Dr Paddy Barrett
@Paddy_Barrett
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Cardiologist who wants to help you prevent heart disease & live longer. Join over 20K+ others on the journey at . Free 5 Day Course Below 👇
Joined March 2010
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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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Things I know as a 42 year old Cardiologist that I wish I knew as a 21 year student.
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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.
📕Make Sure To Bookmark✅
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I hated running.
Then I learned about Zone 2 training and exercising to specific heart rate zones.
It changed my life.
Here's why.
📕 Make Sure To Bookmark ✅
🧵👇
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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.
📕Make Sure To Bookmark✅
🧵👇
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Is it possible to reverse coronary artery disease?
I get this question all of the time.
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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.
📕Make Sure To Bookmark✅
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90% of being healthy is really just:
- Getting 8 hours of sleep
- Exercising 3-4 times/week
- Eating Real Food
- Meditating or at least spending time reflecting on what is important to you.
The little stuff IS the big stuff.
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As a Cardiologist, here are some of the biggest mistakes I see patients make.
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8 hours of sleep is a superpower
Getting adequate sleep is associated with a range of health benefits.
Even more, than these benefits are the clarity that a good night's sleep brings.
Get sleep wrong & you'll likely get everything else wrong.
A Good Night = A Good Day
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I hated running.
Then I learned about Zone 2 training and exercising to specific heart rate zones.
It changed my life.
Here's why.
🧵👇
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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✅
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When I check a patient's blood pressure, I will be honest; it's mostly for show.
Here's why
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Bill Clinton had 8 exercise stress tests when he was in office and 'passed' each of them with flying colours.
He then had a heart test that showed he need coronary artery bypass surgery.
Want to know what test he had?
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Bill Clinton had 8 exercise stress tests when he was in office and 'passed' each of them with flying colours.
He then had a heart test that showed he need coronary artery bypass surgery.
Want to know what test he had?
🧵👇
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Work is important, but it's not everything.
Work should be an important part of your life.
But it shouldn't be THE most important thing.
If it is, you need to reassess things.
I got this one wrong for years and paid the price dearly for it.
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Most people don't understand what causes Sudden Cardiac Death.
You cannot address what you do not understand.
📕 Make Sure To Bookmark ✅
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Time with friends is way more important than I thought it was.
In my 20's & 30's I was doing 100+ hour weeks training as a doctor.
Work was my life.
Spending more time with friends and family has become a major priority.
If you don't schedule it. It won't happen.
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Exercising the right way
I hated running. For years.
I found it miserable no matter what I did.
But once I learned about Zone 2 training based on heart rate (& lactate) things changed immediately.
Now I love it.
And it means my risk of an early death is much lower!
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Being in the top 5% of V02 Max for the population means you are 5 times less likely to die over a 10-year time horizon compared to someone in the bottom 25%.
There is almost nothing medicine that offers that kind of survival advantage.
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As a Cardiologist Who Has Reported on 1000's of Cardiac CT Scans
Here Are 5 Things I Wish Everyone Knew About Them
To Maximally Reduce Their Future Risk Of A Heart Attack.
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Why you need to measure your apoB
To fully understand your cardiovascular risk.
📕Make sure to bookmark ✅
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Those who are near death often have very similar regrets.
Here is one story that always stuck with me.
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Lifting weights should have been a priority.
Although I did aerobic training, I didn't really see the value of resistance training.
I was dead wrong.
Without a strong frame, you cannot load it properly no matter what aerobic activity you chose.
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Does exercise prevent cancer?
📕Make Sure To Bookmark✅
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Minimize Alcohol
Drinking alcohol was a major part of my 20s, and it was a blast.
But I look back now, and I regret all that I could have been doing were I not spending my weekends hungover.
In my 30's & 40's minimal alcohol has unlocked a huge percentage of my week.
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Muscle Mass & Muscle Strength
Are major determinants of how long you will live and the quality of your life as you age.
Here's why.
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A High V02 Max is one of the best predictors of longevity.
