Talk:Hypercholesterolemia/Archive 1

Archive 1

References!

Where are the references. This article grossly ignores the positive feedback mechanism in physiological regulation of lipoprotein levels. The body autosynthesizes over 80% of lipoproteins, and the body will pick up the slack if you eat less, make dietary intake of choleterol of little significance on cholesterol count in the body. Furthermore, the terms "good" and "bad" in reference to LDL and HDL is very unscientific and certainly not warranted in light of statistics. This should be a science article, not an American Heart Association propaganda page.

Is this statement lol, "All three of these activities done together can have a positive effect on one's blood cholesterol level," necessary?

Isn't hypercholesterolemia a form of hyperlipidemia rather than the same thing? Mr. Jones 13:19, 3 Nov 2004 (UTC)

used to indicate a very similar problem. 71.102.121.192 (talk) 17:14, 16 June 2017 (UTC)

My statement which said Hypercholesterolemia is linked with certain diseases, as opposed to being a proven contributer of certain diseases, has been deleted. Did someone feel the researched link is untrue? How can this be when the article already states that the vastly researched link is the backbone of current theory?

To Quote: There are those that claim that cholesterol itself is a healthy nutrient and that the whole "lipid hypothesis", which links cholesterol with heart disease and atherosclerosis, is incorrect, despite vast research linking elevated cholesterol levels to poor outcomes. Acssm 10:17, 13 February 2006 (UTC)

"Linked" is not enough. It is clear that cholesterol alone is sufficient to cause cardiovascular disease. Perfectly healthy young people with an LDL receptor mutation develop premature atherosclerosis. Fact. Now please provide a general-scope article studying the views of cholesterol skeptics, not just their websites. JFW | T@lk 21:50, 13 February 2006 (UTC)

"Correlation" is not the same as "causation" - that's what all the statistics teachers say, but few understand or even pay attention to. 165.21.118.42 (talk · contribs)

But failing a divinely-guided fully random study (the sort which only exists in Statistics courses), a preponderance of different correlations support causation-- that's what everyone who's had to deal with real line-of-combat experimentation says, but which few people who have had introductory Statistics understand or even pay attention to. Kajerm 17:03, 13 August 2006 (UTC)

Re: Kajerm. Let's say factor X is present in each and every experiment. Such results would indeed support factor X as the sole cause. However, just because factor X is present in every experiment, does not necessarily mean factor X is the sole cause, nor even a causative factor at all, despite factor X's presence supporting causation. Acssm 15:32, 11 September 2006 (UTC)

You obviously did not read my comment closely enough. I was referring to familial hypercholesterolemia, a thoroughly understood condition. Patients have markedly elevated LDL cholesterol due to disrupted absorption by the liver. They are otherwise healthy, but they suffer accelerated atherosclerosis. This is proven. You can't get much closer to causation than that. Self-described "cholesterol skeptics" will always demand more proof for facts that are conclusively established. JFW | T@lk 03:35, 15 March 2006 (UTC)

familial hypercholesterolemia is not thoroughly understood - at times it is very difficult to confirm a diagnosis and this could be a spectrum of LDL related issues... 71.102.121.192 (talk) 17:14, 16 June 2017 (UTC)

JFW You raise a point about the demanding nature of skeptics in general. Yet, science depends on skepticism. I am sure we can all agree on that. Acssm 15:32, 11 September 2006 (UTC)

For those interested in a skeptic's point of view, consider this article by Dr. Uffe Ravnskov, MD, PhD: [1] Scroll down and you'll find 30+ references to peer-reviewed medical journals. He also addresses familial hypercholesterolemia (bottom of the page) if you are interested, but this discussion is brief, to say the least (he only covers 2 studies). If you want more info, just do a search for Dr. Ravnskov's papers [2] on MEDLINE, or read his book-- The Cholesterol Myths, 2000, New Trends Publishing [3]--DWT 17:08, 14 May 2006 (UTC)

I added an external link section (which was lacking) and a link to an article by Uffe Ravnskov. I had tried to add this under cholesterol a few days ago, but it was deleted by user Jdfwolff. He insisted instead that I add it under this article, so, without by this act agreeing necessarily to any of his rationales, added this here. Friarslantern 16:31, 9 August 2007 (UTC)

Angina pectoris is not a disease, it is a symptom of ischaemic heart disease.

