Statin Use

[Johnwen]

then it stands to reason that the higher the number of amalgams, the higher the risk.

Why do people with fewer teeth have more heart disease then?

CHD was significantly more prevalent among edentulous subjects than among the dentate population (19.8% versus 12.1%, P=0.003).

[godsilove]

then it stands to reason that the higher the number of amalgams, the higher the risk.

Why do people with fewer teeth have more heart disease then?

CHD was significantly more prevalent among edentulous subjects than among the dentate population (19.8% versus 12.1%, P=0.003).

I'm not seeing the connection with the question of whether amalgams themselves increase cardiovascular risk.

As to why edentulous subjects have higher CHD risk, there a multiple possibilities. The association could either be because these subjects had periodontitis in the past (which studies have shown to be associated with CHD), that they are more likely to be smokers, and thus at higher risk, that teeth actually cause CVD (which I think is unlikely), or some other reason.

[ofonorow]

One of Hill's criteria for causality is that there should a dose-response relationship. If amalgams increase one's risk of heart disease, then it stands to reason that the higher the number of amalgams, the higher the risk.

As just pointed out, what if they lost their teeth/amalgams? How was cardiovascular disease measured? Incidence of cardiac events? (Cholesterol levels would be more interesting). If they can easily determine whether someone has CVD, I'd like to know how they do it because we could then (finally) run objective studies. It is known that the older Amalgams are "safer", I forget the year, but the alloy after some time in the 1970s became an order of magnitude more dangerous, and how do they account for root canals?

So this inverse result is prima facie nonsense. Contrived. Again, the first thing I would look at before bothering to read the paper is the source of funding.

[godsilove]

As just pointed out, what if they lost their teeth/amalgams?

It's a valid concern, and one the researchers were aware of as they adjusted for it in the final analysis. However, one limitation of the study seems to be that they only measured number of amalgams at the baseline, although I'm only basing this on the abstract.

Altogether 1462 women aged 38, 46, 50, 54 and 60 yr were initially examined in 1968-69 in a combined medical and dental population study in Gothenburg, Sweden. Number of tooth surfaces restored with amalgam fillings was assessed. The incidences of myocardial infarction, stroke, diabetes, cancer and overall mortality were determined during a 20-yr follow-up period. Women with few amalgam tooth fillings had increased incidence of myocardial infarction, stroke, diabetes and early death compared with women with a large number of fillings. However, the significant inverse correlations between number of amalgam tooth fillings and the endpoints studied disappeared when number of teeth and socioeconomic group were included in a multivariate analysis. The study thus did not provide any evidence for a correlation between amalgam fillings and cardiovascular disease, diabetes, cancer or early death.

http://www3.interscience.wiley.com/jour ... 2/abstract

How was cardiovascular disease measured? Incidence of cardiac events?

It would appear so.

(Cholesterol levels would be more interesting).

Why? It's not a "hard" endpoint - surely, mortality and morbidity are the more important endpoints.

If they can easily determine whether someone has CVD, I'd like to know how they do it because we could then (finally) run objective studies.

They measured events - you'd need to run a fairly large study otherwise it would be underpowered to detect any statistically significant differences. Since a large trial or observational study seems unfeasible, I still think the best option would be a consecutive case-series or a placebo-controlled crossover trial, depending on the condition being treated.

It is known that the older Amalgams are "safer", I forget the year, but the alloy after some time in the 1970s became an order of magnitude more dangerous, and how do they account for root canals?

That's probably a valid question (assuming that amalgams were only measured at baseline), although even if the older amalgams were safer, one would still expect to see some effect. I simply assumed that you were refering to amalgams when you spoke of dental toxicity, because of the mercury issue. The root canal hypothesis was news to me when I read that dr. Levy suggested it as the main cause of cancer and heart disease.

So this inverse result is prima facie nonsense. Contrived. Again, the first thing I would look at before bothering to read the paper is the source of funding.[/color]

As I said before, the inverse association was there before potential confounders like socioeconomic status were taken into account. The source of funding is not given in the abstract, so I will have to look it up in the full paper whenever I get a chance to visit the library - but given the multidisciplinary nature of the study, my guess is that is some form of public funding not necessarily tied to any dental associations. I agree that the inverse result is not probable, but this is reported in the abstract as being attenuated once certain confounders were taken into account.

The null result for cardiovascular disease is confirmed by a New Zealand study, which appears to have a better design because it had access to yearly dental records (and thus a more accurate measure of amalgam exposure):

http://ije.oxfordjournals.org/cgi/conte ... 4/894#TBL4

[ofonorow]

The wish for measuring cholesterol (assuming no statin use) was to objectively verify the Levy observation (and experimental studies in animals) that cholesterol rises in humans in response to toxicity. In this case, more amalgams would probably be meaningful, (After thinking about this, probably not with all the limitations and widespread statin drug use.)

Thanks for the latest link, but rather than reading the entire paper - tell me, did they only focus on people with amalgams? It would be more interesting to know the health differences between people with and without amalgams (without I assume is a small minority of the population.).

[scottbushey]

Well,
I'm having my VAP test tomorrow. Owen, you're aware of the supplemental regimen I've been taking. I'm praying for improvement. If it comes out bad, what are my options? Should I just test fate? What would you do?

[ofonorow]

If you are not comfortable with posting the results in a public forum, send me a PM. But I am anxious to learn the results of the VAP test. For example, they break Lp(a) into 5 different categories, and the smallest (most dense) are the most atherogenic. THey do this because a high Lp(a) number - if large particles - does not necessarily represent a greater risk. Most tests just provide a total Lp(a) number. (Also, because Lp(a) varies so much in size/density, they count the number of Lp(a) particles, but report it in terms of ordinary (standarized) LDL numbers, so their numbers, again, are unlike most lab results. Closer to the idea of moles/liter.

So lets wait until we see the results before speculating how to correct something that may not be broken.