{"product_id":"paul-d-thompson-untreated-high-cholesterol-6","title":"If high cholesterol is left untreated 6","description":"\u003ch1\u003eUntreated High Cholesterol: Combined Risk Factors, Risk Calculators, and Natural Statins\u003c\/h1\u003e\n\u003ch3\u003eJump To Section\u003c\/h3\u003e\n\u003cul\u003e\n  \u003cli\u003e\u003ca href=\"#it-depends\"\u003eWhy the answer depends\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#combined-risk-factors\"\u003eHow risk factors add up\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#ten-year-risk\"\u003eCalculating heart attack risk\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#patient-and-physician\"\u003ePatient wishes and physician judgment\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#statins-natural-products\"\u003eStatins and natural products\u003c\/a\u003e\u003c\/li\u003e\n  \u003cli\u003e\u003ca href=\"#full-transcript\"\u003eFull Transcript\u003c\/a\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch2 id=\"it-depends\"\u003eWhy the answer depends\u003c\/h2\u003e\n\u003cp\u003eThe outcome of untreated high cholesterol depends on the individual, says cardiologist Dr. Paul D. Thompson, MD. Asked by Dr. Anton Titov, MD, what happens without treatment, he points to how high the cholesterol is and which other risk factors are present.\u003c\/p\u003e\n\u003ch2 id=\"combined-risk-factors\"\u003eHow risk factors add up\u003c\/h2\u003e\n\u003cp\u003eCombined risk factors raise risk more than each one alone, in Dr. Thompson's explanation. High cholesterol carries its own risk and diabetes carries its own risk, but together the risk goes way up. He puts it this way: it is not one and one equals two, but one and one equals three and four.\u003c\/p\u003e\n\u003cp\u003eBy contrast, he says a high cholesterol level with nothing else is not so bad. Smoking, a little bit of high blood pressure, diabetes, or obesity alongside high cholesterol make the whole situation worse, and the more of these factors a person has, the worse it gets.\u003c\/p\u003e\n\u003ch2 id=\"ten-year-risk\"\u003eCalculating heart attack risk\u003c\/h2\u003e\n\u003cp\u003eRisk calculation is how Dr. Thompson and his colleagues decide how dangerous a patient's cholesterol is. They ask whether lowering it would help the person live longer or have fewer heart attacks. He says he can take age, blood pressure, cholesterol level, diabetes, and the good cholesterol level into a formula that gives a percentage.\u003c\/p\u003e\n\u003cp\u003eHe contrasts a low and a high result. With a 1% chance of a heart attack in the next 10 years, he says they probably would not want to treat. With a 20% chance, nobody is calling an ambulance yet, but they may have to in the future, and he would start that person on cholesterol-lowering medication as soon as he possibly could.\u003c\/p\u003e\n\u003ch2 id=\"patient-and-physician\"\u003ePatient wishes and physician judgment\u003c\/h2\u003e\n\u003cp\u003ePatient involvement is something Dr. Thompson encourages. He says many patients want to decide what will happen to them, and that patients know themselves. On the other hand, he notes that most patients did not go to medical school and most ignore these risk calculations. He says that he, like most physicians, does what he thinks is the best thing for the patient.\u003c\/p\u003e\n\u003ch2 id=\"statins-natural-products\"\u003eStatins and natural products\u003c\/h2\u003e\n\u003cp\u003eStatins, which Dr. Thompson calls \"the best way to lower your cholesterol levels,\" are common in natural products, he explains. He mentions mushrooms as one example. Red yeast rice is sold for lowering cholesterol, he adds, because it contains a lot of lovastatin.\u003c\/p\u003e\n\u003cp\u003eFor patients who only want something natural, he points out that statins are derived from natural products. He recalls telling patients that lovastatin was made for Merck by yeast in vats. Statins are chemically manufactured now, he says, but they are derived from natural products.\u003c\/p\u003e\n\u003ch2 id=\"full-transcript\"\u003eFull Transcript\u003c\/h2\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Anton Titov, MD:\u003c\/strong\u003e What happens if I don't treat high cholesterol?\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e What happens if you do not treat high cholesterol depends. It depends on how high the cholesterol is and on the other risk factors. So let us talk about this.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e If you have a high cholesterol, here is your risk. If you have diabetes, here is your risk. If you have diabetes and high cholesterol, your risk goes way up.