I don't know much about the different "types" of hypercholesterolemia discussed in the treatment section. I'm doing my best to find a few sources to describe them, because it seems annoying to readers (at least to this reader) to read about treatments for something when they have absolutely no clue what it is. Any corrections from people with better knowledge or better sources would be much appreciated.Kajerm 17:03, 13 August 2006 (UTC)

Fixed this by linking to an article on the Fredrickson Types, and apparently learned something in the process. This should solve the problem. Kajerm

Genetics

A PD summary of known genetic markers is available here. --Peta 06:41, 29 March 2007 (UTC)

why

this is a very harmful desase. —Preceding unsigned comment added by 168.216.245.103 (talk) 14:32, 4 December 2007 (UTC)

And therefore? JFW | T@lk 21:17, 6 February 2008 (UTC)

Guess that some people just enjoy chewing the fat. — Preceding unsigned comment added by 203.164.154.113 (talk) 07:14, 16 July 2011 (UTC)

Copper

Bork (talk · contribs) added some citations about the role of copper in cholesterol levels.[4] To be frank, this is to the best of my knowledge not something that is generally regarded as an established fact. Suffice it to say that no doctor checks copper levels, and even fewer prescribe copper, for the treatment of high cholesterol. JFW | T@lk 21:17, 6 February 2008 (UTC)

Established fact? OK then, can you show me a study which shows copper deficiency does not cause hypercholesterolemia?

Did you know new studies are made every day and new facts are established constantly?

Is it my fault docs do not bother checking copper levels? What does it have to do with removal of the study?

Bork (talk) 21:54, 6 February 2008 (UTC)

It has a lot to do with removal of studies. We cannot possibly cite every study under the sun. When selecting matters for inclusion, we need to pick those that are well established, covered by professional guidelines etc. WP:WEIGHT is the relevant policy. JFW | T@lk 13:25, 19 March 2008 (UTC)

what studies are suggested to include? Vegaproc (talk) 17:17, 16 June 2017 (UTC)

Taurine

128.151.71.22 (talk · contribs) added an animal study suggesting that taurine improves lipids in rats fed on a high-cholesterol diet (PMID 9635047). I removed this, because (as stated in my post above) we cannot possibly add every study on substances that change lipid levels, especially in laboratory animals and especially under the artificial circumstances of the study.

Bork (talk · contribs) then added another animal study (PMID 17153607) and a very preliminary trial (PMID 18242615, not yet appeared in print) in a small group of volunteers. In my view, none of this comes close to being suitable for inclusion. Much larger studies are needed, and preferably trials that look at hard cardiovascular outcomes (as is required for lipid lowering drugs), and hopefully coverage in clinical practice guidelines. JFW | T@lk 13:25, 19 March 2008 (UTC)

Revising and improving

Much of the content on this page was written by MAlvis (talk · contribs), who has a detailed knowledge on the subject but has chosen to select American sources almost exclusively, use extensive inline URLs and sometimes add content that appears WP:NOR or WP:WEIGHT. I've just taken a first stab at improving it, because this is a very common condition and there are lots and lots of useful sources available. At the moment I'm sticking to Durrington's Lancet review, but a more recent review is doi:10.1136/bmj.a993 (incidentally with Durrington as a co-author). JFW | T@lk 11:11, 7 September 2008 (UTC)

Does fenugreek helps to reduce blood cholesterol and body weight? —Preceding unsigned comment added by 61.16.160.66 (talk) 11:03, 25 February 2009 (UTC)

wat —Preceding unsigned comment added by 174.48.218.39 (talk) 21:03, 17 March 2009 (UTC)

I have added a few sentences to the Alternative Medicine section about the recent meta-analysis on phytosterols/stanols published by Demonty in J Nutr 2009. There is a lot more that could be added about other FDA-approved functional foods [oats, psyllium, barley = soluble fiber approach; niacin as a drug] and other ingredients with lesser or controversial clinical evidence, including red yeast rice, pantathine, polymethoxylated flavones, and so on.David notMD (talk) 14:40, 6 April 2009 (UTC)

What cholesterol levels are associated with risk?

