Absolute cardiovascular disease risk: assessment and early intervention

acvdrlectureThe following lecture was first delivered to term 1, Phase 2 students in the Society and Health term, of the UNSW Medicine Program on Monday 3 March 2014.

  • Length: 50 minutes
  • Class size: up to ~ 300 (lecture)
  • Learners: mid-Program medical students

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Comment: Empirical evidence, not eminence, and certainly not dogma

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The following is a comment/letter to the editor to the online article, “Some catalysts for debate on statins“, published in Medical Observer.  This article covered two somewhat opposing perspectives by Prof Kerryn Phelps, and Prof James Tatoulis to the controversial ABC Catalyst program on the role of lipids and statins on health.  The shorter online response was published on 20 November 2013, and an expanded version was published in the final volume of Medical Observer in 2013.

Empirical evidence, not eminence, and certainly not dogma.

What we know about empirical evidence is that conjectures and suppositions extrapolated from cherry-picked data points, pathophysiological rationale, or anecdote, are often misleading and not “useful” – insofar as being able to make correct predictions of the future.

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Comment: To statin or not to statin?

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The following is a comment to the online article, “To Statin or not to Statin? – That is the question” by Dr Robin Park.  This article is a very readable summary of a number of practical questions about statins for GPs.

Great summary Rob!

A few comments… The evidence for the benefit of LFT and CK monitoring for statins is poor, and the rationale for doing so is questionable in light of the accumulated safety data for statins. An argument can perhaps be made for baseline LFT (even in otherwise fit and well people), but the utility of a baseline CK is rather low in someone not at high risk of myopathy. Stopping a statin in someone who is at mod/high CVD risk, due to an asymptomatic rise in CK, probably does more harm than good. Continue reading