The Skeptical Cardiologist

The Skeptical Cardiologist Unbiased, evidence-based observations on diet, testing, and procedures in cardiology.

Striving for the ultimate in preventive cardiology and for enlightened medical management of atrial fibrillation

Thoughts on a study that shows those who play racquet sports live 10 years longer than those who do no activity.
12/08/2024

Thoughts on a study that shows those who play racquet sports live 10 years longer than those who do no activity.

I had a lot of good comments on my recent pickleball post but one in particular seized my attention. I recently subscribed to the youtube channel of Cara Beth Lee (CBLeeMD), an orthopedic surgeon i…

I will be visiting a dentist in Encinitas next week and as I am sitting in the dentist's chair many skeptical thoughts w...
12/05/2024

I will be visiting a dentist in Encinitas next week and as I am sitting in the dentist's chair many skeptical thoughts will enter my consciousness

In 2016 the skeptical cardiologist wrote a two-part series that expressed doubts about the value of routine dental visits. A few days ago I shared those articles with a physician friend who had exp…

In 2019 the skeptical cardiologist wrote about a trial that he thought was practice changing. a study published in Europ...
11/25/2024

In 2019 the skeptical cardiologist wrote about a trial that he thought was practice changing. a study published in European Heart Journal in October has demonstrated that routine ingestion of BP meds at bedtime as opposed to waking results in improved 24 hour BP control with enhanced decrease in asleep BP and increased sleep-time relative BP decline (known as BP dipping.)...

In 2019 the skeptical cardiologist wrote about a trial that he thought was practice changing. a study published in European Heart Journal in October has demonstrated that routine ing…

The skeptical cardiologist has become an unbridled pickleballl enthusiast in the last year. Since my teens, I’ve had a f...
11/09/2024

The skeptical cardiologist has become an unbridled pickleballl enthusiast in the last year. Since my teens, I’ve had a fondness for all activities that involve whacking a moving ball with a racquet-type instrument, ranging from ping-pong to badminton to racquetball. Tennis was my focus for 40 or so years until a persistent pesky tennis elbow and knee pain convinced me to hang up my racquet…...

The skeptical cardiologist has become an unbridled pickleballl enthusiast in the last year. Since my teens, I’ve had a fondness for all activities that involve whacking a moving ball with a racquet…

When my dad was 70 he suffered a small heart attack, aka MI, and one of my partners performed an invasive coronary angio...
11/02/2024

When my dad was 70 he suffered a small heart attack, aka MI, and one of my partners performed an invasive coronary angiogram on him which demonstrated a long, complicated, severe blockage in his right coronary artery. The other two coronary arteries had significant blockages as well and my partner recommended that he undergo coronary artery bypass surgery (aka CABG, pronounced cabbage)....

When my dad was 70 he suffered a small heart attack, aka MI, and one of my partners performed an invasive coronary angiogram on him which demonstrated a long, complicated, severe blockage in his ri…

In a previous post, the skeptical cardiologist enthusiastically proclaimed CCTA as the ideal tool for assessing stable i...
10/07/2024

In a previous post, the skeptical cardiologist enthusiastically proclaimed CCTA as the ideal tool for assessing stable individuals for the presence, characteristics, and severity of atherosclerotic plaque (aka the atherosclerotic burden) in the coronary arteries. That CCTA-derived coronary artery disease (CAD) burden is the best clinical tool we have for determining the short and long-term risk of heart attack and stroke, the major manifestations of atherosclerotic cardiovascular disease (ASCVD)....

In a previous post, the skeptical cardiologist enthusiastically proclaimed CCTA as the ideal tool for assessing stable individuals for the presence, characteristics, and severity of atherosclerotic…

The skeptical cardiologist wrote a long post in 2017 entitled "Do Statins Cause Memory Loss? The Science, The Media, The...
10/05/2024

The skeptical cardiologist wrote a long post in 2017 entitled "Do Statins Cause Memory Loss? The Science, The Media, The Statin-Denialist Cult, and The Nocebo Effect" which was updated in 2019. If you'd rather not be bothered with the longish discussion in that post, complete with scientific references, the answer is no, statins don't cause memory loss. The FDA added a warning to the statin patient information in 2012 based on a few case reports....