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e It is not one and one equals two. It is one and one equals three and four. So if you have a high cholesterol level and nothing else, that is not so bad.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e But if you have a high cholesterol level and diabetes, or a high cholesterol and you smoke, or a high cholesterol level and you have a little bit of blood pressure, etc., etc. The more other risk factors you have, obesity, all that sort of stuff, the more other risk factors you have, the worse it makes your whole situation. So what happens to you depends on your cholesterol level, it also depends on the other risk factors, and it also depends on that thing called apolipoprotein A.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Now, I talked about that. Apolipoprotein A is a type of bad cholesterol that takes any cholesterol level you have and makes it worse. What I do when I see patients, and what all of us who do this sort of stuff do: when you see a patient, you try to decide, how dangerous is this person?\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e How dangerous is their cholesterol? Is it valuable to them to lower their cholesterol? Will they live longer?\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Will they have fewer heart attacks? That is what we do, and we have risk factor calculations. I can take your age, your blood pressure, your cholesterol level, your diabetes level, your good cholesterol level, put it into a little formula, and we can come out with a percent.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e You have got a 1% chance of having a heart attack in the next 10 years. Well, probably we do not want to treat you. Or you could have a 20% chance of having a heart attack in the next 10 years.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e That person, we are not going to call the ambulance right yet, but we may have to in the future. So that person I am going to get on cholesterol-lowering medications as soon as I possibly can take care of it. So what happens to you?\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e It depends. It depends on all the risk factors. Now, that is one of the important points I always tell patients.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e A lot of patients want to decide what is going to happen to them, and I encourage that. Patients know themselves, but on the other hand, most patients did not go to medical school, and most patients ignore these sorts of calculations. What I as a clinician, a physician, and what most physicians do is absolutely do what we think is the best thing for you.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Now, statins, which are the best way to lower your cholesterol levels, are actually quite common in natural products. For example, you know those umbrella mushrooms that you used to get at the salad bar before COVID got rid of all salad bars? Umbrella mushrooms by weight are about 14% lovastatin.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e Lovastatin, statins are natural in the environment. There is something called red yeast rice. Red yeast rice is sold as a cholesterol-lowering agent.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e You know why it is sold as a cholesterol-lowering agent? Because it has a lot of lovastatin in it. So when patients say to me, \"Oh, I do not want to do anything if it is not natural\"...\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e So statins actually are derivatives of very natural products. I used to tell my patients that when Merck was making lovastatin, which is also in mushrooms and other places, it is actually made in vats by yeast. I used to say that lovastatin is a natural product.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Paul D. Thompson, MD:\u003c\/strong\u003e It is made by a lot of yeast in a vat working for Merck. So, yes, statins are natural products, believe it or not. Now, they are chemically manufactured now, but they are derived from natural products.\u003c\/p\u003e\n","brand":"Diagnostic Detectives Network","offers":[{"title":"Default Title","offer_id":48388538302620,"sku":null,"price":0.0,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0599\/5449\/5644\/files\/2225147660-c72a6353d0389e86406359701c967d9776e450e0357bf820a51c8b04419617b9-d_1920x1080_ccb62e8d-c9df-49ad-b569-a0876bf54143.jpg?v=1794435350","url":"https:\/\/diagnosticdetectives.com\/fi\/products\/paul-d-thompson-untreated-high-cholesterol-6","provider":"DiagnosticDetectives.Com","version":"1.0","type":"link"}