In Ireland I think people tend to wait until we end up in the A&E before they know there is a problem. That said, I also think GPs are getting better at preventative medicine. Is it true that in the USA they tend to put folk on meds such as cholesterol and blood pressure tablets at a younger age? Be interesting to know that.
Yes, I heard one of our most famous Irish authors make that remark over 20 years ago. And even then she was amazed. Unfortunately it is still the same here! However, I think things are improving as people have more information these days. But in my experience, you still have to cajole the GP! Thanks for the reply.
Hi Kathy - Like everything when it comes to HRT the answers are not 100%. The longer term follow up of the big HRT trials showed no real differences in outcomes but the trials themselves were fundamentally very flawed. HRT does improve risk factors however in some and on that basis we are quick to use them. However, we need to integrate that decision into the over CVD risk. Not a straight forward topic.
Paddy I've recently found your Twitter and subsequently Substack. Its an invaluable resource.
I've become interested in cardiology as I've developed chest pains since a single covid infection in July. My journey through consulting cardiologists has been very dismissive as I'm not what you'd consider a traditional CVD risk.
I'd be very interested in your thoughts on Covid and CVD - I know the studies are a long way from conclusive (and I'm hoping to embark on a clinical trial myself next week in Melbourne) but knowing where we stand and documenting what the current risks are would be insightful.
Hi David. I’m glad you found the content useful. Re COVID I have avoided the topic entirely as it too polarised and virtually impossible have nuanced discourse in a public setting like this. In person is far easier. I think we have a lot to learn and there is still so much uncertainty. I wish you the best in your journey and hope you find resolution soon.
Unfortunately it is true but depends on many factors including the particular chemotherapy used and also the location and dosing of radiotherapy used. We see it infrequently but it does come up.
That’s so interesting. My husband had a Wilm’s tumour as a child (age 3) and had his kidney removed. Had a year of chemo and radiotherapy. At a health check last year (age 59) he was found to have significant heart disease and required 6 stents. Never drank or smoked, keeps fit and was never overweight! I vaguely remember reading a paper about it in a medical journal many years ago but wasn’t sure if I was imagining it. Thanks for clarifying.
In Ireland I think people tend to wait until we end up in the A&E before they know there is a problem. That said, I also think GPs are getting better at preventative medicine. Is it true that in the USA they tend to put folk on meds such as cholesterol and blood pressure tablets at a younger age? Be interesting to know that.
Excellent article Dr Barrett, thank you. I'm from the US and I got put on both tablets in my 40s.
Glad you found it useful.
Yes, I heard one of our most famous Irish authors make that remark over 20 years ago. And even then she was amazed. Unfortunately it is still the same here! However, I think things are improving as people have more information these days. But in my experience, you still have to cajole the GP! Thanks for the reply.
Interesting Martina. My experience here is that the GP needs to be cajoled not to order a lot of expensive tests and meds.
Hard to know what to do these days! I suppose it all depends on your health service.
Hi Paddy,
As a lady with a strong family history of CVD, is there a benefit in taking HRT to reduce risk of CVD or is solely about symptom control?
Thank you,
Kathy
Hi Kathy - Like everything when it comes to HRT the answers are not 100%. The longer term follow up of the big HRT trials showed no real differences in outcomes but the trials themselves were fundamentally very flawed. HRT does improve risk factors however in some and on that basis we are quick to use them. However, we need to integrate that decision into the over CVD risk. Not a straight forward topic.
Paddy I've recently found your Twitter and subsequently Substack. Its an invaluable resource.
I've become interested in cardiology as I've developed chest pains since a single covid infection in July. My journey through consulting cardiologists has been very dismissive as I'm not what you'd consider a traditional CVD risk.
I'd be very interested in your thoughts on Covid and CVD - I know the studies are a long way from conclusive (and I'm hoping to embark on a clinical trial myself next week in Melbourne) but knowing where we stand and documenting what the current risks are would be insightful.
Cheers
Hi David. I’m glad you found the content useful. Re COVID I have avoided the topic entirely as it too polarised and virtually impossible have nuanced discourse in a public setting like this. In person is far easier. I think we have a lot to learn and there is still so much uncertainty. I wish you the best in your journey and hope you find resolution soon.
Thanks so much Paddy. Agree with you around the polarisation - completely understand your rationale.
Keep up the great work mate.
Great article. Any truth that chemo/radiotherapy as a child can predispose you to heart disease in your 50’s?
Unfortunately it is true but depends on many factors including the particular chemotherapy used and also the location and dosing of radiotherapy used. We see it infrequently but it does come up.
That’s so interesting. My husband had a Wilm’s tumour as a child (age 3) and had his kidney removed. Had a year of chemo and radiotherapy. At a health check last year (age 59) he was found to have significant heart disease and required 6 stents. Never drank or smoked, keeps fit and was never overweight! I vaguely remember reading a paper about it in a medical journal many years ago but wasn’t sure if I was imagining it. Thanks for clarifying.