I agree that lifestyle changes are hard to do, but I would like to push back in two ways:
Currently, it isn’t standard practice to measure apoB and base treatment on that statistic. This would result in doctors prescribing medication to people that are at risk, but that are currently unaware.
We calculated the number of clinical events prevented by a high-risk treatment regimen of all those >70th percentile of the US adult population using each of the 3 markers. Over a 10-year period, a non-HDL-C strategy would prevent 300 000 more events than an LDL-C strategy, whereas an apoB strategy would prevent 500 000 more events than a non-HDL-C strategy.
Furthermore, there is the option of early treatment with medication, that currently isn’t deployed. Like I described in the article, you can have a lifetime risk of 39-70% while also having a 10-year risk <10%, which means you won’t get treatment. While it is seems plausible that these people would benefit a lot by this.
To summarize it bluntly, it seems that the world would benefit from prescribing more cholesterol lowering medication. Advocacy for doing this would be the cost-effective solution.
Having said that, I didn’t start writing this article while having EA in mind. So I haven’t done an intensive cost/benefit analysis.
I agree that lifestyle changes are hard to do, but I would like to push back in two ways:
Currently, it isn’t standard practice to measure apoB and base treatment on that statistic. This would result in doctors prescribing medication to people that are at risk, but that are currently unaware.
Furthermore, there is the option of early treatment with medication, that currently isn’t deployed. Like I described in the article, you can have a lifetime risk of 39-70% while also having a 10-year risk <10%, which means you won’t get treatment. While it is seems plausible that these people would benefit a lot by this.
To summarize it bluntly, it seems that the world would benefit from prescribing more cholesterol lowering medication. Advocacy for doing this would be the cost-effective solution.
Having said that, I didn’t start writing this article while having EA in mind. So I haven’t done an intensive cost/benefit analysis.