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Private Cardiology

Improving your heart health

Dr Alamgir Kabir

MBBS BSc(Hons) FRCP PhD

Consultant Cardiologist

GMC No 4308173

email:[email protected]

Telephone 07518 082 240 outside the UK 00447518 082 240

My Blog

Blog

High intensity exercise programs

Posted on July 23, 2016 at 1:32 PM Comments comments (861)
There has been increasing evidence for high intensity training in terms of changing and improving your metabolism in terms of insulin resistance. This may have benefits in terms of improving you metabolic profile over the long term.
How does it work?
20 secs of maximal effort in between normal steady paced exercise for three interval that's it.... three times a week.
This may be of benefit but has to be taken in context. Weight reduction is aided by exercise. The mental and physical benefits of exercise are well documented. This is not an alternative but may be incorporated into an exercise program. Remember before starting a high intensity exercise program have a chat with your doctor if you are not used to exercise.
Also weight reduction in overweight patient's is an important part of improving overall health, but remember diet is far more important than exercise.

Statins

Posted on June 17, 2014 at 9:46 AM Comments comments (63)
Statins are a class of medicine that lower cholesterol. Drugs such as simvastatin, rosuvastatin or atorvastatin may be familiar to some. Cholesterol is a key component in causing furring up of the arteries that can lead to heart pains and even heart attacks.
There has been some recent news about who should need a statin, indeed should more of the population take them? What about the side effects?
The answer is to look at the individual patient and assess their individual risk profile. Then decide together if a statin is necessary. There are other measures that reduce your cholesterol risk, such as exercise (increasing the good cholesterol: HDL). Diet may help to a certain extent. Also looking at the whole patient to see if the other risk factors for heart disease can be reduced is very important, such as blood pressure, smoking and weight reduction. See your doctor to find out your risk. Remember prevention is better than cure.

Smoking

Posted on May 26, 2014 at 2:43 PM Comments comments (135)
Smoking is one of the single biggest risk factors for heart disease and stroke. The numbers of smokers is reducing thankfully. This does mean that the remainder of smokers are the more 'hardcore' smokers who are less likely to quite. The fact remains that qutting at any point in your life is of benefit.
There are a number aids to stopping, counselling, patches, gum and even electronic cigarettes. There has been some controversy about the use of these are the amount of nicotine may be unregulated. There is however some good evidence that they increase quitting rates.
Whatever you do, whatever it takes,  just do it just stop.

unsaturated or saturated fats

Posted on March 19, 2014 at 5:32 PM Comments comments (88)
There has been a recent trial looking at the presumed benefit of polyunsaturated fat versus saturated fats (like butter). The trial suggests that there is no benefit from polyunsaturated fats like olive oil. Don't panic. I think the basic message is still the same. Portion discipline and regular exercise still apply. Moderation is the key. Simply follow the same old advice such as fruit and veg regularly, If you do decide to go back to butter as opposed to margarine with polyunsaturated fat, just remember moderation is the key.

Diet and cardiovascular health

Posted on March 2, 2014 at 5:45 AM Comments comments (119)
Supplements and heart health.
Health supplements are promoted to help cardiovascular health. There has been a recent large analysis looking at the benefit of health supplements and cardiovascular health. The results seem to suggest that there is no benefit from these over the counter health supplements. Multivitamins do not seems to prevent cardiovascular events such as heart attacks. (USPSTF Annals of internal medicine Feb 2014).
Having a healthy diet and taking regular exercise are the key to reducing your risk of heart disease.
A further recent study has shown that having a vegetarian diet cuts your blood pressure. This is an association and the other aspects of being vegetarian such as lower body weight and cholesterol may play a part in the mechanism. Nevertheless being vegetarian does lower you blood pressure which is a major factor in development of heart disease (JAMA Internal Medicine Feb 24 2014).
So try just eating a healthy diet, get rid of the supplements and if you can cut out the amount of meat in your diet.

Four rules for exercise

Posted on February 21, 2014 at 1:05 PM Comments comments (60)
1. Gradually build up the intensity to avoid injury.
2. Vary what you do to avoid boredom-- walking, sitting up, bowls it does not matter.
3. Like a medicine take exercise regularly.
4. Start now and make it part of your daily routine.
 
