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Achilles in pain after long ride


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Posted

 If your dad is over 60 his life expectancy is increased with high cholesterol.  Do the reading and then advise him to stop the satins.

 

Are you drunk? Where do you get this information? 

 

 

 

 

When deciding whether to undertake a dietary program to reduce serum cholesterol levels, a person must consider how much benefit to expect. We developed a model that assumes cholesterol reduction is effective and safe in reducing the risk for death from ischemic heart disease. In the model, we considered asymptomatic adults with total serum cholesterol levels between 180 and 300 mg/dL. We defined risk status on the basis of blood pressure, smoking habit, and high-density-lipoprotein cholesterol level. For persons aged 20 to 60 years who are at low risk, we calculate a gain in life expectancy of 3 days to 3 months from a lifelong program of cholesterol reduction. For persons who are at high risk, the calculated gain ranges from 18 days to 12 months. Knowledge of the magnitude of the calculated benefits in increased life expectancy afforded by cholesterol reduction can assist persons in making decisions about dietary change.

https://www.ncbi.nlm.nih.gov/pubmed/3826960

 

Here is the response of the British Heart Foundation on this article you read: 

 

https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/behind-the-headlines/cholesterol-and-statins

 

 

 

Flawed cholesterol study makes headlinesstatins-300x196-noexp.jpg?h=196&w=300&la

A controversial study has argued that if you have a high LDL (bad) cholesterol level when you are aged over 60, you will live longer, there is no increased risk of cardiovascular disease and that statins will have little effect. But can we trust these bold claims?

The researchers, led by Dr Uffe Ravnskov at the University of Lund, Sweden,  looked at 19 existing studies which considered the association between ‘bad’ LDL cholesterol levels and the overall risk of death in people aged over 60. They concluded that 92 percent of people with a high cholesterol level lived longer, and called for a re-evaluation of the guidelines for cardiovascular prevention, “in particular because the benefits from statin treatment have been exaggerated.”

Cholesterol is essential for your body to work, although too much ‘bad cholesterol’ (called low-density lipoprotein or LDL) can lead to fatty deposits building up in your arteries. These fatty deposits can increase your risk of developing conditions such as coronary heart disease, heart attack and stroke.

Statins are drugs that lower your body’s cholesterol level. They work by reducing the production of cholesterol in the liver and therefore reduce your risk of heart disease. 

Reliable research?

The total number of people involved in the study was nearly 70,000, but only 9 of the 19 studies actually included deaths from heart and circulatory disease.

Moreover, two-thirds of the total number of participants in this new analysis are from one study (Bathum et al 2013). This study found that higher cholesterol (total, HDL, or LDL) in people aged 50+ was associated with a lower all-cause mortality.  That study also showed that taking a statin prescription provided a significant survival benefit, regardless of age, whereas the researchers in this new analysis are using it to argue against statins.

They relied on limited, aggregated and inconsistent information …an approach liable to bias

John Danesh

BHF Professor of Epidemiology

Furthermore, the research, published in the BMJ Open journal, has been deemed unbalanced due to what John Danesh, BHF Professor of Epidemiology said was “crude study methods”. This is because their analysis "relied on limited, aggregated and inconsistent information from published sources, an approach liable to bias.”

Similarly Colin Baigent, of the University of Oxford, has described the study as reaching “completely the wrong conclusion. In fact, we know that cholesterol is just as important as a cause of heart disease in older people as it is in the young. We know this because of the evidence from all the randomized trials of statin therapy, which collectively have studied substantial numbers of older people.”

The authors themselves said that “We may have overlooked relevant studies as we only searched PubMed” (an online search for medical publications), and they may have excluded studies that evaluated LDL-C as a risk factor for death, if the study did not mention it in the title or abstract. “We may have overlooked a small number of relevant studies because we only searched papers in English,” they added.

Dr Tim Chico, a consultant cardiologist at Northern General Hospital in Sheffield, said there are several studies that has shown lowering cholesterol using a drug does reduce the risk of heart disease in the elderly. He said: “I am surprised the authors of this study do not refer to such trials, which tends to make their own paper disappointingly unbalanced.”

Evidence from large clinical trials demonstrates very clearly that lowering LDL cholesterol reduces our risk of death overall

Professor Jeremy Pearson

BHF Associate Medical Director

Some of the participants in the study with high cholesterol may have started statins during the study, and therefore their high life expectancy could be due to them being on statins. Similarly, some of them may have started a healthy diet during the study, and this could have increased their life expectancy.

At least five of the study authors have previously written books questioning the links between cholesterol and heart disease. The lead author Dr Uffe Ravnskov, has written a book called ‘The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease’.  Another of the authors, London cardiologist Dr Aseem Malhotra, is a prominent campaigner against statins.

The BHF View

Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: “As we get older, many more factors determine our overall health, making the impact of high cholesterol levels less easy to detect.

"The evidence from large clinical trials demonstrates very clearly that lowering LDL cholesterol reduces our risk of death overall and from heart attacks and strokes, regardless of age. There is nothing in the current paper to support the authors’ suggestions that the studies they reviewed cast doubt on the idea that LDL cholesterol is a major cause of heart disease or that guidelines on LDL reduction in the elderly need re-evaluating.”

The media coverage

The story was covered by the Daily MailGuardianIndependentTelegraphBBC Radio Fourand others. The Daily Mail headline ‘Statins 'may be a waste of time': Controversial report claims there's NO link between 'bad cholesterol' and heart disease’ did at least include the word ‘controversial’, rather than present the evidence as fact, while The Times’ headline Bad cholesterol ‘helps you live longer’ was arguably less balanced.

