27th April 2024, A/Prof Chee L Khoo
PAD is associated with a high incidence of future lower-limb amputations, physical disability, cardiovascular outcomes, other serious health outcomes, reduced quality of life, and mortality (3–8). Some GPs are lucky to have tool that can easily perform ankle brachial index (ABI) as part of a cardiovascular assessment. It is a very simple tool that can detect peripheral arterial disease (PAD).…
31st March 2024, A/Prof Chee L Khoo
In case you have not noticed, there was some disquiet in the cardiovascular community this week on the potential harm intermittent fasting can cause. The headline presentation says “8-hour time-restricted eating linked to a 91% higher risk of cardiovascular death”. Well, any study regarding “diets” are always going to be sus.…
28th March 2024, A/Prof Chee L Khoo
We all know that high LDL-C is absolutely and adversely associated with cardiovascular mortality and morbidity. It’s been “proven” again and again in large clinical trials and meta-analyses after meta-analyses. Reducing lipids levels have also been shown to reduce cardiovascular (CV) events in secondary as well as in primary prevention. This is particularly the case in those with intermediate to high CV risks.…
10th March 2024, A/Prof Chee L Khoo
Myocardial infarction in a patient with minimal coronary artery disease (stenosis <50%) is increasingly being recognised in patients with myocardial injury but no significant coronary obstruction is demonstrated. Myocardial Infarction in Non-Obstructive Coronary Arteries (MINOCA) accounts for approximately 5-10% of all myocardial infarction. The precise pathogenesis is poorly understood. Diagnosing MINOCA is not straightforward and identifying the aetiologies and ongoing management can be challenging.…
24th February 2024, A/Prof Chee L Khoo
We all know how important it is for BP control in prevention cardiovascular, cerebrovascular and renal complications. We are also aware of the difficulty is improving medication adherence. We have a broad range of effective BP lowering medications covering diverse classes of medications. Anti-hypertensives work only if our patients take them regularly.…
24th February 2024, A/Prof Chee L Khoo
In May 2022, the US Preventative Services Task Force (USPSTF) recommended that we avoid routine aspirin for primary prevention of CVD for anyone at all (1). In particular, for those between 40–59-year-old with a 10-year CVD risk 10%, the decision to initiate aspirin for the primary prevention should be an individual one as the evidence of the net benefit of aspirin use in this group is small.…
11th February 2024, A/Prof Chee L Khoo
Hypertriglyceridaemia (HTG) often accompanies hypercholesterolaemia but that is often ignored as it is considered to be a minor villain. Older clinical trials on lipid lowering agents excluded subjects with HTG and that is partly why the significance of HTG is often ignored. The interplay between HTG and atherosclerotic cardiovascular disease (ASCVD) is real but extremely complicated.…
13th January 2024, Conjoint A/Prof Chee L Khoo
Amiodarone started life as an anti-angina drug but it’s used primarily for its anti-arrhythmic properties these days. That’s not because it is such a good anti-arrhythmic agent (AAD) but because there just aren’t that many good and safe anti-arrhythmic agents around. We are all aware of amiodarone’s thyroid effects (hypo or hyper) and we monitor them closely as long as they are on amiodarone.…
13th January 2024, Conjoint A/Prof Chee L Khoo
When we think about extreme physical activity (EPA) such as marathon running, apart from the perceived issue of wearing out knee and hip joints (that’s another issue, another day), we think about the cardiovascular risks or benefits that comes with this intense physical activity. We explored the issue of marathon running and cardiovascular risks 9 months ago here.…
27th December 2023, A/Prof Chee L Khoo
When we think about extreme physical activity (EPA) such as marathon running, apart from the perceived issue of wearing out knee and hip joints (that’s another issue, another day), we think about the cardiovascular risks or benefits that comes with this intense physical activity. We explored the issue of marathon running and cardiovascular risks 9 months ago here.…
27th December 2023, A/Prof Chee L Khoo
Not surprisingly, if dysglycaemia is the major contributor to microvascular complications in type 2 diabetes (T2D), the same complications must plaque our patients with type 1 diabetes (T1D. However, we haven’t had many major advances in the management for chronic kidney disease (CKD) and cardiovascular disease (CVD) in patients with T1D for decades.…
12th December 2023, NIA Diagnostic Imaging
One of the standout diagnoses I remember from medical school is renal artery stenosis. In practice, it is usually someone else that makes that diagnosis. It is not that uncommon. We may hear an abdominal bruit in our general vascular screen. We might struggle to get our patient’s BP to target despite the 4th or 5th agent.…