29th August 2026, A/Prof Chee L Khoo
The European Society of Endocrinology clinical practice guideline for evaluation and management of menopause and the perimenopause recommend that a holistic approach is taken for women during perimenopause and menopause, not having a sole focus on hormone replacement therapy (HRT)/ menopausal hormone therapy (MHT) (1). It recognised that these women can be appropriately managed in primary care according to recognised guidelines.…
28th August 2026, A/Prof Chee L Khoo
Atherosclerotic cardiovascular disease (ASCVD) is considered an inflammatory condition. Not only is inflammation central to the initiation of ASCVD, it is also responsible for the progression as well as the destabilisation of atherosclerotic plaque leading to ischaemia. This is in addition to the other well known risk factors (e.g. dyslipidaemia, smoking, hypertension etc) for ASCVD.…
27th July 2026, A/Prof Chee L Khoo
We are used to keeping patients on dual anti-platelet therapy (DAPT) usually consisting of aspirin and clopidogrel for 12 months following percutaneous coronary intervention (PCI) to prevent stent thrombosis. 12 months can pass quickly and we are supposed to revert these patients back to either aspirin or clopidogrel monotherapy after the 12 months but we may forget and these patients are on DAPT longer than the recommended 12 months.…
12th July 2026, A/Prof Chee L Khoo
We don’t see many acute pancreatitis in our rooms but the incidence of acute pancreatitis is gradually increasing (1). Many will develop further episodes and some will develop chronic pancreatitis. Although most patients with acute pancreatitis have its mild form, some develop moderate or severe acute pancreatitis, both of which include serious complications and an increased risk for death.…
10th June 2026, A/Prof Chee L Khoo
We know that if a woman developed gestational diabetes mellitus (GDM), the risk of development of type 2 diabetes (T2D) later in life increases by 4-10 times. We also know that the same woman also have higher risk of developing elements of cardiovascular disease (CVD) including hypertension, atherosclerotic CVD ASCVD and heart failure (HF).…
25th May 2026, A/Prof Chee L Khoo
All of us have more than a few patients with essential hypertension (i.e. hypertension with no secondary causes) who remain hypertensive despite two or three anti-hypertensives. These are patients who are already on an ACE inhibitor (ACEi) or angiotensin receptor blocker (ARB) plus a calcium channel blocker (CCB) or a diuretic or both.…
23rd May 2026, A/Prof Chee L Khoo
We all know about the causal association between the so called bad cholesterol, LDL-cholesterol (LDL-C) and atherosclerotic cardiovascular disease (ASCVD). There are suggestions that apolipoprotein B (apoB) levels might be a better reflection of atherosclerotic burden. There is now emerging consensus that relying on particle number whether with LDL-C or apoB is rather too simplistic.…
24th April 2026, A/Prof Chee L Khoo
Australian and international guidelines recommend 150– 300 min of moderate physical activity (MPA), 75–150 min of vigorous physical activity (VPA), or a combination of both per week (1,2). Some people prefer slower but longer exercises while other prefer more intense for shorter periods of time. There is data suggesting that VPA leads to superior improvements in cardiorespiratory fitness, functional capacity, and several cardiometabolic risk factors compared to lower-intensity activities at equivalent volumes (3-5).…
12th April 2026, A/Prof Chee L Khoo
When we think about ischaemic heart disease (IHD), we think about obstructive coronary artery disease. Until recently, the aim of management of patients with coronary artery disease (CAD) was to treat the obstructions which cause ischaemia which is essentially what we call unstable angina. The Lancet Commission on rethinking coronary artery disease (CAD) (2025) reminded us that CAD (or should be called atherosclerotic CAD (ACAD)) starts years or decades prior to any symptoms of ischaemia (1).…
13th March 2026, A/Prof Chee L Khoo
Diabetic complications are categorised as either microvascular or macrovascular. Microvascular complications are typically associated with suboptimal glycaemic control which damages the small capillaries that supply our retina, myocardium, kidneys and feet including the long nerves. The brain, in particular, is susceptible to damage by both big and small vessels. Thus, it is not surprising that patients with diabetic retinopathy (microvascular) are likely to have a higher risk of dementia.…
24th February 2026, A/Prof Chee L Khoo
We know that suboptimal glucose control is very associated with the incidence and progression of diabetic retinopathy. The duration of diabetes, high systolic BP, smoking, lack of exercise, poor diet and depression are the other risk factors which increase the incidence of diabetic retinopathy as well as the progression of retinopathy. Sleep disorders, which are commonly observed in people with type 2 diabetes (T2D), are also significant factors that influence the development of diabetic complications [1].…
24th February 2026, A/Prof Chee L Khoo
People on shift work are at higher risk of cardio-metabolic dysfunction including cardiovascular (CV) diseases. People on rotating day and night shifts are even worse because their body has to adapt to a new time clock every couple of weeks. These people include ambulance officers, police officers and hospital doctors! Some of us may not be shift workers but are late owls.…