The article does not offer any insight into what a high cholesterol level would be for different risk groups. It is a simple manner to include a paragraph that would state some risk groups or clinical groups and what might be acceptable ranges for cholesterol levels. (of course if this is in some other article, I'd appreciate a heads up too).66.66.191.229 (talk) 13:03, 5 July 2009 (UTC)

got it and added as links to diagnosis.66.66.191.229 (talk) 13:18, 5 July 2009 (UTC)

"Diet" is intolerably underwritten

it should be vast (consider how important it is said - at least that i've read), & 2. should be reference heavy. safely ignore wikipedia standards for few references & link it up; This is People's Lives!! give them info. good info & tons of good info. bless you whoever does this. the words of "good deed" is with you. lakitu (talk) 09:30, 25 April 2010 (UTC)

what do you suggest at indications to diet to change cholesterol levels? (most people who read will know about saturated fats, exercise, fast food.)Vegaproc (talk) 17:17, 16 June 2017 (UTC)

Please feel free to improve this or any page for that matter. If you need help getting access to sources drop me a note.Doc James (talk · contribs · email) 20:53, 29 May 2010 (UTC)

@Jim1138: Hi Jim1138, I believe you removed a text by mistake (you commented that I removed it...)Tsabarn (talk) 23:22, 19 March 2017 (UTC)

@Tsabarn: My apology. Not sure exactly why I removed your addition. I restored your edit. Thanks for the note! Cheers Jim1138 (talk) 02:06, 20 March 2017 (UTC)

Interesting study looking at primary prevention

[5] Doc James (talk · contribs · email) 16:35, 29 June 2010 (UTC)

And another [6] --Doc James (talk · contribs · email) 01:02, 21 July 2010 (UTC)

Reviews

• Bhatnagar D, Soran H, Durrington PN (2008). "Hypercholesterolaemia and its management". BMJ. 337: a993. PMID 18719012.{{cite journal}}: CS1 maint: multiple names: authors list (link)

--Doc James (talk · contribs · email) 03:05, 17 November 2010 (UTC)

Research section

Do not really find this useful

==Research== Multiple clinical trials, each, by design, examining only one of multiple relevant issues, have increasingly examined the connection between these issues and atherosclerosis clinical consequences. Some of the better recent randomized human outcome trials include ASTEROID, ASCOT-LLA, REVERSAL, PROVE-IT, CARDS, Heart Protection Study, HOPE, PROGRESS, COPERNICUS, and especially a newer research approach utilizing a synthetically produced and IV administered human HDL, the Apo A-I Milano Trial, the results of which were published in JAMA in 2003.

Doc James (talk · contribs · email) 09:57, 25 November 2010 (UTC)

Ohie State rabbit study

Perhaps it would be appropriate to mention the studyat Ohio State University that showed that rabbits, evenwhen genetically bred to develop hardening of thearteries and then fed a high fat diet to speed up theprocess, had a 60% lower incidence of atherosclerosis if they were petted, played with, and talked to when they were fed. The disbelieving researchers then repeated this experiment two more times, with the same results. 69.72.119.48 (talk) 00:37, 24 March 2011

New review of statins

PMID 21989464

--Doc James (talk · contribs · email) 15:16, 13 February 2012 (UTC)

Consistent with the Lancet CTT results, eh? JFW | T@lk 19:46, 21 May 2012 (UTC)

MAlvis

Longterm editor MAlvis (talk · contribs) is back and his edits follow a familiar pattern. I am hoping to start a discussion about the encyclopedic value of his additions. I propose the following two editing standards:

• References need to rigidly conform to WP:MEDRS. This is not a topic where you can use primary sources, because there is a wealth of better stuff available.
• Phrasing needs to be accessible to the general reader. Endless references to lipoprotein particle size are terminally offputting to the general reader, who just wants to know whether his TC of 6.6 is going to give him a heart attack or not.

I will be monitoring the article, and edits not following the above standards are likely to be removed pending further consideration. JFW | T@lk 11:43, 29 May 2012 (UTC)

Agree with the first standard, but not with the second. Distinguishing between various lipoproteins can be relevant to even a casual reader. At the very least we should distinguish between LDL and HDL.Elennaro (talk) 19:29, 2 June 2012 (UTC)

We have three basic particles TC, LDL, HDL. That should be sufficient.--Doc James (talk · contribs · email) 22:55, 2 June 2012 (UTC)

Added tables

I just added some tables. The sources I used were targeted to the United States, so they used mg/dL for the units. Someone asked me to convert this to mmol/L, which is the standard unit elsewhere in the world. I did this per WP:CALC. Blue Rasberry (talk) 19:22, 3 April 2013 (UTC)

[You did the conversion wrong, I'm afraid. As far as I can tell, you used the conversion mg/dL->mmol/L for glucose rather than cholesterol (1 mole of cholesterol = 387 grams, 1 mole of glucose = 180 grams). Anyway, it's fixed now.] --Webbam (talk) 17:48, 2 September 2013 (UTC)

Familial Hypercholesterolemia is NOT "well understood"

Multiple sources claim that only somewhere between one and 10% of those with familial hypercholesterolemia have even been "identified". Those that have been identified are heavily skewed toward a population with heart disease, either directly or through a relative. The "unidentified 90%", almost by definition, would be those individuals that do not have cardiovascular disease sufficient to end up in the hospital. Whether those individuals are fundamentally different from those who have had, or are likely to have, heart disease Is an open question that apparently no one in the business seems to want to explore. As one of those individuals, my experience has been no one is interested in understanding why I, or members of my family, should have a lifetime of extreme LDL cholesterol levels (currently 520) and yet zero heart disease.

