Ciprian Albu - Cardiologist

13/11/2025

☕ Koffie en het hart: nieuwe inzichten uit de European Heart Journal (2025) 🫀

Goed nieuws voor koffieliefhebbers!

Een grote overzichtsstudie in het European Heart Journal toont aan dat matige koffieconsumptie (1–4 kopjes per dag) verband houdt met een lager risico op hart- en vaatziekten én lagere sterfte.

🔍 Belangrijkste bevindingen:
✅ Minder risico op:

- hoge bloeddruk

- type 2 diabetes

- hartinfarct

- hartritmestoornissen (zoals boezemfibrilleren)

- hartfalen

- beroerte

☕ Zowel gewone als cafeïnevrije koffie tonen gunstige effecten.

📉 Alleen on­gefilter­de koffie kan het LDL-cholesterol verhogen door stoffen als cafestol en kahweol.

💡 Mogelijke verklaringen:
Koffie bevat antioxidanten, polyfenolen, magnesium en vezels, die samen een gunstig effect lijken te hebben op bloedvaten, suikerstofwisseling en ontsteking.

⚠️ Wanneer oppassen:

Overmatige consumptie (>6–9 kopjes per dag) kan het voordeel tenietdoen.

📚 Referentie:
Dewland TA, van Dam RM, Marcus GM. Coffee and cardiovascular disease. Eur Heart J. 2025;46(36):3546–3554.

11/11/2025

🫀 De strijd is on! Wat is Lp(a) en waarom is het belangrijk?

Lipoproteïne(a), of Lp(a), is een vetdeeltje in het bloed dat sterk lijkt op LDL (“slecht cholesterol”).

Maar er is een cruciaal verschil: je Lp(a)-waarde is grotendeels genetisch bepaald - gezonde voeding of meer bewegen verandert er weinig aan.

🔍 Waarom meten we Lp(a)?

Een te hoge Lp(a) verhoogt het risico op:

❤️ hartinfarct

🧠 beroerte

🩸 slagaderverkalking (atherosclerose)

Zelfs met normale cholesterolwaarden kan een hoge Lp(a) je risico verhogen.

🧬 Wie zou Lp(a) moeten laten meten?

- Mensen met vroegtijdige hart- of vaatziekten in de familie

- Personen die zelf vroeg een hartinfarct of beroerte hebben gehad

- Volgens sommige richtlijnen: iedere volwassene één keer in het leven

💊 Er is nog geen medicijn dat Lp(a) verlaagt, maar er wordt volop onderzoek naar gedaan.
In de tussentijd is er wél iets dat je kunt doen:
👉 pak de andere risicofactoren stevig aan - zorg voor een gezonde bloeddruk, stop met roken, verlaag je LDL-cholesterol en houd je diabetes goed onder controle.

📚 Meer info:
https://academic.oup.com/eurheartj/article/43/39/3925/6670882

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❗Belangrijk: De inhoud van deze post is bedoeld als algemene informatie, niet als medisch advies. Bij gezondheidsvragen: neem altijd contact op met uw eigen arts.

19/10/2025

🫀 Patent Foramen Ovale (PFO): een klein gaatje met soms grote gevolgen

Bij ongeveer 1 op de 4 mensen blijft er na de geboorte een klein gaatje open tussen de beide boezems van het hart — het foramen ovale.

Tijdens de zwangerschap is dat normaal: het laat bloed de longen omzeilen, omdat een baby in de buik nog niet ademt.

Na de geboorte hoort dit gaatje vanzelf te sluiten. Als dat niet volledig gebeurt, spreken we van een Patent Foramen Ovale (PFO).

Bij afwezigheid van klachten kan dit beschouwd worden als een normale anatomische variant. In de meeste gevallen is een PFO onschuldig en merk je er niets van.

Maar bij een klein deel van de mensen kan het een rol spelen bij:
⚠️ een beroerte op jonge leeftijd (door een bloedstolsel dat via het PFO naar de hersenen schiet)
⚠️ duikersziekte (decompressieziekte) bij beroeps- of sportduikers
⚠️ soms bij onverklaarde migraine met aura

👩‍⚕️ De diagnose kan gesteld worden met een echocardiogram met contrast of een slokdarmecho.

