diabetic men had increased
mortality for all>causes, cardiovascular disease and ischemic disease.
They also noted that>HbA1c concentrations were "continuously related to
subsequent all-cause,>cardiovascular, and ischemic mortality through
the whole population." The>lowest mortality rates were associated with
HbA1c concentrations below>5%.

Further, the group noted that a 1% increase in HbA1c was>associated
with a 28% increased risk of death, which was independent of>age, blood
pressure, cholesterol, body mass index and>smoking.

"Eighteen percent of the population excess mortality risk>associated
with a HbA1c concentration of 5% or more occurred in men with>diabetes,
but 82% occurred in men with concentrations of 5% to 6.9% (the>majority
of the population)," Dr. Khaw and colleagues point>out.

The researchers propose that an elevated concentrations of>HbA1c is a
marker for greater absolute risk among all men, and>"preventive
treatment with blood pressure- or cholesterol-lowering drugs>should be
considered in such patients."

They point out that if>the population of nondiabetic men was able to
lower its HbA1c>concentration by 0.1%, total mortality could be reduced
by 5%, and if the>concentration could be lowered by 0.2%, then total
mortality could be>reduced by 10% in this population.
--

Lancet 1999 Mar 27;353(9158):1045-8

Glycaemic index as a determinant of serum HDL-cholesterol
concentration.

Frost G, Leeds AA, Dore CJ, Madeiros S, Brading S, Dornhorst A

Department of Nutrition and Dietetics, Hammersmith Hospitals NHS
Trust, London, UK. gfrost@xxxxxxxxxx

BACKGROUND: Diet influences the prevalence of coronary heart disease
(CHD). Insulin sensitivity and concentrations of HDL cholesterol,
two metabolic predictors of CHD, are also influenced by diet.
Dietary carbohydrates with a high glycaemic index cause a high
postprandial glucose and insulin response, and are associated with
decreased insulin sensitivity and an increased risk of CHD. This
study examined whether the glycaemic index of dietary carbohydrates
is a determinant of serum HDL-cholesterol concentrations. METHOD:
Dietary, anthropometric, and biochemical data from the 1986-87
Survey of British Adults (n=2200) were reanalysed by a multiple
regression model, which examined the relation between serum total
cholesterol, HDL-cholesterol, and calculated LDL-cholesterol
concentrations and various dietary characteristics, including the
type of carbohydrate, the glycaemic index, and fat intake. FINDINGS:
Among the 1420 participants with complete data, there was a
significant negative relation between serum HDL-cholesterol
concentration and the glycaemic index of the diet for both men
(regression coefficient -0.00724 [95% CI -0.0101 to -0.00434],
p=0.02) and women (-0.01326 [-0.0162 to -0.0102], p<0.0001). No
other significant relation was found with total cholesterol or
LDL-cholesterol concentration or with any other dietary carbohydrate
or fat constituent. INTERPRETATION: In a cross-sectional study of
middle-aged adults, the glycaemic index of the diet was the only
dietary variable significantly related to serum HDL-cholesterol
concentration. Thus, the glycaemic index of the diet is a stronger
predictor than dietary fat intake of serum HDL-cholesterol
concentration.

Ann Intern Med 1998 Apr 1;128(7):524-33



Metabolic risk factors worsen continuously across the spectrum of nondiabetic glucose tolerance. The Framingham Offspring Study.

Meigs JB, Nathan DM, Wilson PW, Cupples LA, Singer DE
Massachusetts General Hospital, Harvard Medical School, Boston University School of Public Health, 02114, USA. jmeigs@xxxxxxxxxxxxxxxxxxx

BACKGROUND: Categorical definitions for glucose intolerance imply that risk thresholds exist, but metabolic risk for type 2 diabetes mellitus or cardiovascular disease may increase continuously as glucose intolerance increases. OBJECTIVE: To examine the distributions of the following metabolic risk factors across the spectrum of glucose tolerance: overall and central obesity, hypertension, low levels of high-density lipoprotein cholesterol, and increased triglyceride and insulin levels. DESIGN: Cross-sectional analysis. SETTING: The community-based Framingham Offspring Study. PARTICIPANTS: 2583 adults without previously diagnosed diabetes. MEASUREMENTS: Clinical data; fasting glucose, insulin, and lipid levels; and glucose and insulin levels taken 2 hours after oral challenge were collected from 1991 to 1993. Glucose tolerance was determined by 1980 World Health Organization criteria. Patients with normal glucose tolerance were categorized into quintiles of fasting glucose. The distributions of each metabolic risk factor and the metabolic sum of the six risk factors were assessed across seven categories from the lowest quintile of normal fasting glucose level through impaired glucose tolerance and previously undiagnosed diabetes. RESULTS: The mean age of patients was 54 years (range, 26 to 82 years); 52.7% of patients were women. Glucose tolerance testing found that 12.7% of patients had impaired glucose tolerance and 4.8% had previously undiagnosed diabetes. Multivariable-adjusted mean measures of risk factors and odds ratios for obesity, elevated waist-to-hip ratio, hypertension, low levels of high-density lipoprotein cholesterol, elevated triglyceride levels, and hyperinsulinemia showed continuous increases across the spectrum of nondiabetic glucose tolerance. Although a threshold effect near the upper range of nondiabetic glucose tolerance could not be ruled out for triglyceride levels in men and for insulin levels 2 hours after oral challenge in men and women, no other metabolic risk factors showed clear evidence of thresholds for increased risk. CONCLUSIONS: Metabolic risk factors for type 2 diabetes mellitus and for cardiovascular disease worsen continuously across the spectrum of glucose tolerance categories, beginning in the lowest quintiles of normal fasting glucose level.

PMID: 9518396, UI: 98175274

.

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