A recent visit to my GP resulted in me being tested for cholesterol. Mine was a little high, above 5. Those who keep up with medical science know that the best indicator is the ratio between HDL cholesterolHDL is short for high density lipoprotein. It is the “good cholesterol” responsible for removing harmful cholesterol from the bloodstream. High HDL levels reduce the… and triglycerides. Triglycerides (blood fats) go up with too many carbs and/or alcohol. Mine was really low. My ‘good’ HDL was really high so my ratio of Triglycerides/HDL was close to 2, putting me in low risk for heart disease. Not so, says the GP, based only on the cholesterol result and my age. He recommended I go on statins for life because ‘they only work if you keep taking them.’ I asked him what was the NNT (numbers needed to treat for a benefit) for a person like me with no signs at all of heart disease. He didn’t know. In a study of people with no heart disease but deemed ‘at risk’ 1,428 people would need to take a statin for 4 years for one to not have a fatal heart attack. In another study involving 34,272 people who hadn’t had a heart attack there was no reduced risk of having one.
So why the hard sell? GPs earn QOF points (Quality and Outcomes Framework) both for testing cholesterol, and lowering it, which statins will do. QOF points convert into money. That’s the way the system works and can make up a fifth of a GPs salary. I thought of saying ‘how much will you earn? Can we split the difference, calculated with this spoof QOFIT app!
Instead I sent him the link to Dr Malcolm Kendrick’s podcast – What Really Causes Heart Disease – the Clot Thickens.
Have you been QOFed? That is, encouraged to have tests or treatments that earn your GP QOF points? I wrote about how GPs are paid to prescribe ineffective drugs last year if you’d like to dig a bit deeper. Also see my podcast with Dr Malcolm Kendrick and Dr Tess Lawrie – What’s Driving Excess Cardio Deaths.
If you are concerned about heart disease please read my book Say No to Heart Disease before you commit to medication for life. Also see my Topic Heart Health, Heart Disease and Cholesterol.
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