Oskar Svendsen, a Norwegian cyclist, topped out at 97 ml/kg/min.
Insane.
But V02 Max results of 20 times higher have been recorded.
Sounds crazy, right? But it's true.
📕 Make Sure To Bookmark ✅
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As a Cardiologist, the 5 keys to cardiovascular health are:
1. High V02 Max
2. Insulin Sensitivity
3. Lifelong Low APOB
4. Normal Blood Pressure
5. High Muscle Strength & Mass
Focus on these right and it's challenging to go wrong.
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High Blood Pressure Is A Silent Killer.
High blood pressure is the risk factor linked to the greatest number of deaths globally.
Here are 5 simple things you should know about blood pressure to reduce your risk of heart disease.
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"What is a normal cholesterol?"
As a cardiologist, I get this question all the time.
Most people are getting this all wrong.
📕Make Sure To Bookmark✅
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Meditation should have been a daily practice.
I've always wanted to meditate, but I just didn't.
Now that I have a daily practice, it has changed my life.
Not in terms of performance but in terms of learning to focus on the correct priorities for me & how I live my life.
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If you can't comfortably run 5K...
Please stop reading about..
Mitochondrial Health
Supplement Stacks
Protein synthesis
Fat oxidation
Get your trainers.
And just get moving.
I promise you it will serve you better.
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We can lower cholesterol by over 85%.
Here's how.
📕 Make Sure To Bookmark ✅
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Walking Can Change Your Life.
Here Are 5 Reasons Why:
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We can lower LDL cholesterol by over 85%.
Here's how.
📕 Make Sure To Bookmark ✅
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Don't be fooled by averages.
The average age of death is 77 for Males & 83 for Females.
But if you are a normal weight, active, non-smoker with a good diet who drinks modestly, those figures change to:
87 years for Males.
93 years for Females.
It's all a game of odds.
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If you have a CT Calcium Score of 0
And have elevated LDL-C/APOB
Should you take cholesterol-lowering medications?
📕Make Sure To Bookmark✅
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We've all heard this story.
A person goes for a stress test to ‘check their heart’ and is told they ‘passed with flying colours’.
The following week they have a heart attack.
How is this possible?
Here's how.
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V02 max does not lie.
You can tell your doctor you have been ‘active’, but your V02 max will tell the truth. A truth you cannot hide from.
The higher your V02 max, the greater the likelihood you will live a longer life.
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That's a wrap!
If you would like free weekly content like this and more, make sure to sign up below.
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If you use it right, Twitter is the most powerful health tool in the world.
Most people have no idea that world-class health & medical advice is available for free.
Here are 7 World Class Experts you should follow: 👇
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Here's how to lower your blood pressure without using medications.
📕 Make Sure To Bookmark ✅
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The evidence that higher aerobic fitness levels are associated with lower rates of dementia is clear!
If cognitive impairment is what you fear.
Move. Move. Move.
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"What can I do to lose weight?"
As a cardiologist, I get this question every day.
Most people get this all wrong and are totally confused when they look online.
Let's break it down.
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This is one of the biggest mistakes that people who regularly exercise make.
I made it.
For years.
And I regret it.
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Your cardiovascular health in your 50s, 60s and 70s.
Will be dictated by the things you do in your 20s, 30s and 40s.
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Most people don't know HOW to get Heart Healthy.
If you do these 7 things
You reduce your chances of dying from heart disease by 93%!
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As a cardiologist, here is what I tell my patients
To help them lose weight and maintain muscle mass using nutrition.
Because most people have this all wrong.
📕Make Sure To Retweet✅
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We've all heard this story.
A person goes for a stress test to ‘check their heart’ and is told they ‘passed with flying colours’.
The following week they have a heart attack.
How is this possible?
Here's how.
📕Make Sure To Bookmark✅
🧵👇
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9 Reasons People Get Heart Disease Earlier In Life.
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Over 60% of adults are not doing enough resistance training.
This likely has serious consequences for their health.