💡 In specifieke gevallen kan een PFO gesloten worden via een katheterprocedure, waarbij een klein parapluutje het gaatje afsluit.

📖 Meer informatie:
• European Society of Cardiology – PFO and stroke

https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/Patent-foramen-ovale-in-patients-with-cryptogenic-stroke-to-close-or-not-to-close



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❗Belangrijk: De inhoud van deze post is bedoeld als algemene informatie, niet als medisch advies. Bij gezondheidsvragen: neem altijd contact op met uw eigen arts.

08/10/2025

🧠 Alcohol & Dementia: New Evidence Challenges “Safe” Drinking

A recent study in BMJ Evidence-Based Medicine, combining observational data and genetic analyses, suggests that no level of alcohol use is free from dementia risk.

📌What the study looked at:

- Over 559,000 adults aged 56–72 from two large cohorts (US Million Veteran Program & UK Biobank).

- Follow-up: ≈ 4 years in US group and ≈ 12 years in UK group.

- Outcomes: new cases of all-cause dementia via health records.

- Genetic (Mendelian Randomisation) data to test for causality.

📌Key findings:

In previous observational models, a U-shaped curve appeared: non-drinkers and heavy drinkers (> 40 drinks/week) had higher dementia risk compared to light drinkers (< 7/week).

Genetic analyses in this current study showed a monotonic increase in dementia risk with increasing alcohol use and no protective effect at low doses!

To quantify: a 1 standard-deviation increase in genetically predicted drinks per week was associated with ~15% higher dementia risk (odds ratio 1.15).

Also, the authors observed that people later diagnosed with dementia tended to reduce alcohol intake before diagnosis, which may explain why some observational studies show “benefits” of light drinking (reverse causation).

📌Implications:

✅The idea that “moderate” drinking is brain-protective is called into serious question by these results.

✅Even light drinking may contribute to long-term cognitive risk.

👉Bottom line:
If brain health is your priority, minimizing or avoiding alcohol may be safer than relying on the idea of a “safe” drinking threshold.

📌 Original study: Topiwala A et al. “Alcohol use and risk of dementia in diverse populations: evidence from cohort, case-control and Mendelian randomisation approaches.” BMJ EBM, 2025.

❗Important: The content of this post is intended as general information, not as medical advice. For any health-related concerns, always consult your own doctor.

05/10/2025

Medicine is serious. But laughter? Essential. Sometimes a good laugh is the best way to end a tough week. Here’s the brilliantly hilarious Alonzo Bodden… poking some fun at us doctors. 🤣👨‍⚕️👩‍⚕️

https://youtu.be/Hs8y_YGp1oc?si=T2063V4praoVa5Uf

Alonzo Bodden Montreal comedy festival VET bit

02/10/2025

🖼️ CT Coronary Angiography: A Window Into Your Heart’s Arteries

When it comes to heart disease, seeing is believing. While there are many tests for detecting coronary artery disease (CAD), CT Coronary Angiography (CTCA) has emerged in recent years as one of the most sensitive and specific.

👉 Often, doctors first use a Coronary Calcium Score — a quick CT scan that measures calcium in the heart arteries. It takes only a few minutes, doesn’t require contrast dye, and gives a “score” that reflects long-term risk of heart attack.
👉 If calcium is present or if more detail is needed, a CT Coronary Angiography may follow. This involves a CT scan with contrast dye to clearly visualize the coronary arteries and spot narrowings or blockages.

🔍 Why are these tests valuable?
✅ Early detection – reveal hidden blockages or early atherosclerosis, even before symptoms appear.
✅ Risk stratification – guide whether lifestyle changes, medication, or further testing is needed.
✅ Reassurance – a normal calcium score or CTCA provides strong reassurance and may prevent unnecessary procedures.
✅ Prevention-focused – uncover “silent” disease early, lowering the risk of sudden heart attack.

📊 Evidence shows that CT-based strategies (calcium scoring + CTCA) lead to better diagnosis, safer management, and fewer missed heart problems compared to traditional stress tests.

