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220

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Hello all.

I have a family history of heart disease so I had an echocardiogram done. It came back abnormal and showed that I had a “q wave.”
That was worrisome because everything I read said it was possible that I had experienced some sort of cardiac event.

A few weeks later I had a stress test done. All the results came back normal except for some slight left ventricle hypertrophy. The cardiologist didn’t seem to be concerned since I train frequently.

He was concerned about my cholesterol panel and prescribed a statin(Rosuvastatin). I’m on the fence about whether or not to take it though. I’ve read through the statin thread and need to read it again.

I still have lifestyle choices that I need to address(daily cardio being one), but I feel relieved to finally have the test results.
Thanks for reading.
 
220 said:
Hello all.

I have a family history of heart disease so I had an echocardiogram done. It came back abnormal and showed that I had a “q wave.”
That was worrisome because everything I read said it was possible that I had experienced some sort of cardiac event.

A few weeks later I had a stress test done. All the results came back normal except for some slight left ventricle hypertrophy. The cardiologist didn’t seem to be concerned since I train frequently.

He was concerned about my cholesterol panel and prescribed a statin(Rosuvastatin). I’m on the fence about whether or not to take it though. I’ve read through the statin thread and need to read it again.

I still have lifestyle choices that I need to address(daily cardio being one), but I feel relieved to finally have the test results.
Thanks for reading.
Click to expand...
Bloodwork?

Lipids
Hs-crp
Lp(a)

Stats?

Waist to height ratio?
 
42.
Height: 5’10”
Weight: 215
Waist: 33”

Not fasted
Total cholesterol: 210
HDL: 35
LDL: 157
Triglycerides: 92
Lp(a) 121
*Don’t have a high Hs-crp test
 
I’ve been on TRT about 8 years. In that time I’ve ran about 6-7 cycles. The 1st was test @ 400mgs. Since then I’ve done 6 cycles of test/primo at 1:1 ratio. The highest total was at 400/400.
 
Last edited:
LOL, cardiologists are never “concerned”.

Too much “concern” before any symptoms develop, and they’ve thinned the pipeline of future customers.

You on the other hand should be concerned, unless you want to embrace the magical thinking that despite PED use, somehow you won’t end up in an early grave like your genetic contributors because you take a fish oil pill from time to time.

Short of smoking(and steroid use), lifestyle makes little difference to cardiovascular disease outcomes. ~15% is generous, and you’re either doomed from birth or blessed.

If you really knew what was going on, with those numbers and family history you’d be sticking a boot up your cardiologist’s ass (or finding a preventative cardiologist), to get a Calcium score, and start aggressive lipid lowering to halt the steady march you’re making on the path your ancestors took.

You’re already in the highest risk category for purposes of lipid lowering treatment without being “Post Myocardial Infarction”, ie, the point at which lazy doctors finally get serious, and bean counters decide it’s worth spending a few bucks to follow the tighter “secondary prevention” guidelines <40 LDL target that would’ve prevented the heart attack in the first place had it been done sooner.

This is without even considering your PED use, and early signs of other cardiac issues.

If you want to try diffusing this time bomb with a “lifestyle” intervention that matters, adopt the one that decides it’s time to get serious and stop the ongoing plaque accumulation >70 LDL tells you is happening, to get CRP down so a chunk of the plaque doesn’t break off while you’re straining to open a stuck jar lid, and Lp(A) down as much as current medicine allows, which means Repatha.

If you follow the latest, most evidence based risk reducing guidelines, you won’t stop until you’re below <40 LDL with a HS-CRP <1.

That means a statin, ezetimebe, and a PCSK9 inhibitor. The latter 2 don’t cause sides for the overwhelming majority. Insist on the right statin and that almost certainly wont cause any sides either, even though you may have to educate or even override your doctor(I’m sure you know which I mean but I’ll drop a clue below), and you’ll stop this slow moving disaster, plaque will even begin to regress somewhat, the rest will slowly stabilize over the coming years, and your risk of cardiovascular death, an ischemic stroke, a lifetime of breathlessness and chest pain when barely exerting yourself, stents, bypasses, and subtle but ultimately devastating cognitive decline as your carotids choke off blood flow to your brain, and lipid clogged microvasculature leads to dozens of undetected “silent strokes”, turning areas of your brain into deserts of inactivity.

I suspect you have BP issues too. If you do, you’re probably on track to see a >500 CAC score by the time you’re 50, if you aren’t already there.

IMG_1924.webp

IMG_2818.gif
 
Last edited:
Thanks for reposting that statin chart. I'd seen it before but didn't save it, and couldn't find it again. That's going with me to my next doc visit.
 
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220 said:
Thanks. I will pull those labs next time as well as provide appropriate units and ref ranges. I appreciate the link as well.
Click to expand...
The Lp(a) was main one to confirm units on. Definitely have discussion with your provider(s) on your risk profile and blood work. Best wishes to you.
 
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Ghoul said:
LOL, cardiologists are never “concerned”.