RockyBob (talk) 15:31, 3 July 2013 (UTC)

Usage of "fat" in the lead

This article states that cholesterol is a type of fat. Technically, of course, it is a type of lipid. A "fat" is a triacylglycerol - chemically distinct from a sterol. If there are no objections, I'll remove that statement. Regards, P. D. Cook ^{Talk to me!} 14:48, 24 October 2013 (UTC)

I went ahead and removed the phrase. P. D. Cook ^{Talk to me!} 23:53, 30 October 2013 (UTC)

Diet

This bit of text is correct "in strictly controlled surroundings, dietary changes can reduce cholesterol levels by 15 percent". Not sure why it was changed. [7] Doc James (talk · contribs · email) (if I write on your page reply on mine) 04:21, 2 November 2013 (UTC)

Screening in young adults

... doubtful doi:10.7326/M16-0946 JFW | T@lk 16:32, 9 August 2016 (UTC)

Heading

The diet sections on this page are a mess. Firstly, there shouldn't be two separate sections labeled "Diet." We can condense it down to one section, and state clearly that dietary saturated fat, dietary trans fat, and dietary cholesterol have a linear, positive relationship with LDL cholesterol, while there is evidence that high amounts of fructose may increase LDL cholesterol as well. In the dietary cholesterol section, the review currently cited concludes that cholesterol feeding increases LDL cholesterol, while this article only quotes the findings of the observational research on cardiovascular disease, which is a different type of study altogether and not necessarily what this article is about, which is hypercholesterolemia. The next sentence is a misleading statement about the US dietary guidelines. It's true that the Advisory Committee recommended a removal of the dietary cholesterol limit, but the final draft of the guidelines published by the USDA (not the same group of people) does still suggest a cholesterol limit. It states "eat as little dietary cholesterol as possible" The references about reviews on saturated fats, while being notoriously flawed in the first place, again, are an inappropriate type of study to cite on this page. This is the page for hypercholesterolemia, not cardiovascular disease. You would expect the citations to be controlled feeding experiments investigating the effect of saturated fat on cholesterol levels directly, not observational studies attempting to look at hard endpoints. Instead, we can just say that dietary saturated fat is known to increase LDL cholesterol, while polyunsaturated fats have an LDL-lowering effect. — Preceding unsigned comment added by 2600:8807:5403:7B00:B0AE:87F0:3666:5BB7 (talk) 06:49, 28 August 2018 (UTC)

References

Table headed "Indications to LDL cholesterol"

1. I couldn't find most of these figures in the cited source, and in any case the article should state that it just represents one opinion.
2. In the 2nd columnn, the first row states that the presence of any risk factors at all automatically puts one in the high risk group, whereas in the later rows you need at least 2 risk factors to qualify for the moderate or moderately high group. This is totally inconsistent.
3. In the 3rd column, what does "should consider >100 mg/dL" mean? and similarly for the 4th column. (I know what the amount means, but it is totally unclear who should consider what.) ----Ehrenkater (talk) 19:15, 4 October 2019 (UTC)

It is simple to convert from American to IU. Lots of tools do it.

I adjusted it to "should consider reduction"

Doc James (talk · contribs · email) 01:46, 5 October 2019 (UTC)

User:Ehrenkater Have you looked at table 2[8]? Doc James (talk · contribs · email) 18:56, 5 October 2019 (UTC)

I agree it's simple to convert. That was an error (which had been left in the article for several years until I pointed it out!) and that point has now been fixed. However you have not addressed any of the three points above. Accordingly I have now reinstated the "expert needed" template. Please stop deleting the template, as the article still needs attention. I could try to fix the mess (described above) in the article myself (perhaps with the help of the Table 2 which you refer to?), but in view of the importance of the article I think it is better that an expert in the subject does it.----Ehrenkater (talk) 18:58, 5 October 2019 (UTC)

Have trimmed it to just the MI risk for those two boxes.

User:Ehrenkater anything else? Doc James (talk · contribs · email) 19:08, 5 October 2019 (UTC)