Here are 5 reasons why you should be doing resistance training.
📕Make Sure To Bookmark✅
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A 20 mmHg increase in systolic blood pressure Doubles the risk of a fatal heart attack or stroke.
~ 50% of all adults have high blood pressure.
Most don't know they have high blood pressure.
Here is how you measure your own blood pressure.
📕Make Sure To…
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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.
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High Blood Pressure is the single most important risk factor for early death worldwide.
But what blood pressure should you aim for?
Getting this wrong can cost you dearly.
Here's why
📕Make Sure To Bookmark✅
🧵👇
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Don't use your watch to calculate your V02 max....
You just need 12 mins
And a pair of trainers.
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Having a child is one of the most profound things you will do in your life.
I had my first child later in life ~ 40.
Here are 5 things that having a child has taught me.
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Here are 5 Tests I would do if I was between 40 to 60 years of age
And concerned about my risk of heart attack in the near future. 👇👇👇
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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.
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Most people go to their doctor to reduce their risk of heart disease.
But here are 10 ways to reduce your risk that don't need a doctor.
📕Make Sure To Bookmark✅
🧵👇
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Between 40 - 60 years of age and want to know if you are at risk of a heart attack in the next 5 years?
Here are five things I would do. 👇
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Focusing on aerobic training in isolation.
I am a major offender here.
If you are using exercise to reduce your risk of major diseases, then you need to do both:
Aerobic & Resistance Training.
Without a proper frame, you cannot load it.
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As a cardiologist, here are 5 things
I think every 30 to 50-year-old should know about preventing heart disease.
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So many people are wondering if they should stop consuming aspartame
Because it ‘might’ cause cancer
(WHO 2B - Lowest level evidence).
Yet frequently drink alcohol
(WHO 1 - Highest level evidence)
Which is in the same category as:
Asbestos
Tobacco
Radiation
🤷♂️🤷♂️🤷♂️
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How To Reverse Coronary Artery Disease With Lifestyle Measures.
📕Make sure to bookmark. ✅
🧵👇
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Why waiting to start on a cholesterol-lowering medication until you are older is NOT a good strategy.
Start at:
Age 60 - 27% reduction in events.
Age 50 - 35 reduction in events.
Age 30 - 52% reduction in events.
And this is with a starting LDL-C of only 3.5 (67).
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If you are serious about living longer with a higher quality of life
You have to be serious about exercise.
If not.
You are not serious.
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Do You Need A Stent To Treat Your Heart Disease?
📕Make Sure To Bookmark✅
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Things I know as a 43 year old Cardiologist that I wish I knew as a 23 year student.
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Most people lose between 30-40% of their muscle strength over their lifetime.
For every 5 kg loss of grip strength the odds of dying from any cause increase by about 15%.
Muscle strength is a trainable metric.
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Cancer is the 2nd leading cause of death worldwide.
Many cancers are preventable.
Here's how
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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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Don’t work continuously for 58 hours.
Ever.
That is all.
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The Benefits of Physical Activity:
1. ⬇️ Blood Pressure
2. ⬇️ Adiposity
3. ⬇️ Inflammation
4. ⬇️ Insulin Resistance
5. ⬇️ Resting HR
6. ⬇️ Sympathetic Activity
7. ⬆️ HDL-C
8. ⬇️ LDL-C
9. ⬇️ Stress
10. ⬇️ Depression
11. ⬇️ Anxiety
12. ⬆️ Cognitive Function
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90% of cardiovascular health is just:
Giving yourself space and time to exercise
Spending time with those you love.
Getting 8 hours of sleep.
Eating real food.
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Muscle Mass & Muscle Strength
Are major determinants of
How long you will live
And the quality of your life as you age.
Few people get this one right.
📕Make Sure To Bookmark✅
🧵👇
/1
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If you are too busy to exercise, then you are too busy.
Physiology does not care about your schedule.
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If you found this thread useful:
Please like or retweet the first tweet in the thread
Follow me:
@Paddy_Barrett
&
On Substack -
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High Blood Pressure is the single most important risk factor for early death worldwide.
