Blog

What does the new NHS 10-year plan mean for heart and stroke prevention? It shifts NHS care toward prevention, digital tools and community-based screening, with cardiovascular disease a named priority — including wider access to wearables and genomic testing by 2035. This post also covers new trial evidence linking LDL cholesterol directly to stroke risk. […]

Today I’ve been ‘acting down’ to cover the registrar rota for the strikes. All OK so far, I’m just hoping not to get called out too much tonight! Over the last month I have written about what in my view have been the biggest advances in heart health in the last 10 years. This has […]

Quick answer: Cardiac amyloidosis was once considered rare and untreatable — it’s now detected far more often, and for the first time we have licensed treatments that can slow it. Atrial fibrillation ablation has also moved on hugely with newer, safer pulsed-field techniques, and wearable devices are transforming how early rhythm problems get picked up. […]

Over the last few weeks I have been summarising the biggest cardiac innovations of the last decade, having just reached that milestone as a consultant in Bournemouth.  When I was a registrar in London at the Heart Hospital, I recall in around 2012 they appointed a consultant in ‘structural intervention’. The Heart Hospital (University College […]

Quick answer: Heart failure care has been transformed over the last decade. Two new drug classes — SGLT2 inhibitors and ARNI — have joined the ‘four pillars’ of treatment, and many patients with severely weakened hearts can now see their heart function return to near-normal on scans, reversing what used to be considered an irreversible, […]

Is heart disease down to genetics or lifestyle? Both — two people with identical cholesterol levels and risk factors can have very different chances of a heart attack, and genetics is a major reason why. This post looks at real cases where genetic risk, not lifestyle, was the deciding factor. My intention had been to […]

Quick answer: A great deal. In the last decade, treatment options for high cholesterol have expanded well beyond statins — including ezetimibe, newer injectable drugs, and Inclisiran, a twice-yearly RNA-based injection. Testing has moved on too: a plain cholesterol test alone is now considered fairly limited, with better blood markers such as Lipoprotein(a) and Apolipoprotein […]

Last week I reached what I think is a fairly significant milestone in my career, as on Wednesday it was ten years to the day since I started my consultant cardiologist job in Bournemouth. A decade has gone in the blink of an eye, yet when I think back, so much has changed. I was […]

I’m sure many of us, myself included, take health for granted much of the time, and it’s only when a health issue occurs do we suddenly appreciate quite how much we should value it. Clearly I see ill-health day in day out, so you might suppose that I would be more aware than most. I […]

Quick answer: Japan has more centenarians than anywhere else on earth — nearly 100,000 people are aged 100 or over — and the reason isn’t genetics. It’s decades of consistent habits: minimal ultra-processed food, staying physically active day to day, and a culture that prioritises long-term health. Those habits are realistic to adopt anywhere, and […]

Quick answer: The ESC’s 2025 update to cholesterol guidelines makes several practical changes: more emphasis on CT imaging to assess risk, clearer cut-offs for Lipoprotein(a), a new recommended medication (bempedoic acid), advice against cholesterol supplements — and, perhaps most important for patients, the guidelines no longer consider HDL (‘good’) cholesterol to be protective. At every […]

Do all heart attack patients need aspirin and beta-blockers long-term? Not necessarily — new trial evidence presented at the 2025 European Society of Cardiology conference found real harm from adding aspirin in some patients already on another blood thinner, and beta-blockers may no longer be justified as routine after a heart attack for everyone. Never […]

It’s the last week of the summer holidays, which for me means the European Society of Cardiology meeting (and also my wife’s celebration that our children go back to school this week!). Why it runs over a weekend is anyone’s guess, but so be it. This year it is in Madrid, and I’m actually writing […]

Quick answer: Atrial fibrillation raises stroke risk because an area of the heart called the left atrial appendage can allow blood clots to form. Blood thinners are the usual protection, but for patients who can’t tolerate the bleeding risk — or in unusual cases like this one — a left atrial appendage occlusion device can […]

Many years ago when my children were around 6 months and under 2, I came back home late one night to our London flat after a friend’s leaving party to hear my daughter crying and crying. Wondering why my wife hadn’t gone to her, I soon discovered the answer was that she couldn’t, because she […]

Quick answer: A cardiac arrest is when the heart suddenly stops beating properly — usually due to a dangerous rhythm problem — and is very often fatal even in hospital. A heart attack is caused by a blocked artery in the heart, and in around half of cases it triggers a fatal cardiac arrest, which […]

The longer I spend as a doctor, the more frustrated I become at how poorly we do at primary prevention, or in lay terms, preventing problems before they arise. Healthcare is extraordinarily expensive for governments to deliver the world over, yet resource always seems to be spent too late, at which point the costs are […]

Quick answer: Hypertrophic cardiomyopathy (HCM) is an inherited condition that causes the heart muscle to thicken, and it’s usually first picked up on an echocardiogram after symptoms like breathlessness or a family history prompt further checks. Genetic testing now identifies the specific causal mutation in around 60% of cases, which helps confirm the diagnosis and […]

All good thing must come to an end, and so it is that I’m shortly to board a ferry home after what has been a lovely week away in France. We got lucky with the weather, hot but not too hot, and it was all rather restful. We stayed at an Airbnb in the Dordogne, […]

Is red wine good for your heart? Not really — there’s no credible evidence that alcohol is healthy overall, though red wine specifically may have some modest benefits for gut health and diabetes risk via polyphenols. The empty calories and effect on sleep are the bigger downsides to weigh against any social enjoyment. A definite […]

I actually started drafting this week’s blog quite a few days ago, as had family plans this weekend and therefore less time. I wanted to write about an inspirational patient from this week, which I have done, but given a tragic accident will start with that. As readers will know I’m a big football fan, […]

Quick answer: Yes — studies show up to half of older male runners have some degree of coronary artery disease. But the paradox is that fitness dramatically reduces your risk of dying even if you do have plaque, so the message isn’t to stop exercising — it’s to know your risk (for example with a […]

I visited my mum in her dementia care home last weekend, and the best word I think to describe it is sad. Sad that she is living out the very thing she always said she did not want. Sad that she didn’t know who I was (although recognised a friendly face). Sad that she did […]

Can intensive lifestyle changes really prevent heart attacks? Yes — a landmark trial found that patients with coronary artery disease who received intensive, regularly-reviewed lifestyle support had significantly fewer heart attacks, strokes and deaths at 5 and 11 years, with results comparable to some major drug and stent trials. Happy Father’s Day! I’m writing this […]