Providing independent clinical excellence since 2005
Detecting coronary calcification on CT has been known as a sign of having coronary artery disease for over 30 years, but now the thinking has changed, and it might be logical to conclude that, if you have non calcified coronary artery disease, the best you can hope for is a strategy that calcifies your plaque!
Recognition that significant coronary artery disease exists without calcification led to the wider user of contrast-enhanced CT scans to detect both calcified and noncalcified plaques. Even more advanced scans identify not only the non calcified plaques, but also areas of inflammation (using data processing to measure FAI), that a non-contrast CT (such as a CAC scan) would otherwise miss. Sequential CAC to follow up disease progression quickly established that an increase in CAC with age was inevitable in most patients and not linked to clinical course, so is not widely practiced.
Diastolic heart failure (often referred to as 'Heart failure with preserved Ejection Fraction' or 'HFpEF') arises from ventricular stiffening due to age, hypertension, and various other rarer heart conditions. The aging component of this process is unavoidable, but maintaining optimal blood pressure through midlife is achievable and, if successful, should prevent additional left ventricular stiffening attributed to hypertension. By regularly monitoring blood pressure and using effective medication, we can help patients live longer with healthier hearts.
Grip strength measurement reveals cardiovascular risk more accurately than traditional markers by reflecting muscle function as endocrine organ. Declining strength drives coronary disease through inflammatory pathways. Progressive resistance training provides powerful cardiovascular protection.
In this guide, we will explore a multifaceted approach involving increased physical activity, dietary modifications, and consistent monitoring to effectively lose fat and enhance overall health.
Lp(a) testing is advised for individuals at high risk for cardiovascular disease, including those with a prior stent or bypass operation, coronary syndrome or heart attack as well as anyone with a family history of coronary heart disease, high FAI (coronary inflammation) or high risk patterns on Cardiac CT angiograms. In our practice, Lp (a) is offered as part of our comprehensive Metabolic Health assessment (MHA1).
Continuous glucose monitors are transforming diabetes care, but their insights may extend far beyond diabetic patients. Evidence suggests that post-meal glucose spikes and glucose variability may influence cardiovascular health. While definitive trials are still needed, CGMs offer a practical tool to help patients understand metabolic responses and adopt healthier dietary and lifestyle habits.
Numerous epidemiological studies have supported the hypothesis that high homocysteine levels are a risk factor for cardiovascular diseases. For example, the Framingham Heart Study demonstrated that individuals with homocysteine levels in the top fifth percentile had a nearly doubled risk of developing coronary artery disease compared to those with levels in the bottom 80 percent.
The medical understanding of a "heart attack" can sometimes diverge from the layperson's perception. Many people interpret a heart attack as any acute, potentially fatal cardiac event, regardless of its cause. This discrepancy necessitates a deeper exploration of heart attack causes unrelated to coronary artery disease, particularly for understanding familial risks and discussing preventative measures like statins.
With growing public awareness and knowledge, there is an understandable and increasing interest in patients employing self help techniques to look out for AF episodes. After all, it is hardly going to be possible to obtain an ECG from your GP every time you feel a slightly irregular pulse.
Bempedoic acid offers a new avenue for patients who require an alternative to statins for managing high cholesterol. Its liver-specific action and excellent safety and side effect profile make it a valuable addition to available treatments we can use to combat high LDL cholesterol levels to reduce coronary inflammation and stabilise high risk coronary plaque.
While aiming for the lowest possible blood pressure without experiencing adverse effects, individuals can explore a range of non-pharmacological strategies to maintain or improve their cardiovascular health. Personalised experiments, supported by accurate home monitoring, can lead to significant insights and potentially delay or reduce the need for medication, contributing to a healthier, longer life.