Bad advice on high cholesterol from Ride London

[Psamathe]

...
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.

True, but for the event [Ride London] they are giving advice to people who have symptoms or are aware of risk factors.

As to general screening, probably beyond the remit of Ride London, but it is something that does seem to be happening once you get over a certain age. In my case I felt it was a waste of time but went anyway. However, I guess for those where potential risk is identified it allows them to modify their lifestyle or get treatment. Only aware of this from personal experience so I'm not sure how widespread it is although I understand it is a national policy/scheme.

Ian

[bigjim]

I thought they had changed their ideas about cholesterol levels. Trouble is that everybody seems to be treated the same though some people may do fine on either high cholesterol or blood pressure etc because that is how their body works. I have always had quite high blood pressure and highish cholesterol. I have never been prescribed any medication for either. I've recently been for an exercise stress test on my heart as I was experiencing chest pains. Informed today, cardiologist says there is nothing wrong with me and has removed me from his list. No meds required.

[Vorpal]

I've recently been for an exercise stress test on my heart as I was experiencing chest pains. Informed today, cardiologist says there is nothing wrong with me and has removed me from his list. No meds required.

My former roommate had a mystery chest pain. It took a while, but he eventually found out that it was referred back pain.

[bigjim]

I've recently been for an exercise stress test on my heart as I was experiencing chest pains. Informed today, cardiologist says there is nothing wrong with me and has removed me from his list. No meds required.

My former roommate had a mystery chest pain. It took a while, but he eventually found out that it was referred back pain.

Cardioligist suggested it may be my position on the bike. he is a very keen cyclist. Not had it for a while though. can see the connection with the back.

[pete75]

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.

Professor Sharma knows a damn sight more about this than you do.

https://www.stgeorges.nhs.uk/people/pro ... ay-sharma/

From 1996 to 2001 Professor Sharma was a consultant cardiologist and physician at University Hospital Lewisham. He then moved to the role of director of heart muscle diseases at King's College Hospital from 2001-2007.

In 2007 he became a professor of inherited cardiac diseases in sports cardiology, before in 2010 becoming consultant cardiologist for Cardiac Risk in the Young, a charity that promotes awareness of SADs.

Since 2001 Professor Sharma has been the medical director of the Virgin London Marathon, the Silverstone half-marathon, the BUPA 10k run and the Adidas Women's 5k run. He is also cardiologist for the Lawn Tennis Association, the British Rugby Union and the English Institute of Sport Congress.

[Mick F]

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.

I stopped the meds last Sunday and was feeling absolutely fine. Last tablet Saturday.
I took another tablet yesterday morning (Thursday) so that was four tablets not taken.
By mid afternoon, I felt low and miserable, lethargic and almost zombi-like. Rotten night's sleep too.
I had intended to carry on taking them for a few more days, but there is now way on God's Earth that I'll be taking another.

.......... it'll be yet another drug that they've given me that will go in the bin.

I'll try and get another appointment with the doc, and discuss the way ahead. Meanwhile I have an appointment next month at the hospital regarding cholesterol so I may leave it until after then.

[pete75]

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.

I stopped the meds last Sunday and was feeling absolutely fine. Last tablet Saturday.
I took another tablet yesterday morning (Thursday) so that was four tablets not taken.
By mid afternoon, I felt low and miserable, lethargic and almost zombi-like. Rotten night's sleep too.
I had intended to carry on taking them for a few more days, but there is now way on God's Earth that I'll be taking another.

.......... it'll be yet another drug that they've given me that will go in the bin.

I'll try and get another appointment with the doc, and discuss the way ahead. Meanwhile I have an appointment next month at the hospital regarding cholesterol so I may leave it until after then.

Have they given you beta blockers Mick? I was taking those for blood pressure and had similar symptoms to those you describe. Changed to ACE inhibitors and everything fine.

[mjr]

Professor Sharma knows a damn sight more about this than you do.

Nice appeal to authority. His qualifications don't make him infallible and a lot of very qualified people will even now tell you that statins are almost completely without side-effects (for example), but I'd suggest that the official NHS advice on high cholesterol is a damn sight better than one Professor's freelance writing.

[pete75]

Professor Sharma knows a damn sight more about this than you do.

Nice appeal to authority. His qualifications don't make him infallible and a lot of very qualified people will even now tell you that statins are almost completely without side-effects (for example), but I'd suggest that the official NHS advice on high cholesterol is a damn sight better than one Professor's freelance writing.

A fine example of Gove like dismissal of expert knowledge.

His qualifications might not make him infallible but they, along with his experience show he knows much more about this than you.

Your posts on this might have more credibility if you'd fully quoted what he wrote on the ride London website rather than editing it to suit your argument. What he says is, to this lay person, sound advice.

"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!"

[Psamathe]

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.....

Although virtually the same advice (slightly different wording) is on their web site which I assume has been available for a lot longer (thereby giving those with symptoms or risk factors time to have them checked).

Ian

[mjr]

A fine example of Gove like dismissal of expert knowledge.

Surely it's more Govey to cling steadfastedly to one expert and ignore that the peer-reviewed expert advice says the opposite? Which is what you're doing.

His qualifications might not make him infallible but they, along with his experience show he knows much more about this than you.

Never mind me. Does he know more than the NHS?