But what blood pressure should you aim for?
Getting this wrong can cost you dearly.
Here's why
📕Make Sure To Bookmark✅
🧵👇
/1
15
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Here's the math behind extending your lifespan by 12 to 14 years.
Don't smoke
Stay active
Normal weight
Modest Alcohol
Good Diet.
Get these right at age 50:
For Males - Add 12 years to your life
For Females - Add 14 years
Nothing fancy.
Just get the fundamentals right.
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A friendly reminder that bookmarking a thread on fitness does not improve your V02 Max or Muscle Mass.
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Here are 4 targets for optimal cardiovascular health:
- APOB <5th Percentile
- Fasting Insulin - Low single digits
- Blood Pressure <120/80
- VO2 Max Top 25th Percentile
Get these right. You win the game.
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High Levels Of Muscle Strength are associated with longer life spans.
How to measure at home:
The 30-Second Chair Test
1. Sit on a stable chair with arms crossed.
2. Stand up & sit as many times as you can in 30 seconds
3. See where you stack up.
4. Train accordingly.
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V02 max does not lie.
You can tell your doctor you have been ‘active’, but your V02 max will tell the truth. A truth you cannot hide from.
The higher your V02 max, the greater the likelihood you will live a longer life.
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Here are 4 targets for optimal cardiovascular health:
- APOB <5th Percentile
- Fasting Insulin - Low single digits
- Blood Pressure <120/80
- VO2 Max Top 25th Percentile
Get these right. You win the game.
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Regular physical activity significantly reduces the risk of dementia.
But how much exercise do you need to do?
And what types?
🧵👇
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Muscle Mass & Muscle Strength are major determinants of how long you will live and the quality of your life as you age.
Here's why.
🧵👇
/1
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Lp(a) is a type of cholesterol particle that can raise your risk of heart disease and stroke.
But what is it and how can you lower it?
🧵👇
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Here are 3 Secrets Every Cardiologist WANTS you to know:
- A blood pressure in the 130s is ok. A BP in the 120s is better.
- Non-HDL isn’t perfect but it’s almost as good as an APOB.
- Have a family history of early heart disease? Please check your Lp(a)
Psst… Tell Everyone
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Here are 4 targets for optimal cardiovascular health:
- APOB <5th Percentile
- Fasting Insulin - Low single digits
- Blood Pressure <120/80
- VO2 Max Top 25th Percentile
Get these right. You win the game.
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I am 43. This is what I am doing to make sure I get to 83.
📕Make Sure To Bookmark✅
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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.
📕Make Sure To Bookmark✅
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If you are too busy to exercise, then you are too busy.
Physiology does not care about your schedule.
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Insulin Resistance (IR) is a key factor in the 3 diseases that are likely to be the cause of your death:
- Cardiovascular Disease
- Cancer
- Dementia
IR is not causal. But a huge amplifier of risk.
But how do you know if you have Insulin Resistance?
Here's how
🧵👇
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Beating the Odds: Inside the Tribe with a Near-Zero Rate of Heart Disease.
📕Make Sure To Bookmark✅
🧵👇
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Between 40 - 60 years of age and want to know if you are at risk of a heart attack in the next 10 years?
Here are five things I would do. 👇
📕Make Sure To Bookmark✅
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In my experience
The number one cause of 'White Coat High Blood Pressure' is....
High Blood Pressure.
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Optimising Your Cardiovascular Health is about stacking the odds in your favour.
Here are 10 things you can do to ensure you are on the lower end of the risk curve.
🧵👇
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So many of you have asked when I was going to write a book.
Well.
Here it is.
Heart: An Owners Guide.
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Someone asked me a great question:
If I could only test 5 things on a patient to assess their cardiovascular risk what would they be?
My answer:
1. V02 Max
2. APOB
3. Insulin Kinetics
4. Blood Pressure
5. Visceral Fat
I would optimise these first.
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