Prediction of Aircrew Tests for Coronary Heart Disease

[seafuryfan]

Had my 5 yearly Av Med refresher recently.

A couple of interesting points from the doc:

Non-invasive (x-ray/digital) inspections of the arteries which carry blood to and from the heart are improving at an incredible rate (much like anything digital). Which means that it will soon be far easier to detect your own stage of coronary heart disease (starts in males from about the age of 12). All males have this condition, it's the extent of the disease in each of us which varies (genetic, lifestyle etc). With me so far? Doc predicts that within about five years, using these new methods of detection, all aircrew will be tested for coronary heart disease. I think that it'll probably start with the civvys, who's employers are almost paranoid about individuals keeling over from heart attacks. Then the military will follow suit.

Ever heard of statins? Neither had I. They are, apparently, cholestoral reducing drugs which are spectacular in their effectiveness, with no side effects. Doc thinks that all male adults should be taking this wonder drug to counter heart disease (a massive killer). Why are they not available now? Because the patent on them does not run out for another 3 or 4 years. When it does, the formula can be freely marketed. So if orders will permit, this stuff looks like an excellent counter the any problems raised in his first point. Even if your cholestoral level is not life threatning, Doc still thinks we should all be popping these pills.

One of the guys on the course rasied the question of results being held against you (insurance, employment etc). No easy answers to that one.

Remember the drug name: statins (re. speculative shares buy).

If you've got a medic mate in the bar, run this stuff by him and see what he thinks.

(Edited because I remembered the word 'arteries' instead of using 'tube' :) )

[Blacksheep]

As an old fart who has had one heart attack and coronary bypass surgery I'm quite familiar with Statins and they DO have side effects. In fact Statins can kill you - they can cause liver damage.

I take 10mg of Simvastatin every day and the doc follows me up with six monthly blood tests. These check the usual HDL & LDL cholestrerol levels, lipids, triglycerides but since I started on Simvastatin the doc is especially interested in my liver function. At the first sign of trouble he'd take me straight off Simvastatin again.

Statins are very effective in reducing cholesterol - my LDL cholesterol and triglyceride levels remained stubbornly high on a low fat, low salt diet. Reducing saturated fat to less than 16 grammes per day had not the slightest effect, although I lost more than eight Kilogrammes in weight - ending up at just 63 Kgs (height 167 cml) The doc persuaded me to go on to Simvastatin before I disappeared completely and I reluctantly agreed. The effect on my cholesterol levels was immediate and dramatic - down from 6.8 to 4.0 in two weeks, so Statins are certainly effective - but no-one should consider using them except under close medical supervision.

[14greens]

why on earth will the military bother with this for aircrew!! its gonna cost money so it isnt gonna happen
10 years ago blood tests were carried out to keep an eye on levels etc to help predict heart problems, why was the frequency of blood test reduced!!? quite simple, cost, so there is little chance of this new system ever getting brought in
In a similar vein, was threatened with being grounded as I had not had my annual dental check up a few years ago, tried to book for this year got told to go away till i get a reminder as the time limit between check ups has been extended up to 18 months!!! why??????????? to save money!!!

[ShyTorque]

14greens,

"In a similar vein", eh?. Good one. :ok:

[Spur Lash]

May I refer you all to this link, which will give you advice on how to avoid being a risk in the first place. Speaking as a person with suitable levels of HDL and LDL; I am, of course, suitably smug:ok:

Moral of the story? Do phys, and eat your greens:D


http://hcd2.bupa.co.uk/fact_sheets/html/cholesterol.html

[Blacksheep]

Actually, the moral of the story is that if, like me, you are one of the ten per cent that have the inherited factor then all the exercise and greens in the world won't help you. People should be tested early for high cholesterol and, if dietary methods fail, then Statins can be used under close medical supervision to reduce the risk of artherosclerosis.

On the cost saving side of things, the military will be finished with your services as expensively trained killing machines by the time arterial disease begins to affect your performance, so they don't see any benefit in preventing it. Its your body though, and you still have to live in it long after the government has finished with it. So it makes sense to have the necessary checks while you are still young - paying for it out of your own pocket if necessary. Bypass surgery costs 20 grand you know, so its a good investment...

[gingernut]

Why are they not available now?
Should be available "over the counter" from your friendly pharmacist soon.

with no side effects.
They said that about thalidomide. Never say never......slight chance of dodging up your liver, and can cause muscle aches.

They are, apparently, cholestoral reducing drugs which are spectacular in their effectiveness,
So they say, some even think we should put then in the water !

All males have this condition
Not, apparently, in Fiji, where the sea is green, the gin sipped slowly, and the fish is oily !!

Remember the drug name: statins (re. speculative shares buy).
Think you may have missed the boat, we got there first (only kidding)

[Timothy]

Statins are now available OTC as Zocor HeartPro. The blurb indeed proclaims them to be a wonder drug, and I have started taking them.

However, last night I found myself chatting with one of the Government doctors who regulates the safety of medicines, and he described what was available OTC (simvastatin 10mg) as "useless homeopathic doses".

Can any medics tell me if he is right?

[slim_slag]

Simvastatin is good stuff, one of those 'put it in the drinking water' type drugs. The effect on cholesterol is dose dependent and 10mg once a day is probably not much use to most people, but will help a few. Generally you are started on 20mg and cholesterol levels are monitored and adjustments made. Upper limits are less than 80mg per day.

A problem with the statins is that you need less if you are on other cardiac medication, so it's probably safer to reduce the dose available over the counter as the average patient has no idea of drug interactions. The average patient has also no real ability to properly monitor his blood cholesterol so cannot effectively titrate his over the counter dose. However I am sure it makes large profits for the pharma companies so will be here to stay. Even so, if you can afford it, why not take two 10mg tabs?

As for these non invasive x-ray tests, probably a very inefficient use of money and no better than other much cheaper tests. A new one is C-reactive-protein, now being touted as far better at pointing to future problems than even cholesterol levels, and only costing around USD15 a test.

As always anything coming from American cardiology like x-ray investigations will tend towards expensive testing with expensive interventions of dubious merit which are very lucrative to the cardiologists who perform them. Much better to eat healthy, exercise, not smoke and probably take aspirin. All these things reduce the nasty chemicals floating around in your blood. Statins also reduce c-reactive protein and so should be considered by your GP/cardiologist if your levels are such that he is concerned. It's early days with CRP, but exciting all the same.

[Timothy]

So, 20mg it is then. Thank you.

[mach79]

Hey guys don't jump too quick with the statins.There can be side effects to taking them, can't remember exactly what it was, perhaps something to do with reduction in the heart function, by reducing co-enzyme Q-10.
Don't quote me in this, but there was a problem.

[Timothy]

I am only a layman, but I have read the research.

The two commonly quoted side effects are liver damage, which is very rare, and muscle ache which is a little more common.

But isn't this a matter of balance of risks and balance of probabilities?

Making numbers up, but in the right ballpark, you could say that taking statins gives a .001% chance of liver damage whereas not taking them gives a 40% chance of heart attack. Which is safer?

[slim_slag]

I think you summed it up Timothy.