Bad advice on high cholesterol from Ride London

[mjr]

If you have a family history of heart disease or sudden death, or have a high risk from high cholesterol or high blood pressure but particularly if you have symptoms of heart disease, such as [...] see your GP [...] but continuing to ride with these symptoms may shorten your cycling career catastrophically!

I believe the expression is <moderated>? Cycling is great for reducing high cholesterol as long as you're not silly about it. I'm glad I'm not one of his patients.

[Mick F]

Me too!

Cholesterol?
My blood must be 50% cholesterol!

[Psamathe]

If you have a family history of heart disease or sudden death, or have a high risk from high cholesterol or high blood pressure but particularly if you have symptoms of heart disease, such as [...] see your GP [...] but continuing to ride with these symptoms may shorten your cycling career catastrophically!

I believe the expression is <moderated>? Cycling is great for reducing high cholesterol as long as you're not silly about it. I'm glad I'm not one of his patients.

I would interpret what he is saying as basically, if you have a heart or circulation problem or risk, check with your GP 1st. He is a medical practicioner and were he to reflect your comments without having 1st examined those taking that advice he would lay himself very open to criticism and possibly liability were somebody to suffer from his advice.

Some people by their nature/character can be "over motivated" (I am one under certain circumstances) where being successful at an undertaking is a far stronger motivation than "common sense".

The "check with your GP before starting a physical activity" is increasingly common as it has to be able to be interpreted appropriately by everybody. e.g. I've seen people interviewed on documentaries who are massively obese yet see their weight as "fine" - so they would presumably regard their health risks from starting a physical activity as being the same as somebody with a normal weight. General advice has to be more cautious.

I was going to say that he might have added more encouraging advice but any example I wrote out I could then see potential issues and people mis-interpreting.

I think the UK is actually less cautious than some other countries in this regard. When I lived in France I needed a medical certificate signed by a GP before I could go dinghy sailing (and I have no medical conditions relevant or irrelevant) - everybody needs one and to enter a race you need to present said medical certificate.

Ian

[Vorpal]

If you have a family history of heart disease or sudden death, or have a high risk from high cholesterol or high blood pressure but particularly if you have symptoms of heart disease, such as [...] see your GP [...] but continuing to ride with these symptoms may shorten your cycling career catastrophically!

I believe the expression is <moderated>? Cycling is great for reducing high cholesterol as long as you're not silly about it. I'm glad I'm not one of his patients.

He isn't saying that having high cholestrol is a risk factor for cycling. He's saying that it's a risk factor for heart disease, and that people with high risk factors for heart disease should speak with their GPs.

I don't see anything wrong with that advice.

[mjr]

If you have a family history of heart disease or sudden death, or have a high risk from high cholesterol or high blood pressure but particularly if you have symptoms of heart disease, such as [...] see your GP [...] but continuing to ride with these symptoms may shorten your cycling career catastrophically!

I believe the expression is <moderated>? Cycling is great for reducing high cholesterol as long as you're not silly about it. I'm glad I'm not one of his patients.

I would interpret what he is saying as basically, if you have a heart or circulation problem or risk, check with your GP 1st. He is a medical practicioner and were he to reflect your comments without having 1st examined those taking that advice he would lay himself very open to criticism and possibly liability were somebody to suffer from his advice.

It's that combination of "risk" and "first" I object to. I think his advice is dangerously overcautious, discouraging physical activity among some of the people it could help most, for whom lack of physical activity would itself be an extra risk factor.

If you've actual limiting symptoms, then maybe check first, but if one has merely a mostly-asymptomatic risk factor like high cholesterol, then I'd keep cycling and check when you can. The advice for people with high cholesterol to stop exercising is contrary to the NHS advice to exercise more and trying to scare people out of cycling by suggesting that it's likely to kill them seems extremely unethical.

But I guess few doctors get punished for being overcautious in this way.

[Mick F]

If you read it like it's actually written, and separate it out a bit ...............

1. If you have a family history of heart disease or sudden death
or
2. have a high risk from high cholesterol
or
3. high blood pressure but particularly if you have symptoms of heart disease

............... continuing to ride with these symptoms may shorten your cycling career catastrophically!

Now, what is he saying?

For me:
1. No
2. Yes
3. Yes for high BP but No for heart disease.

[Psamathe]

...
But I guess few doctors get punished for being overcautious in this way.

I wonder if it is Drs being overcautious or the public effectively/indirectly demanding it (or their insurance companies based on the behaviour of the public). In the UK we seem to be ever more demanding of medical outcomes where when something does go wrong there are so often demands for public enquiries, demands the practitioner be struck-off, demands for the hospital board to be sacked, etc. Of course there are situations where such checks are appropriate, but the situations where such follow-up actions are demanded by grieving/impacted relatives seems to be getting ever more routine.

If I were a medical practitioner these days I would be overcautious as well - or one person behaving stupidly could end my career.

Ian

[Psamathe]

If you read it like it's actually written, and separate it out a bit ...............

