1. Never(!) use ASA for primary prevention! Especially not without any hint of subclinical atherosclerotic disease.
I read here that ASA also has other unique properties, such as cancer prevention?. My rationale was that athero disease cannot be ruled out fully unless one gets a coronary or carotid cath. Is that a reasonable argument for continuing ASA?
The effect size of the anti-cancer effects of ASA may be a nice extra if you take it for secondary prevention but the increased bleeding risk sets it off otherwise. The letter is basically true also for primary prevention of CVD. Even with a ten year risk of 20% excess bleeding risk and preventing events levels eachother off! If calculated risk is even larger and/or if there is evidence for subclinical atherosclerotic disease or an equivalent (diabetes!) ASA may be worth it.
Noted. I will have him stop.
2. Stop this butter oil WPF bullshit!!!
LOL - I came across the butter oil plus cod oil blend and read that it provides optimal balanced omega levels. I may be wrong. Product is this: http://www.greenpast...Blend/index.cfm
Should I stop using? If so, what product is recommended?
I can't judge your dad's diet. If it is lacking longchain Omega 3 PUFA and IF he won't change it think about adding ordinary fish oil.
Avoid anything like the plague if it is pushed by the crackpot-orginazation the WPF is. Really... An atherogenic diet combined with atherogenic supplements and magic (AKA homeopathy) won't help your dad or yourself live longer to say the least!
Noted. I am certain he will benefit from Omega 3. What daily dose and brand of product do you recommend?
There is no universal agreement about dosages. For general supplementation, if increased triglycerides are not an issue, I would aim for something between 0.6 and 1.2 g of EPA+DHA daily. With most products that equals 2-4 g of fish oil.
I have absolutely no overwiev over the huge US supplement markets. But AFAIK despite what some manufacturers claim differences between fish oil products are miniscule.
4. If his lipids are borderline this would be the most logical vector to improve longevity, aka to implement primary prevention of CVD. If for whatever reason he doesn't want to take a statin for that or isn't able to control it effectively by diet alone, niacin could be an option to some degree. But that is nothing just to "give him" for obvious reasons.
Well statins were mentioned by his PCP. I read on here that statins do more harm than good. He would not have any qualms with taking statins. I just wasn't sure that I should give the 100% backing of statins as I read on here about the host of other issues they can cause...
*sigh* I really have to take a deep breath being confronted with these "specialists" again. Yes, there are a few very vocal self-proclaimed "statin-victims" on this board, and no, it's all bullshit, of course! The chance of suffering a meaningful side effect from a statin, let alone a really relevant one are about as low as being hit by a piano falling down some apartment buildings front. And yes, the net benefit is absolutely without any question if said piano didn't hit your head sometime before.
Good analogy. I will reach out to PCP to start statin. Is any one statin recommended over the other? Should he supplement with anything in particular while he is on the statin?
In general the difference between statins most important are the differences in pharmacokinetics. So depending on comedication some have less potential for trouble then others. I would suggest
leaving the decision on what specific statin to use to his practitioner.
Studies trying to reduce the incidence of myalgia by Coenzyme Q10 supplementation have general been failures so this most certainly is not well spent money. Some argue that a healthy vitamin d level is useful to reduce the incidence of myalgia but it's also rather anecdotal. I wouldn't worry much about it as long as it doesn't happen. Myalgia is fully reversible and IF it should happen cofactors can still be investigated. A healthy vitamin d level isn't wrong in any case.