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Open letter to President of American Heart Association as he recovers from a recent heart attack
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I'm not a troll. There seems to be a rigorous debate at the highest levels about nutrition, CVD, diabetes and I'm interested in this conversation.
I don't have an opinion. I just fly large airplanes for a living so I don't know enough to have one. There seem to be a growing number of doctors and scientists who think CVD is related to hyperinsulinemia rather than eating saturated fat. It's a question that deserves rigorous study and debate.
In aviation we are a pioneering profession in terms of always being ready to re-evaluate mental models, risk factors and avoiding shutting down contrarian opinions. These are some of the factors that have led to major improvements in safety that the medical field is now emulating. It's called CRM if anyone is interested.
But I do wonder why so many resort to ad-hominen attacks and get so emotional in an area that's supposedly a question of science not religion or politics.
What happened to "play to the ball not the man"?
And think the point is that you're not playing either...5 -
Alatariel75 wrote: »I'm not a troll. There seems to be a rigorous debate at the highest levels about nutrition, CVD, diabetes and I'm interested in this conversation.
I don't have an opinion. I just fly large airplanes for a living so I don't know enough to have one. There seem to be a growing number of doctors and scientists who think CVD is related to hyperinsulinemia rather than eating saturated fat. It's a question that deserves rigorous study and debate.
In aviation we are a pioneering profession in terms of always being ready to re-evaluate mental models, risk factors and avoiding shutting down contrarian opinions. These are some of the factors that have led to major improvements in safety that the medical field is now emulating. It's called CRM if anyone is interested.
But I do wonder why so many resort to ad-hominen attacks and get so emotional in an area that's supposedly a question of science not religion or politics.
What happened to "play to the ball not the man"?
And think the point is that you're not playing either...
Place a ball on the street then go home. Wonder why people ask you why you put a ball down.13 -
stevencloser wrote: »Alatariel75 wrote: »I'm not a troll. There seems to be a rigorous debate at the highest levels about nutrition, CVD, diabetes and I'm interested in this conversation.
I don't have an opinion. I just fly large airplanes for a living so I don't know enough to have one. There seem to be a growing number of doctors and scientists who think CVD is related to hyperinsulinemia rather than eating saturated fat. It's a question that deserves rigorous study and debate.
In aviation we are a pioneering profession in terms of always being ready to re-evaluate mental models, risk factors and avoiding shutting down contrarian opinions. These are some of the factors that have led to major improvements in safety that the medical field is now emulating. It's called CRM if anyone is interested.
But I do wonder why so many resort to ad-hominen attacks and get so emotional in an area that's supposedly a question of science not religion or politics.
What happened to "play to the ball not the man"?
And think the point is that you're not playing either...
Place a ball on the street then go home. Wonder why people ask you why you put a ball down.
Good analogy. OP is like a guy in the stands who tosses a ball into the crowd below and sits back to watch the fun, only to wonder why the people aren't playing the game for his entertainment.
And yeah - the premise for this letter is vile.5 -
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I'm not a troll. There seems to be a rigorous debate at the highest levels about nutrition, CVD, diabetes and I'm interested in this conversation.
I don't have an opinion. I just fly large airplanes for a living so I don't know enough to have one. There seem to be a growing number of doctors and scientists who think CVD is related to hyperinsulinemia rather than eating saturated fat. It's a question that deserves rigorous study and debate.
In aviation we are a pioneering profession in terms of always being ready to re-evaluate mental models, risk factors and avoiding shutting down contrarian opinions. These are some of the factors that have led to major improvements in safety that the medical field is now emulating. It's called CRM if anyone is interested.
But I do wonder why so many resort to ad-hominen attacks and get so emotional in an area that's supposedly a question of science not religion or politics.
What happened to "play to the ball not the man"?
So if someone in your industry was piloting a plane and it crashed and you didn't know much about the cause, their flying history, or the particulars of the plane, would you consider using them as an example in a published "open letter" to get attention for your pet theories about aviation?
Dr Davis seems to be "playing the man" pretty hard here, I can't imagine having hearing my name bandied about like this when I was recovering or hearing about this if it was my husband, brother, or father in the hospital recovering.12 -
Could always compromise and play with men's balls instead.
Is it just me or is this analogy getting weird.13 -
That article is full of kinda truths and massive jumps in reaching conclusions.
Riskfactors for coronary artery disease are just that. Risk factors.
Some, like non familial cholesterol issues, obesity, smoking and the oxidative/inflammatory effects of each, some kinds of hypertension etc are modifiable.
Others, like age, gender, familial hypercholestemia, some types of hypertension, genetic predisposition, diabetes, clotting disorders etc etc are not.
