High Cholesterol - Do I Need To Take Medication?

[Music] wow [Music] hi welcome to another episode of talking with docs i'm dr paul zalzel and i'm dr brad wayne talking with docs if you haven't watched it it's sort of uh talking with docs about different topics it's supposed to be entertaining and informative often we err on the side of informative and not so entertaining and do apologize but we are covering some interesting topics and today we're going to talk about a topic that's close to my heart cholesterol and should i take medication uh or how can i lower my cholesterol and what's the big deal if i have high cholesterol and today we have a guest dr mike heffernan he's been on videos before he's a cardiologist he's gonna give us the lowdown on cholesterol and thank you so much for joining us my pleasure guys okay so very common problem a lot of people have high cholesterol yeah so let's first start with the why like why do people have high cholesterol actually let's start with what do you even need okay even better so you know we need cholesterol um cholesterol is an important uh you know component in our body we need it to make steroids uh we needed to make uh components in our cell membrane so we can't survive without cholesterol the problem is um when cholesterol is processed in our body and a lot of it is synthesized by our organs the liver makes a lot of it um it it gets degraded and so parts of it gets used and then there's sort of kind of garbage components that are left over that aren't really necessary and so these are some of the bad ones you probably heard about like ldl and it's particularly this ldl you know kind of remnant it's small in essence or low density low density lipoprotein so it's small it uh you know it's able to kind of get into the the walls of the arteries and that's where that kind of the cholesterol buildup has supposed to lol but couldn't be more different exactly um so that's that that's the the what and why about cholesterol okay and uh you know the other i think the other important thing to know is um what can you change and what can't you change so there's a genetic component to how much cholesterol we have in our bodies and on the order of about 85 of the cholesterol that you have in your body right now has been made by you um you can thank your mom and dad those are the genes that you were given yeah and um and so because people often ask you know how much can i change through diet and exercise sure and on the order of about 20 percent now now some people can change more there's no question through some lifestyle modifications so you don't mean 20 of people can get normal cholesterol no the average person can reduce their cholesterol by 20 percent i did that i did that i had my cholesterol i went plant-based like a year and brought it down to 20 percent yeah about that but i was still elevated okay yeah and then so it's a combination of your genetics so but some people say well if it's just our genetics why why wasn't high cholesterol a big problem before like 100 years 80 years ago because we just weren't testing it or because we'd live different lifestyles as well or yeah well we weren't testing it yes um and the average age of people in the world was definitely lower than it is now i think 50 in 1900 actually i learned that to respond to a comment somebody we're 83 right now in canada right so there's a big change to advancement in medicine and and what you guys do and what we do so so speaking about the lifestyle stuff just quickly then for that 20 what can what kind of stuff can we do you know just all the things that we probably know we need to do so it's maintaining a healthy weight yeah it's making sure that that your diet is is good and so you know you mentioned plant-based diets um and if it's not going to be as you know plant-based or vegetarian it's about making sure that the diets are rich in you know vegetables in fruits in legumes in whole you know whole grains that sort of thing less processed food less meat if there's meat it's lean it's lean meat more chicken wings and that's high in the processed caffeine trying to find something chicken yeah chicken wings is not an answer to any of the medical questions we have no i try every time um does the smoking or your weight have any effect on your cholesterol so weight does yeah so showing smoking yeah i apologize i apologize to our viewers every video we're telling you to lose weight and you know you're sick of hearing it but i thought you were going to say chicken wings chicken wings i mean one thing i'm going to find something that chicken wings are good for alcohol consumption right which is also complicated so do you think it is um necessary for people to drink any alcohol or again just drink a sensible amount yeah sensible amounts right current guidelines here in in canada are less than 14 beverages in a week for a man less than 10 for a woman and that's and you can't stockpile it on a friday and a saturday night and obviously if you're a higher risk maybe less than the right absolutely 14 alcoholic drinks per week for the world health organization has said zero yeah that alcohol really solves no problems and causes a fair share yep yeah yeah so and i think the same thing for a lot of the cancer guidelines they're like listen we don't know exactly what alcohol does but we know it doesn't help yeah i mean like what what did our viewers take from that like world health organizat organization and they've that we've seen this before with other topics where world health organization says one thing and then other health organizations or regional ones say something i think you pick the one that makes you happier i think people want good news about bad habits yeah it's a that's a very real phrase right and where you live yeah yeah yeah okay good because it can be part of your culture too unfortunately good or bad so just some people just drink more okay so you've tried all that stuff yep you still have high cholesterol and now you're like okay like should i be worried about my cholesterol do i need to take medication believe me we know that medications made by pharmaceutical companies this is not a big pharma promotion we're just letting you know that this is a way to reduce your cholesterol to reduce your risk of having an adverse event and potentially ending your life prematurely yeah i think and there's no question right and you know there is uh there are a variety of medications that we use to lower cholesterol yeah um most people know about statins and and there has never been a hate