Hello XXXXXXX
Thanks for writing in.
I am a qualified and certified cardiologist and I read your mail with diligence.
Let us review risk factors for coronary artery disease at any age. Seven are modifiable and for three non modifiable no one can do much:
1. High Blood Pressure
2. High Bad Cholesterol or its component that is Total Cholesterol, LDL and
Triglycerides
3. Low Good Cholesterol or its components HDL is the main
4. Stress in fact Hypertension is stress in action.
5. Diabetes
6. Smoking
7. Obesity and Sedentary life style.
in elderly deficiency of folic acid leading to increased homocysteine and in Indians especially, Lipoprotein a (LPa) are additional risk factors.
Non Modifiable Risk Factors:
1. Family History
2. Being a man (women are protected till the age 45)
3 Increasing age

So, you have some risk factors that is one can conclude. Please see your doctor and get the list completed and medicines prescribed for high blood pressure and high bad cholesterol and low good cholesterol (a suitable blood pressure medicine like ramipril for example, a statin with fenofibrate will be good choice but let your doctor decide). I do not know your height and weight, that will determine type of diet you ought to take. And finally to counter these risk factors you must aim for doing adequate exercise which is brisk walk at the speed of 5 KM/Hour for forty minutes a day is sufficient cardiac exercise. The diet depends upon you are vegetarian or non vegetarian. If you have any question for me I will be happy to answer however in health care magic drugs are not prescribed only recommended. Good luck.
With Best Wishes.

With best wishes.
Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)http://www/ WWW.WWWW.WW

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Dear AAAAA

Symtoms you have just decribed are those of gasto esophageal reflux diseasee GERD. Take OTC available antacids one and three hours after meals, tell your doctor and get proper medicine (like Metoclopramide and protein pump inhibitors like pentoperazole) prescribed. You will feel better and get rid of chest pain.

With cholesterol rise (with previous mail stating hypertension) we are talking of risk factors for coronary artery disease.

At any age, following is the list of risk factors for future development of Coronary Artery Disease. Let me enumerate and you can place yourself the risk you are carrying ('*' means you have the risk factor, '+/-' means I do not know and about others you know better):-

A: MODIFIABLE RISK FACTORS
Diabetes +/-
Hypertension*
Smoking+/-
Stress* (in fact hypertension has been called stress in action..you may be
sensitive person and modern life is full of stresses)
Obesity and Sedentary Life Style - (Normal weight for height)
High Bad Cholesterol and Lipid Component +
Total Cholesterol above 190 mg%, LDL above 130 mg%, VLDL above 40 mg%,
Triglycerides above 150 mg%, Apolipoprotein B above reference value
Low Good Cholesterol and Lipid Component: +/-
Apolipoprotein a below reference range for the lab and
HDL below 40 mg% for man & and 50 mg% for woman
B: NON MODIFIABLE RISK FACTORS
Family History 0f Coronary Heart Disease +/-
Increasing age*
Being a Man (as opposed to women) till the age 45*

From the list, above you have some risk factors. Hypertension, Stress, being a man and increasing age has been identified. Therefore, I will strongly recommend consulting your cardiologist when you are seeing you for AF; he may complete the list as well do the EKG / TMT to find out target organ damage due to hypertension.
Once the suspicion Coronary Artery Disease causing AF is over, then resume your good diet and good exercise activity. For cardiac health following is recommended
Exercise: Brisk walk at the speed of 5 KM/Hr for 40 minutes per day every day is enough aerobic exercise you need for keeping your heart healthy.

Now about stress. Please do this yogic exercise for ten minutes twice a day. will write about the progressive muscular relaxation which is used for non pharmacological treatment of blood pressure. This has opposite effect to heavy isometric exercise. Additionally, this is a great stress buster. It is called Savasana: corpse pose if literally translated.This translation I have taken from internet. Old manuscripts in Sanskrit has been translated in many languages. In English, this comes close to what I want to say
BEGINNING OF TRANSLATED QUOTE

No yoga session is complete without the final pose – Savasana. The body needs this time to understand the new information it has received through practicing yoga. Even though Savasana is a resting pose, it’s not the same a sleeping! You should stay present and aware during the five to ten minute duration of final relaxation.

Instructions:

1. Come to lie down on the back.

2. Let the feet fall out to either side.

3. Bring the arms alongside the body, but slightly separated from the body, and turn the palms to face upwards.

4. Relax the whole body, including the face. Let the body feel heavy.

5. Let the breath occur naturally.

6. To come out, first begin to the deepen the breath. Then move the fingers and toes, awakening the body.

7. Bring the knees into the chest and roll over to one side, keep the eyes closed.

8. Slowly bring yourself back up into a sitting position.

Here are some ideas on ways to use props during savasana to make this pose more comfortable and relaxing.
END OF TRANSLATED QUOTE
If there is any further query I will be most happy to answer asap. It is a pleasure interacting with you.
With Best Wishes.

Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

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Dear AAAA

I missed addressing your last concern on Tablet Atorva F10. Atorva F 10 is atorvastatin and fenofibrate is the drug you will have to take as prescribed by your doctor.

THANK YOU

Dr Anil Grover

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