The only thing i changed was setting the proccessaffinitymask setting. I tweaked my GPU settings too at some point but i always reverted everything to default after exiting the sim. My results are similar to the OP's, i sat and waited for the patches and now the sim runs fine for me on a two year old PC:
i7 920 @ 2.7 Ghz
Asus P6T motherboard
3GB of DDR3 RAM in triple channel (yes, just three)
Ati 4890 1GB
I run it at 1680x1050
model detail, effects, damage decals and land shading high
building detail low
SSAO off
Vsync, roads, shadows and grass on
the rest on medium
After the last beta patch i actually capped my framerate (it's limited to 60 FPS because i use Vsync on a 60Hz monitor) for the first time. Super smooth, barely a bit of loading here and there but it recovers so fast that it's perfectly playable (ie, it doesn't pause long enough to stutter, it might just skip a frame or two when first loading a certain effect or texture when i'm in zoomed view).
My issue was my GPU wasn't clocking to full speeds, the latest beta patch fixed this for me.
As a a routine, i delete the contents of the cache folder after applying each patch and go fly. Each and every single patch, beta or not, has been an improvement over the previous one on my system. I was getting 15 FPS over water when i first installed the sim back in April, now i'm getting 40-60 with a bunch of aircraft flying and shooting.
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