Too much “concern” before any symptoms develop, and they’ve thinned the pipeline of future customers.

You on the other hand should be concerned, unless you want to embrace the magical thinking that despite PED use, somehow you won’t end up in an early grave like your genetic contributors because you take a fish oil pill from time to time.

Short of smoking(and steroid use), lifestyle makes little difference to cardiovascular disease outcomes. ~15% is generous, and you’re either doomed from birth or blessed.

If you really knew what was going on, with those numbers and family history you’d be sticking a boot up your cardiologist’s ass (or finding a preventative cardiologist), to get a Calcium score, and start aggressive lipid lowering to halt the steady march you’re making on the path your ancestors took.

You’re already in the highest risk category for purposes of lipid lowering treatment without being “Post Myocardial Infarction”, ie, the point at which lazy doctors finally get serious, and bean counters decide it’s worth spending a few bucks to follow the tighter “secondary prevention” guidelines <40 LDL target that would’ve prevented the heart attack in the first place had it been done sooner.

This is without even considering your PED use, and early signs of other cardiac issues.

If you want to try diffusing this time bomb with a “lifestyle” intervention that matters, adopt the one that decides it’s time to get serious and stop the ongoing plaque accumulation >70 LDL tells you is happening, to get CRP down so a chunk of the plaque doesn’t break off while you’re straining to open a stuck jar lid, and Lp(A) down as much as current medicine allows, which means Repatha.

If you follow the latest, most evidence based risk reducing guidelines, you won’t stop until you’re below <40 LDL with a HS-CRP <1.

That means a statin, ezetimebe, and a PCSK9 inhibitor. The latter 2 don’t cause sides for the overwhelming majority. Insist on the right statin and that almost certainly wont cause any sides either, even though you may have to educate or even override your doctor(I’m sure you know which I mean but I’ll drop a clue below), and you’ll stop this slow moving disaster, plaque will even begin to regress somewhat, the rest will slowly stabilize over the coming years, and your risk of cardiovascular death, an ischemic stroke, a lifetime of breathlessness and chest pain when barely exerting yourself, stents, bypasses, and subtle but ultimately devastating cognitive decline as your carotids choke off blood flow to your brain, and lipid clogged microvasculature leads to dozens of undetected “silent strokes”, turning areas of your brain into deserts of inactivity.

I suspect you have BP issues too. If you do, you’re probably on track to see a >500 CAC score by the time you’re 50, if you aren’t already there.

View attachment 356790

View attachment 356791
Click to expand...
I appreciate the detailed response. This is the kick in the rear that I needed. I took the chart that you posted in with me during my visit and requested Pitavastatin and a PCSK9 inhibitor.

I am going to find a new doctor more willing to listen and is up on the current literature. This guy didn’t even know about the LP(a) medications that are awaiting FDA approval.

I am truly grateful for the information. I want to be around to see my kids grow up.
 
Ghoul said:
LOL, cardiologists are never “concerned”.

Too much “concern” before any symptoms develop, and they’ve thinned the pipeline of future customers.

You on the other hand should be concerned, unless you want to embrace the magical thinking that despite PED use, somehow you won’t end up in an early grave like your genetic contributors because you take a fish oil pill from time to time.

Short of smoking(and steroid use), lifestyle makes little difference to cardiovascular disease outcomes. ~15% is generous, and you’re either doomed from birth or blessed.

If you really knew what was going on, with those numbers and family history you’d be sticking a boot up your cardiologist’s ass (or finding a preventative cardiologist), to get a Calcium score, and start aggressive lipid lowering to halt the steady march you’re making on the path your ancestors took.

You’re already in the highest risk category for purposes of lipid lowering treatment without being “Post Myocardial Infarction”, ie, the point at which lazy doctors finally get serious, and bean counters decide it’s worth spending a few bucks to follow the tighter “secondary prevention” guidelines <40 LDL target that would’ve prevented the heart attack in the first place had it been done sooner.

This is without even considering your PED use, and early signs of other cardiac issues.

If you want to try diffusing this time bomb with a “lifestyle” intervention that matters, adopt the one that decides it’s time to get serious and stop the ongoing plaque accumulation >70 LDL tells you is happening, to get CRP down so a chunk of the plaque doesn’t break off while you’re straining to open a stuck jar lid, and Lp(A) down as much as current medicine allows, which means Repatha.

If you follow the latest, most evidence based risk reducing guidelines, you won’t stop until you’re below <40 LDL with a HS-CRP <1.

That means a statin, ezetimebe, and a PCSK9 inhibitor. The latter 2 don’t cause sides for the overwhelming majority. Insist on the right statin and that almost certainly wont cause any sides either, even though you may have to educate or even override your doctor(I’m sure you know which I mean but I’ll drop a clue below), and you’ll stop this slow moving disaster, plaque will even begin to regress somewhat, the rest will slowly stabilize over the coming years, and your risk of cardiovascular death, an ischemic stroke, a lifetime of breathlessness and chest pain when barely exerting yourself, stents, bypasses, and subtle but ultimately devastating cognitive decline as your carotids choke off blood flow to your brain, and lipid clogged microvasculature leads to dozens of undetected “silent strokes”, turning areas of your brain into deserts of inactivity.