This article is some guys muddied science with a dash of pseudoscience opinion.
I will concede though, there is some evidence that statins lower your cholesterol but not your risk of heart attack, necessarily. There is still s greater base of evidence that they help though, thus they are part of the goldstandard pharmaceutical management of coronary artery disease.
...........
I write this from the perspective of the nurse that deploys the stents in the blocked arteries of people having heart attacks.4 -
That article is full of kinda truths and massive jumps in reaching conclusions.
Riskfactors for coronary artery disease are just that. Risk factors.
Some, like non familial cholesterol issues, obesity, smoking and the oxidative/inflammatory effects of each, some kinds of hypertension etc are modifiable.
Others, like age, gender, familial hypercholestemia, some types of hypertension, genetic predisposition, diabetes, clotting disorders etc etc are not.
This article is some guys muddied science with a dash of pseudoscience opinion.
I will concede though, there is some evidence that statins lower your cholesterol but not your risk of heart attack, necessarily. There is still s greater base of evidence that they help though, thus they are part of the goldstandard pharmaceutical management of coronary artery disease.
...........
I write this from the perspective of the nurse that deploys the stents in the blocked arteries of people having heart attacks.
Thanks for your thoughts. What do you think about calcium scoring MRIs as in his point 3? If they are as conclusive as the author states, I don't understand why the AHA would resist them?1 -
https://www.heart.org/idc/groups/heart-public/@wcm/@adv/documents/downloadable/ucm_437479.pdf
AHA explanation of the position that they are taking.
https://www.health.harvard.edu/heart-health/high-tech-heart-tests-and-procedures-you-may-not-need-and-why
Discussion of why it does not make sense to require various tests for asymptomatic adults (this is similar to the discussions over when to start recommending people get routine mammograms or prostate checks).
http://www.acc.org/latest-in-cardiology/articles/2014/05/20/14/40/cover-story-coronary-artery-calcium
Discussion of the issue.3 -
There's a story about Jim Fixx, a running guru, who died at age 52 of a heart attack (1984).
Nathan Pritkin, diet and fitness guru, died of leukemia (1985). He died with excellent cardiovascular health however.
I admit to casting these messages in doubt because of the cause of death.0 -
There is a word for people who become smug when someone they disagree with dies in an "ironic" manner (ie health professional dying of heart attack). They are called A**holes.24
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There's a story about Jim Fixx, a running guru, who died at age 52 of a heart attack (1984).
Nathan Pritkin, diet and fitness guru, died of leukemia (1985). He died with excellent cardiovascular health however.
I admit to casting these messages in doubt because of the cause of death.
Had Jim Fixx followed doctor’s recommendations and had a 12-lead ECG graded exercise test, they would have discovered in about 2 minutes that he had significant coronary artery disease. He didn’t because, as a “running guru” he was afraid that finding out he had heart disease would ruin his career as a running guru. (Turns out that dying of a heart attack messes up your career even worse).
One could say that instead of interpreting his death as “oh look, the running guy still had a heart attack”, the interpretation should be “wow, all that running kept a guy who might have died at 40 from having a heart attack for 12 years”.
Given the state of knowledge about risk factors, development of coronary disease, etc, and given that a lot of runners were younger, there was a certain amount of hubris about the protective effects of running back in those days.
Fixx’s death significantly changed the discussion and people began to discover and acknowledge the limits of exercise in mitigating risk factors. Exercise is a powerful, powerful, preventive tool, but it doesn’t confer immunity.
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lemurcat12 wrote: »https://www.heart.org/idc/groups/heart-public/@wcm/@adv/documents/downloadable/ucm_437479.pdf
AHA explanation of the position that they are taking.
https://www.health.harvard.edu/heart-health/high-tech-heart-tests-and-procedures-you-may-not-need-and-why
Discussion of why it does not make sense to require various tests for asymptomatic adults (this is similar to the discussions over when to start recommending people get routine mammograms or prostate checks).
http://www.acc.org/latest-in-cardiology/articles/2014/05/20/14/40/cover-story-coronary-artery-calcium
Discussion of the issue.
Thanks! Very interesting - especially the acc.org one. Was interesting to read them singing the praises of Statins though. I just watched the movie Statin Nation a few months ago. The gist of it was that some evidence shows they only improve total morbidity for 1 in 100 people and have a lot of side effects for many. I guess that many have been discussed before so i'll do a search.0 -
That article is full of kinda truths and massive jumps in reaching conclusions.
Riskfactors for coronary artery disease are just that. Risk factors.
Some, like non familial cholesterol issues, obesity, smoking and the oxidative/inflammatory effects of each, some kinds of hypertension etc are modifiable.