1. If you have a family history of heart disease or sudden death
or
2. have a high risk from high cholesterol
or
3. high blood pressure but particularly if you have symptoms of heart disease

............... continuing to ride with these symptoms may shorten your cycling career catastrophically!

Now, what is he saying?

For me:
1. No
2. Yes
3. Yes for high BP but No for heart disease.

The originally quoted advice included a "see your GP". I can't find the original advice on the internet (but only a brief search - all I could find was https://www.prudentialridelondon.co.uk/training/staying-healthy/medical-advice/ which does say

Fit to compete

Cycling is good for the heart but in any strenuous endurance event there are occasionally fatalities from serious heart disease in athletes apparently unaware that they had a problem. Their condition may have been detected if they had had medical advice and the relevant heart tests. A ‘fitness test’ is not sufficient to detect these problems.

If you have a family history of heart disease or sudden death, or have a high risk from high cholesterol or high blood pressure but particularly if you have symptoms of heart disease, such as chest pain or discomfort on exertion, sudden shortness of breath or rapid palpitations, see your GP who will be able to arrange for you to have a proper cardiac assessment.

Such an assessment may not be instantly available, but continuing to ride with these symptoms may shorten your cycling career catastrophically!

I don't know if that was the source of the original quoted advice but in what I found I think the 1st paragraph puts the advice in context (the paragraph starting "Cycling is good for the heart ...".

And from your previous posts in other threads I understood that you had seen your GP and I assume given the OK to keep riding (following tests ?).

Ian

[Mick F]

Yes, I have seen my GP and I'm under a specialist at the main hospital ....................... but all that is comparatively recently.
I only saw my GP about all that after going to him because my sister had high cholesterol ......... and she only found out because her husband was given a routine screening so got her to too.

Had he not had that screening, my sister wouldn't have been tested, and I wouldn't have known anything.
At present, I'm not on any statins.

I'm as fit as a flea.
No-one would DARE tell me not to cycle.

I'm on meds for high BP but they are making me tired and lethargic ........ well, I think it's them that's doing it ............ so for the past few days I've not taken anything, and I feel SO much better. I'll give it a few more days, then get back onto them again and see if I go downhill. If I do, it'll be yet another drug that they've given me that will go in the bin.

[Psamathe]

...
No-one would DARE tell me not to cycle. :shock:
...

My impression is that the Ride London advice is not telling people not to ride. It is telling them that if they have certain symptons they should see their GP.

Ian

[mjr]

My impression is that the Ride London advice is not telling people not to ride. It is telling them that if they have certain symptons they should see their GP.

It's telling them they may die unless they stop cycling if they have certain symptoms or risk factors until they've seen their GP. The source of the quote is the "final instructions" paperwork sent to participants a week or so ago. Some people aren't going to get a GP appointment that quickly and the general NHS advice is for people with high cholesterol to exercise more (within reason), not less. Ride London's medical director seems to be badly off-message.

As I've mentioned before, I feel there seem to be more and more attempts to stop "sickies" from participating in large cycling events: as well as the widespread bans on electric-assist, recumbents and trikes (actually, RL is one of the few to allow some recumbents and trikes, as long as you can fit one of the approved handlebars), there are also things like "good health" conditions of entry and now this scaremongering.

I know you've written about everyone needing a medical certificate for certain events in France, but that's a term of entry applied to everyone, not a discriminatory scare-away tactic only used against long-term illnesses.

[georgew]

I'm on meds for high BP but they are making me tired and lethargic ........ well, I think it's them that's doing it ............ so for the past few days I've not taken anything, and I feel SO much better. I'll give it a few more days, then get back onto them again and see if I go downhill. If I do, it'll be yet another drug that they've given me that will go in the bin.

Good for you and more power to your elbow.

What size was your Mercian again?

[Mick F]

Hey, it's in my will that it'll get buried with me.
You can have the Moulton instead.

[NATURAL ANKLING]

Hi,

If you read it like it's actually written, and separate it out a bit ...............

1. If you have a family history of heart disease or sudden death
or
2. have a high risk from high cholesterol
or
3. high blood pressure but particularly if you have symptoms of heart disease

............... continuing to ride with these symptoms may shorten your cycling career catastrophically!

Now, what is he saying?

For me:
1. No
2. Yes
3. Yes for high BP but No for heart disease.

You've ticked two boxes......................without meds you will probably die 10-20 years earlier like my father did after a visit to the little boys room.................not a joke.

[Mick F]

Two boxes?
Good Grief, I should go and sit in a darkened room and lie down.

My point, is that unless you actually have any evidence/facts about these "boxes", you would say "No" to them all.
Therefore, how can anyone know what their risks are?
We are all living in Cloud Cuckoo Land knowing absolutely nothing about our health ............ even as fit as we feel we are.

I'm furnished with info about my body and my cardiology, and therefore I know the risks associated with this info.

Knowing something, is better than knowing nothing ..................... and most people know nothing.