🔗 References:
NICE CG95: Chest pain guidelines, https://www.nice.org.uk/guidance/cg95

❗Important: The content of this post is intended as general information, not as medical advice. For any health-related concerns, always consult your own doctor.

This guideline covers assessing and diagnosing recent chest pain in people aged 18 and over and managing symptoms while a diagnosis is being made. It aims to improve outcomes by providing advice on tests (ECG, high-sensitivity troponin tests, multislice CT angiography, functional testing) that suppo...

29/09/2025

✈️ “Stay ahead of the airplane.”
It’s a phrase every pilot hears during training — and one I heard many times while learning to fly. It means more than just reacting; it’s about anticipating what’s coming next.

Pilots prepare for each phase of the flight in advance and stay alert for what could go wrong. We’re taught to always have a plan B ready. For example, at takeoff I practiced saying out loud what I’d do in case of an engine failure at low altitude: pick up the glide speed, avoid the “impossible turn,” and prepare for an emergency landing.

This mindset isn’t only vital in aviation — it’s equally important in medicine, especially in prevention.

🩺 The same principle applies to your health:
✅ Check your blood pressure and cholesterol before problems arise.
✅ Get your screenings (heart, diabetes, cancer) at the right age.
✅ Act early on symptoms — don’t wait until they force you to land unexpectedly.

Just as a pilot plans for fuel, weather, and navigation, you can plan ahead for your health. Prevention keeps you in control of your life’s flightpath — and it might even save your life when turbulence comes.

26/09/2025

💊 Statins: Why they matter in heart disease prevention

Statins are among the most studied and prescribed medications worldwide. Their main job is simple: lower “bad” cholesterol (LDL-C). But the benefits go far beyond just numbers on a blood test.

🔹 Secondary prevention (patients who already had a heart attack, stroke, or vascular disease):
Statins reduce the risk of another heart attack, stroke, and even death. They are standard of care because they clearly save lives.

🔹 Primary prevention (patients at high risk but without previous events):
In people with risk factors (high cholesterol, diabetes, hypertension, smoking, strong family history), statins significantly lower the chance of the first heart attack or stroke.

📊 Large meta-analyses (such as from the Cholesterol Treatment Trialists’ Collaboration) have shown:

Every 1 mmol/L (≈40 mg/dL) reduction in LDL cholesterol reduces major cardiovascular events by about 20–25%.

This benefit applies in both primary and secondary prevention, across men, women, and different age groups.

⚖️ Like every medication, statins can have side effects (e.g. muscle aches in a small proportion of patients), but overall the benefits in reducing heart attacks and strokes far outweigh the risks for those with elevated risk.

👉 In short: Statins save lives, both for those who already have heart disease and for those at high risk of developing it.

📖 Reference:
Lancet – Cholesterol Treatment Trialists’ (CTT) Collaboration (https://www.thelancet.com/article/S0140-6736(12)60367-5/fulltext)

❗Important: The content of this post is intended as general information, not as medical advice. For any health-related concerns, always consult your own doctor.

24/09/2025

🪑 Sitting is the new smoking?

Modern life has made us sit more than ever—at work, in the car, on the couch. But did you know that long periods of sitting increase your risk of heart disease, diabetes, cancer, and even premature death?

📉 Studies show that sitting for more than 8 hours a day with little physical activity carries a health risk similar to smoking or being obese.
🚶 Even small changes help: stand up every 30 minutes, take walking breaks, use the stairs, or try a standing desk.
❤️ Your heart (and body) will thank you.

The European Society of Cardiology (ESC) recommends performing at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week for able-bodied individuals. An equivalent combination of moderate and vigorous activity is also acceptable.

The ESC also advises breaking up periods of sedentary time with some activity and performing muscle-strengthening activities twice a week.

👉 For more background, see:

https://pmc.ncbi.nlm.nih.gov/articles/PMC4838429
https://www.who.int/news-room/fact-sheets/detail/physical-activity
https://www.escardio.org/Education/ESC-Prevention-of-CVD-Programme/Rehabilitation

❗Important: The content of this post is intended as general information, not as medical advice. For any health-related concerns, always consult your own doctor.