The skeptical cardiologist wrote a long post in 2017 entitled “Do Statins Cause Memory Loss? The Science, The Media, The Statin-Denialist Cult, and The Nocebo Effect” which was updated …

This is a quick post to notify individuals with high lipoprotein(a) levels of a clinical trial of lepodisiran that they ...
09/19/2024

This is a quick post to notify individuals with high lipoprotein(a) levels of a clinical trial of lepodisiran that they may qualify for. I’ve written in detail about the hidden risk of lipoprotein(a), (aka Lp(a)), here and here. If you or family members have developed atherosclerotic complications at an early disease you need to be tested for it. Briefly, Lp(a) is the strongest single inherited (monogenetic) risk factor for the early development of coronary artery disease, heart attacks and strokes....

This is a quick post to notify individuals with high lipoprotein(a) levels of a clinical trial of lepodisiran that they may qualify for. I’ve written in detail about the hidden risk of lipoprotein(…

The skeptical cardiologist attempted to answer the question "Should you take a statin drug if you feel fine over the age...
09/07/2024

The skeptical cardiologist attempted to answer the question "Should you take a statin drug if you feel fine over the age of 75 years ?" in 2018. When I wrote about statins in the elderly in 2018 it was clear that very good evidence from randomized controlled trials supported the use of statin therapy for the primary prevention of nonfatal stroke and heart attack events in elderly individuals 66 to 75 years of age....

The skeptical cardiologist attempted to answer the question “Should you take a statin drug if you feel fine over the age of 75 years ?” in 2018. When I wrote about statins in the elderl…

In March of 2022 the skeptical cardiologist and his wife, (formerly the eternal fiancee') loaded half of their St. Louis...
08/27/2024

In March of 2022 the skeptical cardiologist and his wife, (formerly the eternal fiancee') loaded half of their St. Louis belongings into a green Mini Countryman and set off down the semi-lethal I-44 for Encinitas, California.* We had grown tired of cold and gloomy St. Louis winters (although they are definitely less cold and snowy these days) and the hot and humid St....

In March of 2022 the skeptical cardiologist and his wife, (formerly the eternal fiancee’) loaded half of their St. Louis belongings into a green Mini Countryman and set off down the semi-leth…

I want to make the case today that one’s cardiorespiratory fitness (CFR) should be considered a “vital sign”: akin to th...
08/09/2024

I want to make the case today that one’s cardiorespiratory fitness (CFR) should be considered a “vital sign”: akin to those measures of bodily function; temperature, blood pressure, heart rate, and respiratory rate that we routinely measure to assess our patient’s health status. Previously, on the skeptical cardiologist, I made the case that a patient’s physical activity as measured by the minutes spent in moderate to vigorous physical activity per week (MVPA) should routinely be assessed by PCPs and cardiologists…...

I want to make the case today that one’s cardiorespiratory fitness (CFR) should be considered a “vital sign”: akin to those measures of bodily function; temperature, blood pressure, heart rate, and…

Although my clinical focus is on cardiovascular health, when I give recommendations to patients on what to eat, I am con...
07/31/2024

Although my clinical focus is on cardiovascular health, when I give recommendations to patients on what to eat, I am concerned also with their overall health, well-being, and health span. Many diets give the promise of reducing specific chronic diseases but solid scientific evidence to support, say a diet that specifically targets Alzheimer's or cardiovascular disease is lacking. Fortunately, the optimal diet for reducing the risk of atherosclerotic cardiovascular disease (the cause of most strokes and heart attacks) turns out to be also optimal for weight management and is associated with a lower risk of dementia, cancer and other chronic diseases....

Although my clinical focus is on cardiovascular health, when I give recommendations to patients on what to eat, I am concerned also with their overall health, well-being, and health span. Many diet…

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