Your posts on this might have more credibility if you'd fully quoted what he wrote on the ride London website rather than editing it to suit your argument.

The website was not the source. The only reason I didn't type the irrelevant bits off the paper source was that I felt they were irrelevant.

Even the text you quote (but didn't link to!) is essentially bad advice, contrary to the official NHS advice, for people with high cholesterol that I linked earlier.

[pete75]

A fine example of Gove like dismissal of expert knowledge.

Surely it's more Govey to cling steadfastedly to one expert and ignore that the peer-reviewed expert advice says the opposite? Which is what you're doing.

His qualifications might not make him infallible but they, along with his experience show he knows much more about this than you.

Never mind me. Does he know more than the NHS?

Your posts on this might have more credibility if you'd fully quoted what he wrote on the ride London website rather than editing it to suit your argument.

The website was not the source. The only reason I didn't type the irrelevant bits off the paper source was that I felt they were irrelevant.

Even the text you quote (but didn't link to!) is essentially bad advice, contrary to the official NHS advice, for people with high cholesterol that I linked earlier.

So it's essentially bad advice to recommend that people who may have heart problems to get their heart checked before they engage in what may be unaccustomed exertion? Could you find an expert who disagrees with this?
He's not saying someone with those symptoms or conditions shouldn't cycle but that it might be advisable to have a medical check first. People with high cholesterol levels may have heart disease that they're unaware of. No harm in them making sure they haven't. What is your objection to this?

I didn't link to it because someone else did further up in this post - do try and keep up

[Mick F]

Have they given you beta blockers Mick? I was taking those for blood pressure and had similar symptoms to those you describe. Changed to ACE inhibitors and everything fine.

I have a touch of asthma, and beta blockers aren't so good for asthmatics I believe. I'll see what the doc says.

Firstly, they gave me Ramipril - an ACE inhibitor. They gave me the lowest dose for a couple of weeks, then doubled it. Within three weeks of starting on the low dose, I was ill and tired, and lethargic and headaches, and feeling generally crap. My BP didn't drop much at all even when they doubled it.

They then put me on Amlodipine - calcium channel blocker. These have worked a treat. BP normal, even for my age.
Trouble is, towards the end of the first packet of 28, I began feeling like I did with the Ramipril. I experimented in not taking them for four days and I felt wonderful again. Yesterday, I took one more, and by mid afternoon, I was feeling rubbish. I was ready for bed by 8pm but couldn't sleep. I eventually dropped off around 11pm but was awake at 01:30 so got up for a cuppa and back to bed an hour later, and got up at 05:30.

Steadily, all day, I've been feeling better. Just come in from a spot of gardening, and feeling just about ok and normal (whatever that is)
Goodness knows what my BP is now, but no doubt it's steadily increasing.

It seems that my BP is proportional to the way I feel. The higher it is, the better I feel.

[mjr]

So it's essentially bad advice to recommend that people who may have heart problems to get their heart checked before they engage in what may be unaccustomed exertion?

No, it's essentially bad advice to recommend that people who have high cholesterol get their heart checked before they continue cycling - I've marked where I'm talking about something different to you in bold, so now you try and keep up

He's not saying someone with those symptoms or conditions shouldn't cycle but that it might be advisable to have a medical check first.

He actually says that people shouldn't cycle until checked because "continuing to ride with these symptoms may shorten your cycling career catastrophically!" which is just BS. If you've only got high cholesterol, moderate exercise will almost certainly help.

People with high cholesterol levels may have heart disease that they're unaware of. No harm in them making sure they haven't. What is your objection to this?

He's trying to scare hypercholesterolaemiacs into stopping exercise unnecessarily until they can get a GP appointment. Both stressing hypercholesterolaemiacs and stopping them cycling are unethical.

[pete75]

Have they given you beta blockers Mick? I was taking those for blood pressure and had similar symptoms to those you describe. Changed to ACE inhibitors and everything fine.

I have a touch of asthma, and beta blockers aren't so good for asthmatics I believe. I'll see what the doc says.

Firstly, they gave me Ramipril - an ACE inhibitor. They gave me the lowest dose for a couple of weeks, then doubled it. Within three weeks of starting on the low dose, I was ill and tired, and lethargic and headaches, and feeling generally crap. My BP didn't drop much at all even when they doubled it.

They then put me on Amlodipine - calcium channel blocker. These have worked a treat. BP normal, even for my age.
Trouble is, towards the end of the first packet of 28, I began feeling like I did with the Ramipril. I experimented in not taking them for four days and I felt wonderful again. Yesterday, I took one more, and by mid afternoon, I was feeling rubbish. I was ready for bed by 8pm but couldn't sleep. I eventually dropped off around 11pm but was awake at 01:30 so got up for a cuppa and back to bed an hour later, and got up at 05:30.

Steadily, all day, I've been feeling better. Just come in from a spot of gardening, and feeling just about ok and normal (whatever that is)
Goodness knows what my BP is now, but no doubt it's steadily increasing.

It seems that my BP is proportional to the way I feel. The higher it is, the better I feel.

Funny how different people's bodies are - it's Ramipril I changed too from beta blockers and it's fine for me. There's lots of different drugs to treat high blood pressure so you'll find one that suits you eventually. It's worth persevering hypertension can eventually cause all sorts of problems - or I'm told .