 
Forming a habit of exercising is a lifelong gift. If I could prescribe it I would. Make exercise your medicine before you need to start taking medicine.

Diabetes and extra virgin olive oil

Posted on January 7, 2014 at 4:53 PM Comments comments (95)
A recent trial in the Annals of Internal Medicine looked at the role of a Mediterranean diet in reducing the onset of type 2 diabetes. It seems to suggest that eating this type of diet which is especially high in extra virgin olive oil  (50ml/day) in some way prevents the onset of diabetes. The benefit was a 30% risk reduction in developing diabetes compared to controls who were on a low fat diet. The diet was relatively low in dairy products and low in carbohydrate content.
Although the mechanism of how the Mediterranean diet reduces the onset of diabetes is not completely understood it may be related to the relatively low carbohydrate content and the prevention of insulin resistance.
This is not conclusive evidence but it does suggest that a Mediterranean diet is better for us and in particular reducing the carbohydrate content in our diets is a good thing.
 
Reference
Ann Intern Med January 6 2014 http://annals.org

high blood pressure

Posted on September 9, 2013 at 5:58 PM Comments comments (342)
High blood pressure is a major risk factor for heart disease and strokes. As we age blood pressure can become more likely. The major problem with blood pressure is that we can have it without feeling any ill effects and therefore be undiagnosed for years. So it is really important to get is checked if you think you could be at risk-- a simple check by your family doctor or practice nurse or even at the local pharmacy is a start.
Blood pressure readings above 140/90 mmHg indicate some degree of high blood pressure. Blood pressure can be labile and subject to large swings so it is important to get it checked a number of times before confirming the diagnosis.
Above the age of 40 we usually consider that it is related to essential hypertension, in other words it has no underlying cause. Below this age there could be a secondary cause that may need investigation by a specialist.
Things that you can do to bring your blood pressure down
1. Worry less. Anxiety and stress does almost certainly have an effect on your blood pressure. Try simple relaxation techniques.
2. Exercise more. Gentle exercise can lower blood pressure by reducing what is known as peripheral vascular resistance.
3. Reduce your weight. This again has an effect on peripheral vascular resistance which in term can reduce blood pressure.
4. Reduce your salt intake. There is good evidence that even modest reduction in salt intake can help to reduce blood pressure.
5. Stop smoking and drink less alcohol as both of these factors increase blood pressure.

Diabetes and heart disease

Posted on August 31, 2013 at 4:57 PM Comments comments (635)
The number of people with diabetes is growing. The likelihood of developing in particular type II diabetes goes up if you have relatives with the condition. It is also associated with having a higher body mass index (BMI) (greater than 27). If you have a family history, it is better to keep your BMI low as you get older. The lower the better, some have argued that between 23 and 25 is better.
The reason that diabetes affects the heart is that it makes the blood vessels, the coronary arteries more likely to develop atheroma (fatty deposits blocking up the arteries). This can lead to angina and is some cases an increased risk of heart attacks.
Prevention is better than cure. It is worth checking with your family doctor if you have diabetes by doing a simple blood test. It can also pick up impaired glucose tolerance which may be a forerunner of developing diabetes. If you have impaired glucose tolerance and are in the diet controlled diabetic group it is more important to keep your weight down. There is good evidence that reducing your weight can reduce the likelihood of developing diabetes or at least delay the onset.
1.Check your BMI.  BMI calculator
2.If you think you may be at risk of diabetes get it checked
3.Consider reducing your BMI by diet and exercise if you are at risk
 

Risk factors for heart attacks

Posted on August 21, 2013 at 1:53 PM Comments comments (101)
There are traditionally five main risk factors for artherosclerosis (furring up of the blood vessels that can lead to angina and heart attacks)
 
1. high blood pressure
2. smoking
3. high cholesterol
4. a family history of heart disease below the age of 60
5. a previous heart attack
 
addressing the ones you can modify is important
1. checking and if necessary reducing your cholesterol (usually less than 4.8mmol/l)
2. checking and if necessary reducing your blood pressure (usually to less than 135/85mmHg)
3. stopping smoking ( www.smokefree.nhs.uk is a useful resource)
 
prevention is better than cure!

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