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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
Satisfied Customers: 10204
Experience:  14 years experience in the field of Family Practice
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3 weeks ago I had a Transient Ischeimic Attack My GP has insisted

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3 weeks ago I had a Transient Ischeimic Attack My GP has insisted that I take Statins and I have refused What can I do to make sure that I do not in 90 days time experience a full blown stroke and end up either deceased or helpless in a wheelchair?

Anthony Bray MD : Hello!
Anthony Bray MD : with a history of TIA --- you probably should be on a combination of baby aspirin 81 mg plus Plavix 75 mg/ day for the best effect to reduce risk of blood clot in artery that may lead to stroke.....
Anthony Bray MD : Good control of blood pressure is also essential to reduce your risk!! Your BP ( resting--seated position --resting ten minutes first---average of 15 or so numbers). Should be less than or equal to 135/85 and with history of TIA should be less than or equal to 130/80.... If it is without MEDS then that is fine.... If you need MEDS to bring it to this level then that is fine as well!! ( don't hesitate to use BP MEDS if needed to keep BP to 130/80 or less....
Anthony Bray MD : If you are diabetic then good control of your diabetes becomes very important to reduce risk!! Average blood sugar should be 150 or less( fasting) and hemoglobin A1C should be less than7.0....
Anthony Bray MD : your cholesterol is another significant risk factor related to risk of stroke....your "bad" cholesterol or LDL is recommended to be controlled to less than 70 mg/dL if least less than 100mg/dL if main goal can't be achieved. Now the decision to go on a statin would improve your future life expectancy ---botXXXXX XXXXXne--- 30% improvement basically in overall mortality rate...Crestor best to both raise the good cholesterol and lower bad cholesterol...if you can meet goals with very low fat diet then that is fine!!! ( most people fail to do this however...) this is just FYI for you to consider...
Customer: I am on Bendroflumethiazide 2.5 and 5mg
Anthony Bray MD : If you are a smoker then this doubles your risk of stroke each year that you continue do if this should be the case please try your best to stop!!
Anthony Bray MD : OK >> how well is your BP controlled??
Anthony Bray MD : Do you know what your cholesterol numbers were??
Anthony Bray MD : i gave targets in terms of mg /L but your units may be different ( US vs UK...)
Anthony Bray MD :
Anthony Bray MD : The favorable ratio of good cholesterol vs bad cholesterol ( HDL vs LDL) is more important than total cholesterol...
Customer: adalat60mg + clopidogrel75mg I simply do not wish to take Statins having read so much about them for a long time I do not like putting chemicals in my body at all and would find an alternative for everything if I could
Anthony Bray MD : OK the Adalat is BP med of course and clopidogrel is Plavix ( this latter one makes blood less likely to form clots )
Anthony Bray MD : Keep in mind that the cardilogists whom read the MOST on statins place themselves on these MEDS even when not essential due to the data... The benefits actually do outweigh risks for most people BUT this is your choice! :) as I said it is possible to lower cholesterol with very low fat diet( less than equal to about ten percent calories from fat ... Possible to do but not easy!!)
Anthony Bray MD : If your diet fails to adequately control cholesterol after a couple or three months or so then you might wish to reconsider statin or other med..... The most common side effect had to do with muscle pain and this occurs in about ten percent but the most serious would be liver inflammation / damage which is rate... Again overall mortality in use of statins is indeed reduced significantly overall... So to me this is the botXXXXX XXXXXne.... That is why your doctor recommended it... The muscle pain if occurred would lead to stopping med... Keep in mind that IF you decided to try statin you could always stop it if you did have any adverse effects...
Anthony Bray MD : Again I emphasize that the choice is yours--- I simply wish you to be best armed with correct information...
Customer: I need to close as I have many things to do today You seem to be in agreement with statins Many GPs are but many are notand after all the body needs cholesterol ssurely
Anthony Bray MD : As for BP as a risk factor every 20 points higher on top number( systolic) and ten points bottom number( diastolic ) there is a doubling of relative risk of heart attack/stroke over time....
Anthony Bray MD : Ok well I hope this has been helpful for you! Let me know if you have further questions!!
Customer: I am sorry did you leave because I took so long?
Anthony Bray MD : If my answers have been helpful and to your satisfaction then please remember to leave positive feedback. That would be very much appreciated! Thank You and Best Regards,
Anthony Bray MD : Anthony Bray Md
Anthony Bray MD : No I am still here!!
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