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by sliverstorm 4656 days ago
It sounds to me like your father's issue was not that he was not white, but that he had a rare genetic condition...

There was even a study that found on the whole, simvastatin is equally helpful across races: http://www.ncbi.nlm.nih.gov/pubmed/16709304
1 comments
dnautics 4656 days ago
Oh, it reduces his cholesterol level[0]. But he has at least one allele that increases the risk of myopathy when taking simvastatin (Assuming there were no milkmen - I do look quite a bit like him - I'm homozygous, and this allele is not terribly rare).

The part about being asian is that asians tend not to catabolize statins as effectively, so his plasma levels are probably higher, since I found out he was taking a full "white person dose" despite advisories that simvastatin should be given at half dose for asians.

[0]I also recall hearing somewhere from a biochemist that while statins decrease cholesterol levels in asians the effect on coronary heart disease (which is what your really care about) is attenuated, and that there may be a secondary mechanism for CHD in asians... But I cannot find the source he was quoting.

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dnautics 4656 days ago
ah, I found it, after all these years:

http://www.ncbi.nlm.nih.gov/pubmed/21160131

as a bonus, here is the review on why asians should take less statins (hepatic enzyme clearance, probably a cyp450):

http://www.ncbi.nlm.nih.gov/pubmed/17261409

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sliverstorm 4656 days ago
That's not a consequence of being non-white so much as it is a consequence of your doctor being uninformed, which impacts people of all races.

I'm not saying it doesn't suck, I just take issue with your narrative of how race is the issue at hand, and how the medical system is bigoted towards minorities.

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dnautics 4656 days ago
It's not just the medical system. It's just reality. I live with it. I'm okay with it. I'd just rather not these disparities be magnified and exacerbated by universalizing something which shouldn't be.

>That's not a consequence of being non-white so much as it is a consequence of your doctor being uninformed, which impacts people of all races.

But it impacts minorities in the most general sense (i.e. not just color of skin) more than non-minorities. For fundamental reasons, studies are less statistically reliable, for starters.

I should remind you also that my father is being cared for under a universal system (the VA) I think that the unversality of it does play into the way that the doctors are informed.

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