Others, like age, gender, familial hypercholestemia, some types of hypertension, genetic predisposition, diabetes, clotting disorders etc etc are not.
This article is some guys muddied science with a dash of pseudoscience opinion.
I will concede though, there is some evidence that statins lower your cholesterol but not your risk of heart attack, necessarily. There is still s greater base of evidence that they help though, thus they are part of the goldstandard pharmaceutical management of coronary artery disease.
...........
I write this from the perspective of the nurse that deploys the stents in the blocked arteries of people having heart attacks.
Thanks for your thoughts. What do you think about calcium scoring MRIs as in his point 3? If they are as conclusive as the author states, I don't understand why the AHA would resist them?
Calcium scores are done as part of a CT angiogram. They are widely referred to here (in Australia) and considered as part of a patients risk burden for coronary artery disease, however my understanding is that the my can be very misleading particularly in the presence of comorbidity such as diabetes etc and their significance is open to broad interpretation.
CT coronary angiograms in themselves, though less invasive than formal angiograms. There are a lot of false positives and not quite right info deduced from them.
For example, CT might say moderate to severe lesion in the mid circumflex, when there’s really only a mild clinically insignificant lesion in the right coronary artery (which in some people supplies a similar territory of muscle). Sometimes they are spot on though.
Another interesting point is that anyone with a suspicion of coronary artery disease on CT (where they measure the calcium score) will be sent for a formal coronary angiogram in a cardiac catheterisation lab.
That makes 2 expensive investigations rather than just having a proper look the first time. The formal fluoroscopy angiogram is the gold standard. An interventionalist cardiologist can treat a severe lesion as they see it in most cases,
Also, not all blockages are calcified. And, not all calcified areas (while not great) are causing any impairment to blood flow to heart muscle.
........
The angry dude is not *wrong* exactly, really.
What he’s arguing has pretty well grounded and evidence based counter arguments to explain why he’s not right.
Also, using a person’s misfortune for what is essentially a political (him vs the machine that is the medical/cardiac patriarchy) is douchey.
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Notes upon reading link:
Ads, ads, ads.
"Wheat Belly"? Oh FFS.
"Big Pharma"?
There goes any credibility you might have from your white coat.
The AHA were not saying the heart attack counted as a success. Stop congratulating yourself on killing a straw man.
"Thinking that a statin drug (+ aspirin and a beta blocker) are sufficient to prevent coronary events is absurd and overly-simplistic" - no *kitten*. Who ever says that? Ever heard of exercise, genetics, general health? Oh, sorry, carry on killing your straw men.
So low carb is magic, and wheat is Teh Debbil? Hmmm. Have fun with your obscurity hanging on the coat-tails of a fad.11 -
Aaron_K123 wrote: »There is a word for people who become smug when someone they disagree with dies in an "ironic" manner (ie health professional dying of heart attack). They are called A**holes.
So much this.4 -
I once worked with a doctor who later retired early on account of ill health and then died of renal failure.
One of the doctors I currently work with has severe asthma
Does this mean the things doctors recomend for asthma or renal health are based on false assumptions????
That seems the same logic as the article is using and just as nonsensical
OP if your intention is to discuss the importance or otherwise of current cardiovascular risk factors or preventative strategies, both pharmecutical ( role of aspirin, statins etc) and non pharmecutical ( smoking, weight control, exercise etc) then not sure why you opened with this silly article??8 -
This is interesting - How would any of us create a healthier thyroid?0
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My cardiologist died of a massive coronary. He was outwardly one of the healthiest people I knew.
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snickerscharlie wrote: »My cardiologist died of a massive coronary. He was outwardly one of the healthiest people I knew.
One of my colleagues, aged 55 - runs several triathlons a year - suffered a heart attack about a year ago. He survived thankfully but he lost his commercial pilot's medical. He's a physics Phd and all round smart guy. He's looked into it for himself and he concluded it was likely due to carb loading / hyper-insulinemia / inflammation over many years. He's since gone keto / LCHF (but uses a slow carb called Super Starch for event performance).
I can't speak with any expertise about whether he's correct but he's dropped about 8kg and recently beat his 22 year old son in a half marathon.
This heart surgeon seems to agree with him though....
"The rest of us have simply followed the recommended mainstream diet that is low in fat and high in polyunsaturated fats and carbohydrates, not knowing we were causing repeated injury to our blood vessels. This repeated injury creates chronic inflammation leading to heart disease, stroke, diabetes and obesity."
http://myscienceacademy.org/2012/08/19/world-renown-heart-surgeon-speaks-out-on-what-really-causes-heart-disease/?utm_content=bufferba509&utm_medium=share&utm_source=facebook&utm_campaign=msa
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