Much of the news coverage did show the controversy that the report has caused, although in some cases this was not mentioned till most of the way through the article.

It is important that people at high risk of a heart attack or stroke take their prescribed medication. Individuals can assess their cardiovascular risk and find information about how to reduce it using the Heart Age Tool, developed by the BHF, Public Health England, NHS Choices and Joint British Societies. If someone is unsure about their heart medicines, they can speak with their GP or contact our Heart Helpline on 0300 330 3300.

Posted

Are you drunk? Where do you get this information? 

 

 

 

 For one from The Old Mutual Insurance figures.  They insure hundreds of thousands of lives and in my age group their figures show those with Cholesterol > 7.5 have the lowest mortality rate whilst those <5.0 the highest. mortality.  - 

Posted

 For one from The Old Mutual Insurance figures.  They insure hundreds of thousands of lives and in my age group their figures show those with Cholesterol > 7.5 have the lowest mortality rate whilst those <5.0 the highest. mortality.  - 

 

You sure? I work with the life cover, I'll double your premium if that's your Cholestrol lol

Posted

Back to the OP's topic.

 

Tendons tend not to do well with a combination of compression and tension.  The achilles tendon is under tension while cycling, but the additional introduction of compression can be problematic.  Depending on the actual location of the problem within the length of the tendon, the cause of the compression is usually something as simple as a pair of socks applying too much compression in the area...

Posted

ALERT!      :offtopic:  ALERT! 

 

 

 For one from The Old Mutual Insurance figures.  They insure hundreds of thousands of lives and in my age group their figures show those with Cholesterol > 7.5 have the lowest mortality rate whilst those <5.0 the highest. mortality.  - 

 

Hmm. Some funny stuff going on after some reading. 

 

Seems there was a research article published in 2016 whereby the researchers came to the following conclusion: 

 

 

 

Conclusions High LDL-C is inversely associated with mortality in most people over 60 years. This finding is inconsistent with the cholesterol hypothesis (ie, that cholesterol, particularly LDL-C, is inherently atherogenic). Since elderly people with high LDL-C live as long or longer than those with low LDL-C, our analysis provides reason to question the validity of the cholesterol hypothesis. Moreover, our study provides the rationale for a re-evaluation of guidelines recommending pharmacological reduction of LDL-C in the elderly as a component of cardiovascular disease prevention strategies.

 

That seemed quite interesting, but alarm bells started going off when I read this: 

 

 

Strengths and limitations of this study

 

This is the first systematic review of cohort studies where low-density lipoprotein cholesterol (LDL-C) has been analysed as a risk factor for all-cause and/or cardiovascular mortality in elderly people.
 
Lack of an association or an inverse association between LDL-C and mortality was present in all studies.
 
We may not have included studies where an evaluation of LDL-C as a risk factor for mortality was performed but where it was not mentioned in the title or in the abstract.
 
We may have overlooked relevant studies because we have only searched PubMed.
 
Minor errors may be present because some of the authors may not have adjusted LDL-C by appropriate risk factors.
 
Some of the participants with high LDL-C may have started statin treatment during the observation period and, in this way, may have added a longer life to the group with high LDL-C and some of them may have started with a diet able to influence the risk of mortality.
 
We may have overlooked a small number of relevant studies because we only searched papers in English.

 and then this: 

 

 

Competing interests

 

TH has received speaker fees from Nissui Pharmaceutical and Nippon Suisan Kaisha. KSM has a US patent for a homocysteine-lowering protocol. RH, HO, RS and UR have written books with criticism of the cholesterol hypothesis.

 

Thus, you have a flimsy systematic review, done by published critics of the accepted relationship between cholesterol and CVD (or even all cause mortality), some of whom received some $ from the pharma industry. 

Posted

You haven't been prescribed antibiotics lately?

 

Reason I ask is there is a class of antibiotics called Fluoroquinolones which are associated with tendon issues and increased risk of damage.

Never taken any in my life. 

Posted

 

ALERT!      :offtopic:  ALERT! 

 

 

 

Hmm. Some funny stuff going on after some reading. 

 

Seems there was a research article published in 2016 whereby the researchers came to the following conclusion: 

 

 

That seemed quite interesting, but alarm bells started going off when I read this: 

 

 and then this: 

 

 

Thus, you have a flimsy systematic review, done by published critics of the accepted relationship between cholesterol and CVD (or even all cause mortality), some of whom received some $ from the pharma industry. 

 

 

https://www.youtube.com/watch?v=SYlhG8_nZe0

Posted

 

Hmm. Again, very odd.

 

Had a look into the researcher in your video. David Diamond, Ph.D. He publishes on psychology, particularly stress related diseases/conditions, where he does his own research. However, every couple of years he drops a systematic review (i.e. he basically summarizes existing research) on the 'myth that high cholesterol causes CVD'. 

 

Here's an overview of his publications if you want to have a look: https://www.researchgate.net/profile/David_Diamond2

Posted

I had a problem like that, but was caused by the padding on the back of my shoes being warn out and thus shoe pressing and aggravating the tendon. new shoes and problem solved

Posted

I had a problem like that, but was caused by the padding on the back of my shoes being warn out and thus shoe pressing and aggravating the tendon. new shoes and problem solved

Sounds like a legit reason. I am looking at getting a new pair, so I'll place more emphasis on it!

Posted

I recently got a new pair of Carbon MTB Shoes. 

 

I don't think I am feeling the pain that you feeling, but I can feel that there is a lot more strain on my Achilles after a ride. 

 

I noticed that in order to tie my shoes tighter, I push my feet all the way to the back and that, together with the tight shoes causes the strain. 

 

Maybe try loosening your shoes a notch?

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