on for a particular medication class than statins probably in all of medicine how come um it's honestly it's really hard to know why they hate them so much yeah yeah there was um you know there was one statin years and years ago um that was very potent but also had a lot of side effects that had to be withdrawn from the market and i think a lot of trust got lost as a result of that and that's kind of proceeded okay um so we use statins to lower cholesterol we use other medications one's called acetamide it stops um cholesterol reabsorption okay we have injectable medications um ones that that kind of go right to kind of where the the liver is and where the where the receptors are and uh and try and and reduce the amount of cholesterol in the body uh and they're very effective so so it's not just statins you know we have a we have a lot of things now and there are some other medications that are actually coming online probably in the next couple of years non-statin related in in fact there's there's one called benpedoic acid um it was created by a scientist who's uh whose wife was intolerant to statins oh wow and it kind of motivated him to look for something that is a good husband yeah honey what did you do for me lately i created a new drug so so there are other things that we can look for you didn't take out the garbage how about that that made me happy that's right nobody asked you to make a new drug just take out the freaking garbage so you're tight so it could be stop the cholesterol from coming into our bloodstream stop the liver from making it yeah make it go out of our bodies faster so some of them are binding agents right where you actually get rid of them faster those have some side effects obviously yeah we don't use those very much because people don't tolerate those right those are the oldest you know cholesterol lowering medications okay so the study basically we always make our clinton these days we make our clinical decisions based on clinical evidence and we get our clinical evidence from clinical studies are the clinical studies for statins that good are they like cut and dry is it you know what i mean or is there a lot of bias in those i remember when i was prescribed a stat and i'm like are these studies funded by pharma you know what i mean to say that you got to take statins and i'm sure a lot of viewers are typing comments right now to that effect but like are the studies that great first did that support the use of status i they are you know and and to answer your question a lot of the studies were funded by pharma it just makes sense right they have a medication their business is to try and and and so first of all have a business yeah um but their business is healthcare yeah and their business is so if they don't have something that's successful and a medication that works um they have to move on right and so they're hoping that their medication's gonna work and so but it's not just one company of course there were numerous companies that all got into this game um and it's not just statins but all the other medications i was also talking about and the the studies are overwhelming and if you put all of them together over a course of about 20 years you know you can expect a reduction in heart attack stroke and death of at least 25 to 30 percent so for some patients even more if they're higher risk because that's the question someone's going to say well listen i'm not going to take him what what's going to happen to me what are the consequences could i be okay and this is the trouble i think is that some people will say my grandpa had high cholesterol for 50 years and nothing happened he's maybe the same guy who smoked and they get lung cancer drove without a seatbelt didn't get in a car accident so unfortunately some of those people will get through like meet your grandfather man here's a good man party with him yeah some people get lucky yes some people get lucky but the majority don't right and and it's all about risk so you know here in canada there's a risk-based algorithm right um to decide you know who needs to be on a cholesterol pill not necessarily a statin but who needs to be on a cholesterol pill and that's after the lifestyle modifications have happened and so are you low risk are you moderate risk or are you high risk and then we look at your risk and then we look at okay so let's find out what's your number and where's your risk and do you really need to be on a medication so it's you know and if somebody wants to google the framingham risk calculator that's probably one of the most common out there it's something that you can do at home and and kind of calculate your risk they are complicated those algorithms are not straightforward i've looked at them it's like that's the biggest thing from massachusetts is it nursing small little towns nurses it's a whole town downtown outside boston right yeah yeah i found the algorithm incredibly confusing when i tried to look at it personally but it could be just me i'll take another look at it they have some simpler sites do they can can you can you send me we'll send yeah anything that starts with like sesame street dot i'll be done there you go yeah so that's a very good summary of high cholesterol what it means what you should do about it obviously discuss all the stuff with your family doctor or your cardiologist your healthcare provider but if you like this video please like it and subscribe to our channel and remember you are in charge of your own health and a special thanks to dr heffernan for going over this very complicated topic for us thanks see you next time i'm honest dad and i gotta get i gotta go i ran out like a few weeks ago but now i'm gonna go call your doctor call your doctor i'm supposed to get blood work i was late on that you're you're typical [Music] appreciation i got a patient to clean that up you don't even take vitamin d i do actually now after a video three years ago good yeah i used to not good man you guys

Channel: Talking With Docs

Views: 993,955

Keywords: cholesterol, high cholesterol, ldl cholesterol, how to lower cholesterol, bad cholesterol, high cholesterol symptoms, hdl cholesterol, lower cholesterol, cholesterol levels, signs of high cholesterol, causes of high cholesterol, good cholesterol, what causes high cholesterol, symptoms of high cholesterol, cholesterol symptoms, high cholesterol causes, high cholesterol treatment, how to reduce cholesterol, high cholesterol diet, high cholesterol signs

Id: x2twqK-5tqA

Length: 11min 31sec (691 seconds)

Published: Fri Aug 13 2021