Exercise Stress Tests Are Incredibly Useful

Just not for the reasons you might think.

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/1 If you are ‘getting your heart checked’

You must do an exercise stress test, right?

Well. Not any more.

Here’s why.

Let’s first state our goal when we are in the business of ‘Heart Disease Prevention’:

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The Math of Longevity: How Small Changes Today Can Add Decades to Your Life.

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/1 Let's be clear by what we mean by longevity.

It's not about living to 150.

It is not about living forever.

No matter what Bryan Johnson says.

It's about something different.

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Psst...

Did you know there is an app on your phone that can tell you A LOT about your risk of dying prematurely?

Want to know what to look for?

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/1 Whether you have an iPhone or an Android phone, there is a 'Health' App that tracks many of your health biometrics continuously over time.

Your metrics today are useful, but the average over the last year is even more insightful.

Have a look at yours & see where you stand.

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Jeanne Calment died in 1997 age 122.

She is thought to be the oldest living person on record.

What can we learn from healthy centenarians to extend our lifespan?
🧵 "All I Want To Know Is Where I'm Going To Die, So I'll Never Go There".

First off let’s see what most people die from.

That is, so we don’t go there.
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Exercise is probably the single best way to extend lifespan.

You need to exercise like your life depends on it.

Because it does.

Here's why.

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/1 When someone says they ‘want to get fit’, I typically have no idea what they mean.

How you exercise if you want to be an Olympic-level sprinter compared to running 5 km at the weekends is vastly different.

So when you say you want to exercise to get fit, to what end?
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Is it possible to reverse coronary artery disease?

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

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/1 Every time I tell a patient they have coronary artery disease, their first response is usually:

“Can you get rid of it?”

My response:

Get rid of it completely?

No.

But....

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Why you need to measure your apoB

To fully understand your cardiovascular risk.

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/1 Atherosclerosis occurs when a cholesterol particle becomes trapped in the artery wall.

It is the inflammatory response to this particle retention that causes the formation of atherosclerosis.

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"What is a normal weight?"

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

My answer is not what most people expect.

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/1 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...

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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.

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/1 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.

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I am 44. This is what I am doing to make sure I get to 84.

📕Make Sure To Bookmark✅ Exercise to increase V02 Max

Those in the top 20% of V02 Max percentiles are 4 times less likely to die over a 10 year time frame than those in the bottom 25%.

For those in the top 2.5% - Its 5 times.

Lp(a) - probably the most important cholesterol test you have never heard of.
 
For those with a family history of heart disease, this is a must do test.
 
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/1 90% of the risk factors for early heart disease have been described.
 
There are others we do not see or do not measure.
 
Lp(a) is one of them.
 
Knowing your Lp(a) level is crucial to understanding your cardiovascular risk.   
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Hearing Loss is a major risk factor for dementia.

Most people are unaware of this fact.

And more importantly that this risk can be reduced.

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/1 Dementia is the fourth leading cause of death in the US and Europe.

A fact that most people are unaware of.

When considering major preventable diseases

We focus most of our attention on cardiovascular disease and cancer.

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Cardiovascular Disease Is The Leading Cause Of Death Worldwide.

By Age 55 most Males will have some advanced plaque in their coronary arteries.

This happens at 65 for females.

Here are 3 ways you can reverse coronary artery disease. 1. Exercise

Multiple studies have shown regression of coronary artery disease with exercise.

A recent study examined the utility of HIIT based training and it resulted in a 1.4.% ⬇️ in plaque volume.

That might sound small, but a 1% ⬇️ is assoc with a 20% ⬇️ in events.

"What is a normal cholesterol?"

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

Most people are getting this all wrong.

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/1 When people ask this question

They are normally referring to their Total Cholesterol.

That number... is mostly irrelevant.

Here's what you need to look at.

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Heart disease is the leading cause of death worldwide.

Insulin resistance is a key driver of that risk.

Insulin resistance is rarely tested for so most people are in the dark.

Want to shed some light on the problem?

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/1 Everyone is somewhere along the continuum of insulin sensitivity to insulin resistance.

Type 2 diabetes typically represents the most extreme end of insulin resistance.

Your risk is determined by where you sit on this line.

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5 Essential Tests For Cardiovascular Health.

Most of these tests are easy to obtain. While others can be slightly tricky.

We will start with the most accessible and informative.

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/1 1. Daily Step Count

Walking at least 7000 steps per day is associated with half the risk of dying from any cause over a ten-year time frame.

This is a huge deal.

There are very few, if any, things in medicine that are associated with that magnitude of benefit.

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A huge percentage of adults have a condition that seriously increases their risk of heart disease.

The problem is.... most don't even know they have it.

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/1 Insulin resistance is a core risk factor for the three leading causes of death:

- Cardiovascular Disease
- Cancer
- Dementia

Not the cause.

But a massive amplifier of risk.

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Most people are surprised when they have a heart attack.

They didn't see it coming.

They didn't have any symptoms leading up to it.

Why Does This Happen?

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/1 Let's start with what a heart attack really is.

Because most people have this a$$ backwards.

The general idea most people have is an artery progressively narrows because of plaque

And then closes over.

Voila... A Heart Attack.

That is NOT what happens.

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How To Reverse Coronary Artery Disease With Lifestyle Measures.

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/1 Reversing or regressing coronary artery disease is possible.

But can coronary artery disease be reversed with lifestyle measures, including changes to nutrition and exercise?

The answer it seems, is yes, but the devil is in the detail.

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Weight Loss Medications For Obesity Have Changed Everything.

The pace of change is incredible.

But with staggering weight reductions, there are some downsides.

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/1 "There are decades where nothing happens; and there are weeks where decades happen"

Vladimir Ilyich Lenin.

This is what the world of weight loss medications feels like right now.

The introduction of semaglutide changed everything

But since then a LOT has changed.

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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✅ 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.