Comment by KempyKolibri
24 days ago
Because medication is more effective. Side effects from statins are relatively uncommon and generally mild, so it wouldn’t be ethical to use lifestyle as a first-line treatment in place of, say, a combination of low dose statin and pcsk9 inhibitors.
However many clinicians do take a “let’s sort out the problem as quickly as possible with medication, and if you want to try lifestyle and back off (or even stop entirely) the meds and see how your cholesterol is afterwards, we can do that.”
This seems like a good balance to me.
Wait isn’t this the other way around?
In reality lifestyle modifications are more conservative than using a medication so lifestyle modification would be first line from an ethical perspective.
In reality though it does seem like statins are used first line by many clinicians. But ethically speaking conservative interventions like lifestyle modification in terms of changing diet and exercise should be used prior to medicating a young otherwise healthy person.
In other groups such as when someone has had a recent heart attack of course the thought process is different. Such people should be immediately placed on a statin.
No, because we have a huge body of evidence pointing to both the safety and efficacy of lipid lowering medications. We know that as far as LDL-c goes, the lower the better, so since we have safe drugs that lower more effectively than lifestyle interventions, these are the first line option in most cases.
This isn’t true in the slightest.
Lifestyle is more effective and has less side effects.
Lifestyle is the first line of treatment, with meds being a later line of action.
What’s the evidence that lifestyle intervention is more effective than combination medication therapy?