Dr Paddy Barrett Profile picture
Dec 17, 2023 8 tweets 3 min read Read on X
As a cardiologist, I've seen thousands of patients over the years.

Here are the 5 things I recommend to every patient I see.

📕Make Sure To Bookmark✅ Image
1. Make Fitness A Priority

High levels of fitness have the strongest associations with longevity.

The evidence is overwhelmingly clear.

If you are not prioritising fitness.

You are leaving the biggest opportunity for benefit on the table. Image
2. Understand That Lifetime Risk Is What You Should Focus On

Most people focus on 10 year risk estimations.

At younger ages, these calculations are as close to useless as makes no difference in my view.

Use Lifetime Risk calculators to determine risk/benefits. Image
3. Know Your Lp(a) Levels

There is about a 1 in 5 chance you have an elevated Lp(a)

Which significantly increases your risk of early heart disease.

It's easy to check.

Most people have no idea what their levels are. Image
4. Track Quantifiable Metrics

Use validated metrics to assess your risk and progress over time:

Blood Pressure
Muscle Mass
Visceral Fat
V02 Max
APOB

What isn't measured isn't managed. Image
5. You Are The One Driving The Ship

Your doctor really does care about you.

But YOU are the one in charge.

Don't be a passenger. Be the driver.

YOU have the most to GAIN and the most to LOSE.

Act accordingly. Image
That's a wrap!

👋 If you enjoyed this thread, you might like to join over 16K others on my weekly newsletter, getting actionable insights on heart disease prevention. Link in bio above☝️ Image
If you like Tweets like this, you might enjoy my weekly newsletter.

Actionable content to help you understand and improve your health.

Join thousands of other subscribers by checking out the link in my bio.
Have to do it this way. Blame Elon ;)

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More from @Paddy_Barrett

Dec 28, 2025
A high V02 Max is the metric most closely linked to a longer life.

But what is V02 Max?

And more importantly, how do you increase it?

Because most people are doing it wrong.

📕Make Sure To Bookmark✅

🧵👇

/1 Image
V02 Max is the variable most closely related to longevity.

Sure, longevity is a complex multifactorial process with a good sprinkling of luck involved.

But A high V02 Max = A Much Lower Probability Of An Early Death.

/2 Image
But what is V02 Max & How Can You Improve It?

V02 Max is, by definition:

“The maximum rate of oxygen consumption attainable during physical exertion.”

First, we need to do a little math

And as my 3-year-old son likes to say, “Don’t get scared now”.

/3 Image
Read 20 tweets
Dec 27, 2025
"What is a normal weight?"

As a cardiologist, I get this question all the time.

My answer is not what most people expect.

📕Make Sure To Bookmark✅

🧵👇

/1 Image
The answer to this question assumes

You are trying to optimise for health & the prevention of chronic disease.

If, however, you are looking to be a sumo wrestler or achieve a specific look?

"I ain't got nothin for ya"

But for disease prevention, the answer is clear...

/2
The issue with weight is primarily down to excess Visceral fat.

What is that?

It is the fat located in your major organs - Liver, Pancreas, Intra abdominal etc.

Not subcutaneous fat which you can pinch on your side.

/3 Image
Read 12 tweets
Dec 14, 2025
As a Cardiologist, here are some of the biggest mistakes I see patients make.

🧵👇

/1
Thinking that their HDL Cholesterol will protect them.

Often referred to as 'Good' cholesterol (Not my words).

Very high HDL cholesterol >2.5 mmol/l or >100mg/dl is likely harmful!

Pay more attention when it is low rather than high.

/2 Image
Thinking about cardiovascular risk far too late in life.

The time to start thinking about risk is in your 20s, 30s & 40s.

Not your 60s, 70s & 80s.

Plaque in your arteries starts accumulating from childhood.

The earlier you act the better.

/3 Image
Read 6 tweets
Dec 13, 2025
The time to think about heart disease prevention is not age 60 but age 16.

Here's why.

🧵👇

/1 Image
Heart Disease is the leading cause of death worldwide.

The primary driver of this is atherosclerosis.

Although it results in death later in life.

It starts far earlier and can be prevented.

How early?

/2
Atherosclerosis is a plaque build-up in the body's arteries.

- Coronary arteries
- Thoracic Aorta
- Abdominal Aorta

And pretty much every other artery.

/3 Image
Read 9 tweets
Dec 7, 2025
"What is a normal weight?"

As a cardiologist, I get this question all the time.

My answer is not what most people expect.

📕Make Sure To Bookmark✅

🧵👇

/1 Image
The answer to this question assumes

You are trying to optimise for health & the prevention of chronic disease.

If, however, you are looking to be a sumo wrestler or achieve a specific look?

"I ain't got nothin for ya"

But for disease prevention, the answer is clear...

/2
The issue with weight is primarily down to excess Visceral fat.

What is that?

It is the fat located in your major organs - Liver, Pancreas, Intra abdominal etc.

Not subcutaneous fat which you can pinch on your side.

/3 Image
Read 12 tweets
Dec 6, 2025
A high V02 Max is the metric most closely linked to a longer life.

But what is V02 Max?

And more importantly, how do you increase it?

Because most people are doing it wrong.

📕Make Sure To Bookmark✅

🧵👇

/1 Image
V02 Max is the variable most closely related to longevity.

Sure, longevity is a complex multifactorial process with a good sprinkling of luck involved.

But A high V02 Max = A Much Lower Probability Of An Early Death.

/2 Image
But what is V02 Max & How Can You Improve It?

V02 Max is, by definition:

“The maximum rate of oxygen consumption attainable during physical exertion.”

First, we need to do a little math

And as my 3-year-old son likes to say, “Don’t get scared now”.

/3 Image
Read 20 tweets

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