Walking shoes, Liquid Plum’r, and Cholesterol

There was a pretty big announcement at the American Heart Association’s Scientific Sessions 2010 meetings last week: the new drug Anacetrapib is very good at raising “Good” cholesterol (HDL) while at the same time lowering “Bad” cholesterol (LDL) with very little side effects!

Why is this important? (Part 1): Here’s a good way to remember the difference: HDL is Happy Cholesterol and LDL is Lousy Cholesterol. Lousy Cholesterol gunks up your blood vessels and causes blockages. Blocked arteries are official, certified BAD THINGS. Happy Cholesterol, on the other hand, eats Lousy Cholesterol and then drops it off in the liver, where it is processed out of the body.

Why is this important? (Part 2): Drugs don’t always work like you think they will. A few years ago there was a big clinical trial for a new drug that would also raise your HDL while lowering your LDL. Suddenly the trial was cancelled… a significant percentage of the trial participants suffered from high blood pressure and/or heart attacks. Some of them actually died.

Ouch.

So there was a lot of excitement when anacetrapib came through the clinical trial with acceptable results. Dr. John M. has a good post on the new drug, including how it is more like Liquid Plum’r. Or maybe Pac-Man.

We’re still a long way from this drug going to market, the next step is another clinical trial involving 30,000 people. But in a few years it will be available – and someone will promote it as “an alternative to exercise.”

In the words of the great philosopher, Mr. Bruce Hornsby, “…don’t you believe them.” A pill can not replace exercise, no matter how much LDL it gets rid of. Your heart and lungs are muscles – If you push them just a little past their optimal range of use on a regular basis, they’ll get stronger. If you don’t – if you sit on the couch and take your pill – they’ll slowly wear out. It’s a rule of life; you can’t stop it. We all age, but some of us do what we can to slow it down.

The new drug won’t be cheap. New drugs never are, there is too much Research and Development funding sunk into it. No one knows what the price will be yet, so let’s make a guess. The new anticoagulation drug Dabigatran will probably cost about $240 per month. That’s not taking into account any insurance plan you may use, but if you walked up to the pharmacy counter with your prescription and paid cash.

Using this as our estimate, a one year supply of Dabigatran would cost $2,800 per year. You can figure that Anacetrapib’s price will probably be somewhere in that range.

But one pair of good walking shoes will cost you $85. Shoot, let’s splurge a bit and get one of the more expensive brands. That will cost us $130. If we just use them for our high intensity walks, they’ll last a while. If we use them as our everyday shoes, we may need a new pair in a year. Cost of drug: $2,800 per year. Cost of shoes: possibly $260 per year, more likely to be less.

Exercise is cheaper than drugs – and a lot more fun!

When the box says “Heart Healthy”, they don’t mean YOUR heart

“Blam-O Cereals are fortified with nutrients!”

“Every box of Blam-O Cereal is fired out of a cannon, to give you that extra POP in the morning!”

“Blam-O Cereals have been certified Heart Healthy!”

That’s one of the things that irritates me when I shop… the numerous labels that say their products are “heart healthy”. Because they aren’t.

They aren’t Heart Healthy for me. For someone who has suffered a heart attack or is trying to get his cholesterol down, they very well might be magic in a box. But not for me.

It’s a common problem for CHDer’s: A lot of times, the phrase “heart problems” bring to mind acquired heart problems. The problems you get naturally from age, or by “misbehaving”. That thought conficts with reality, as a lot of CHD patients are of below average height and weight, especially when they are young. I’ve actually been told “But you don’t look overweight!” The speaker should be glad that I was 14 at the time and was too shy and reserved to challenge them. If that happened today, they’d get an earful. Not only are they insulting me, they’re judging all of my friends who happen to not meet society’s artificial norms.

I’m sorry to shatter your assumptions, but I did not overeat, undereat, smoke, drink, or do anything else “wrong.” In fact, a CHDer’s heart usually makes them “be a good kid”. We look before we leap, think before we act, and because of dietary or physical restrictions, you’d probably think we’re a bit boring. Also, our minds work better than yours does. Can you keep track of ten (or twelve, or fifteen) different medications?

Didn’t think so.

Oh, by the way, it is not our mother’s fault that we have a Heart Defect. No one know why or how a heart defect occurs, but it happens early. By the time a woman looks her man in the eye and says “We’re going to have a baby!” the heart is already forming. So if you are dumb enough to think momma contributed to my problems, show some discretion and keep that opinion to yourself. Heart Moms are a special breed of woman, someone who was thrown for a loop during what should be the happiest time of her life. For the rest of her days she’s going to have an inner strength that the rest of us will envy… but she’ll live her life waiting for the other shoe to drop.

My eight year old niece has the perfect advice: “If you’re waiting on the other shoe to drop, sell that shoe on eBay! You can sell anything there!”

The wisdom of children!