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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
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Mar 1 • 8 tweets • 4 min read
Lower resting heart rate (HR) and its health-related benefits

1. My resting HR has reduced from 72 bpm (in 2020) to 42 bpm (in 2023); mainly due to consistent running (average mileage of 15 km/day in 2021; 12.6 km/day in 2022) and weight loss (28 Kg)
#running #fitness #longevity
2. People with higher resting HR have a higher risk of death due to cardiovascular disease and cancers (breast, lung, kidney or colorectal cancers)
dx.doi.org/10.1136/heartj…
3a. In another study, people with RHR >75 bpm had 2-fold higher risk of all-cause death, or deaths due to stroke or heart attack (over 10-yr follow up), as compared to those with RHR <55 bpm.
Risk of all cause death increased by 3% for every bpm rise in RHR in the study period.
3b.
dx.doi.org/10.1136/openhr…
4. Resting HR declines in the oldest old, and this decline is associated with greater longevity.
doi.org/10.1111/jgs.12…
5. Women have a significantly higher resting HR in all age brackets. In a large study, it was found that 95% of men had an RHR between 50 and 80 bpm, while the corresponding range for women was between 53 and 82 bpm
doi.org/10.1371%2Fjour…
6. Resting HRs were higher in people with higher body mass index (BMI).
*The risk of diabetes is higher in people with higher resting HR.
*Lowest resting HR was noted in people who slept 7-7.5 hours per night.
7. How can one lower the resting HR?
*Regular moderate-vigorous physical activity, such as running, cycling, swimming, brisk walking
*Adequate night sleep: 7-8 hours
*Reduce stress/anxiety
*Maintain ideal body weight
*Quit smoking
*Avoid excessive caffeine (2-3 cups/day is fine)

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Mar 3
A seemingly innocuous habit resulted in tinnitus and hearing impairment in a young woman

1. 30-year old Lata presented with tinnitus in both ears of three months duration. It was a constant buzzing sound in ears, which was quite annoying for her.
#MedTwitter #HearingLoss
2. One month back Lata also developed hearing problem in both ears. She was unable to respond to her children's voices from the adjoining room at home. She missed registering a few words during routine conversation with others. She consulted an ENT surgeon for evaluation.
3. ENT exam confirmed the worst- she had high-frequency hearing loss. However, local examination of ears was normal.
Lata was too young to develop age-related hearing loss, as it usually affects people aged 65 and above. ENT doctor wanted neurological cause to be excluded.
Read 16 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Mar 2
When something meant to aid a runner became a pain in his "thigh"

1. 45-year old Dev presented with sharp, shooting pain & tingling in right thigh for three months. Pain occurred in episodes, lasting a few minutes to a few hours; repeating several times in a day.
#MedTwitter
2. Dev also had mild numbness in the rigft thigh region, however, he had no back pain and the pain did not radiate below the knee. He had no leg weakness and had normal urinary control.
His daily life was adversely affected due to thigh pain.
3. Dev consulted a local doctor, who conducted several tests, including MRI lumbar spine and nerve conduction studies, which were normal. He was prescribed pain-relief medicines, however, Dev was not keen to take medicines without knowing the root cause of his symptoms.
Read 9 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Mar 1
A few patient consultations may not require prescribing medicines

1. When patients consult a doctor, in most cases, they expect a pill to be prescribed.
Vice versa, a doctor may feel compelled to prescribe a drug to ensure patient's satisfaction.
#doctor #patient #MedTwitter
2. There are some situations, where a medicine need not be prescribed. As a doctor, it is our duty to explain this aspect to the patient, so that un-necessary medicine prescription may be avoided. It can save costs as well as prevent any drug-related "adverse effects".
3. Case 1: 25-year old presented with pins & needles sensation in scalp for 3 days. It was mild & didn't interfere with daily activities. Patient was anxious that it could be something serious. Clinical exam was normal. I reassured the patient and asked to review, if needed.
Read 9 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Feb 25
Regular laxative use is associated with a higher risk of dementia

1. A recently reported study looked at association between #laxative use and new-onset #dementia in >5,00,000 UK Biobank participants.
#MedTwitter
n.neurology.org/content/early/…
2. Regular use of laxative was associated with 51% higher risk of all-cause dementia and 65% higher risk of vascular dementia. There was no significant association with risk of #Alzheimers disease.
3. The risk of dementia increased by 28% in people using one type of laxative, as compared to 90% in people using two or more types of laxatives.
Only osmotic type of laxative use was associated with higher risk of dementia.
Read 7 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Feb 24
Gender equality is good, however, in this situation, it is better that women lag men

1. 45-year old Vani was admitted with complaints of epileptic fits followed by disorientation and confusion. A small brain infarct (clot) was seen, which was presumed to be the cause of seizure.
2. She had no obvious risk factors for stroke, and moreover, the clot was located in cerebellar vermis, which usually does not cause convulsions. So, we needed to look for other causes for her epileptic fits. Vani had become conscious the next day, and history was reviewed.
3. Vani admitted to consuming alcohol on daily basis for more than a year, and had abruptly stopped consuming alcohol one day prior (as she was fasting for a religious festival).
Now, the cause of seizure was obvious- alcohol withdrawal syndrome (ADS).
Read 8 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Feb 24
Vegetable, but Not Potato, Intake Is Associated With a Lower Risk of Type 2 Diabetes
1. 54,793 people were followed up for 16.3 years. Participants in the highest total vegetable intake quintile (median 319 g/day) had a 0.35 kg/m2 lower BMI and a 21% lower risk of incident T2D.
2. Participants in the highest compared with the lowest (median 256 versus 52 g/day) potato intake quintile had a 9% higher risk of Type 2 Diabetes (T2D).
3. Of the vegetable subclasses, higher intake of green leafy and cruciferous vegetables was associated with a statistically significantly lower risk of Type 2 Diabetes.
Read 4 tweets

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