I suspect you have BP issues too. If you do, you’re probably on track to see a >500 CAC score by the time you’re 50, if you aren’t already there.

View attachment 356790

View attachment 356791
Click to expand...
I forced my parents to go to the cardiologist. All results came back awful.

My dad and I have an SNP that allows us to have low LDL and decent HDL. My dad eats sticks of butter (literally) because internet grifters/fad diets told him too. He's obese with a large pot belly. His LDL was 60 and HDL was in the 70s.

My LDL is in the 30s while using orals and primo.

My mom was about 150ish ldl. Her echo showed her heart as heavily calcified. Her side of the family has trash genes. She told me the cardiologist said "everything was normal" and she was fine. Her 23andMe shows apo3/4 and a few other shit ass heart genes.

I begged them all to do something about their terrible lipids and high BP. They essentially got mad at me for bothering them and looked at me like I was crazy.

Boomers don't give a single fuck about this sort of stuff. Most people don't.


Most of my relatives responded with the usual "statins give you diabetes/dementia and BP meds are just a conspiracy for big pharma to sell more drugs"

Thanks for listening to my rant! I expect my mom to stroke out any day now. Honestly don't give a fuck at this point. At least if she survives she'll believe what I said, assuming she has any functioning brain cells left after the stroke.
 
Also I'd like to add, high LDL fucking up your arteries / heart is very real and much faster than people think.

Even "sorta" high LDL like 130-150s. I've seen the echo and bloodwork of multiple relatives in that range. Most were age 50-70s.

You don't sudden hit "heavily calcified" in your 70s with high LDL. That takes decades and probably started in their 20s/30s.

Edit: Also, if you're on steroids your inflammation / BP (we all probably used tren to achieve a mediocre physique, didn't we?) is much higher than the normal population, so this is even more sped up.
 
Last edited:
explodingHeart said:
Also I'd like to add, high LDL fucking up your arteries / heart is very real and much faster than people think.

Even "sorta" high LDL like 130-150s. I've seen the echo and bloodwork of multiple relatives in that range. Most were age 50-70s.

You don't sudden hit "heavily calcified" in your 70s with high LDL. That takes decades and probably started in their 20s/30s.
Click to expand...
It's a vicious cycle, too. Plaque raises blood pressure, creating tears in the vessel, causing additional plaque to accumulate easier... so on and so forth. Also, after calcification, it's virtually impossible to remove, so it's quite possibly one of the most important markers to control, and ironically, one of the easiest.

Sorry to hear about you mom. I've had something similar happen to my father with smoking. They're too stubborn until it begins showing acute complications. At that point, it's usually already too late :(
 
rxzed said:
I've had something similar happen to my father with smoking.
Click to expand...

Every single fat or older person I've encountered had an uppity "fuck you, I'm healthy and heart disease is bullshit" attitude. The older, the worse attitude.

Shrug. "It is what it is" I guess.

Also, it doesn't matter how bad their labs or echo is. They'll shrug it off and not care.


I used to think: "Maybe if I can get them to a doctor to see how bad things are, they'll change their attitude!"

Nope. The worst the results, the more they will deny it and dig in with their beliefs.
 
rxzed said:
It's a vicious cycle, too. Plaque raises blood pressure, creating tears in the vessel, causing additional plaque to accumulate easier... so on and so forth. Also, after calcification, it's virtually impossible to remove, so it's quite possibly one of the most important markers to control, and ironically, one of the easiest.

Sorry to hear about you mom. I've had something similar happen to my father with smoking. They're too stubborn until it begins showing acute complications. At that point, it's usually already too late :(
Click to expand...
My mom has had two heart attacks, a stroke, and lung cancer. She still smokes and won't take her diuretics because they make her pee too often.

Dad always thought he knew more than the doctors - he finally started listening after he'd lost most of his foot and was waking up bleeding rectally. Of course, by that time it was way too late to reverse.
 
Raww said:
My mom has had two heart attacks, a stroke, and lung cancer. She still smokes and won't take her diuretics because they make her pee too often.

Dad always thought he knew more than the doctors - he finally started listening after he'd lost most of his foot and was waking up bleeding rectally. Of course, by that time it was way too late to reverse.
Click to expand...
Man that’s tough. Sorry to hear that.
 
220 said:
Man that’s tough. Sorry to hear that.
Click to expand...
It is what it is.

My wife sometimes works in hospice. When patients get to that point, there's no point in trying to change them. Trying to just makes their last time on earth less enjoyable.

The time for my parents to change isn't now, or when they were in their 70's. It was back when they were younger.

Hell, the time for me to change my ways was twenty years ago - not the 7 or so I've been working on it.

Hopefully I haven't permanently damaged myself too much.
 
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