22/09/2025

📉 Heart Attacks: from Deadly to Treatable

Not long ago, a heart attack (myocardial infarction) often meant a very high risk of dying. In the 1960s, 1 in 3 patients admitted with a heart attack did not survive.

In just a few decades, groundbreaking advances in care have dramatically reduced this risk. Here’s the timeline of this progress:

🔙 1950–1960: In-hospital mortality after an acute myocardial infarction was around 30–40%. Treatment mainly consisted of bed rest and oxygen, without effective medications or interventions.

⏩ 1970–1980: Introduction of coronary care units (CCUs) and monitoring → mortality dropped to about 20%. Beta-blockers and thrombolysis began to play a role.

⏩ 1990–2000: With thrombolysis, aspirin, ACE inhibitors, and early revascularization (PCI/CABG), mortality decreased further to 10–15%.

✅ 2000–present: With emergency stenting (primary PCI) as the gold standard, dual antiplatelet therapy, and improved acute care, in-hospital mortality in acute myocardial infarction (STEMI) has fallen to 4–6% in many countries.

👉 Thanks to faster diagnosis, effective medication, and timely revascularization, most people today survive a heart attack — and many can return to an active, healthy life.

📖 Read more:
https://www.ajmc.com/view/a213_09mar_kolanskys36to41
https://pmc.ncbi.nlm.nih.gov/articles/PMC3760556
https://www.sciencedirect.com/science/article/pii/S2772930322005993

19/09/2025

❤️BaxHTN studie: nieuwe hoop bij moeilijk behandelbare hoge bloeddruk

Bij sommige mensen blijft de bloeddruk hoog, ondanks 2 of zelfs 3 verschillende medicijnen. Dit noemen we resistente hypertensie.

🔬 In de BaxHTN studie werd het nieuwe middel baxdrostat onderzocht – een remmer van het hormoon aldosteron.

✅ Resultaten na 12 weken:
-Daling van de bovendruk (systolisch) met bijna 10 mmHg meer dan placebo.
-Ongeveer 40% haalde een bloeddruk < 130 mmHg (vs ~19% met placebo).
-Goed verdragen; slechts weinig gevallen van te hoog kalium.

👉 Conclusie: Baxdrostat kan een belangrijke nieuwe optie worden voor patiënten met moeilijk behandelbare hoge bloeddruk.

❗Belangrijk: De inhoud van deze post is bedoeld als algemene informatie, niet als medisch advies. Bij gezondheidsvragen: neem altijd contact op met uw eigen arts.



ESC nieuws:

https://www.escardio.org/Congresses-Events/ESC-Congress/Congress-resources/Congress-news/Hot-Line-4-BaxHTN

17/09/2025

🧼 Do we have the courage to abandon old habits and prejudice when evidence strikes?

A lesson from history.

In the mid-19th century, hospitals faced a deadly problem: childbed fever. Women who had just given birth developed high fevers and often died within days. In some maternity wards, mortality rates reached 20%.

👨‍⚕️ In 1847, at the Vienna General Hospital, the young Hungarian physician Ignaz Semmelweis noticed a striking difference: In the ward staffed by doctors and students (who often came directly from autopsies), many women died. In the ward run by midwives, far fewer women died.

🔬 Semmelweis proposed a daring hypothesis: doctors were carrying “invisible particles” from the autopsy room to the maternity ward. His solution? Handwashing with chlorine solution before every delivery.

📉 The result was dramatic: maternal deaths dropped from about 20% to less than 2%.

😔 Yet his ideas were not accepted. Many colleagues felt accused, and his discovery was dismissed. The year was 1847… a certain Mr. Pasteur would only publish his germ theory in 1861... and Joseph Lister’s work on antisepsis only emerged in 1865. Semmelweis was recognized... posthumously for his discoveries. Today the Medical University of Budapest proudly bears his name.

🌍 The lesson of Semmelweis
- Simple measures can save thousands of lives.
- Medical progress often requires courage and the willingness to abandon old habits.
- Even today, hand hygiene remains one of the most powerful tools against infections – from maternity wards to intensive care units.