• Our Team
  • GP Symposium 2025
  • GP Heart Blog
  • Patient Info
  • New patient form
  • Contact
Menu

Cardiology Institute

Unit 109, 119 Apollo Drive, Albany, Auckland
consult@cardiologist.co.nz
P: xxx-xxxx; F xxx-xxxx
Unit 109, 119 Apollo Drive, Albany, Auckland. P: 000-0000. F: 000-0000. consult@cardiologist.co.nz. EDI: cardinst

T 09-980-6363. M 022-672-8255. F 09-929-3248. consult@cardiologist.co.nz. EDI: CARDINST

North Shore - Suite 109, Level 1, 119 Apollo Drive, Albany

Silverdale - Northern Specialist Centre @Beyond; 5 Painton Road, Silverdale.

Central Auckland - 110 Specialist Centre @ Beyond;v110 Grafton Road, Grafton

East Auckland - East Care Specialist Centre, 260 Botany Road, Howick, Manukau

Cardiology Institute

  • Our Team
  • GP Symposium 2025
  • GP Heart Blog
  • Patient Info
  • New patient form
  • Contact

Primary aldosteronism - the cardiologist's simplistic approach

September 7, 2019 Andrew To
Aldosterone

Aldosterone

Screening for secondary causes of hypertension is important, though often not thought of. Primary aldosteronism is the most common endocrine cause. The screening test is the aldosterone-renin ratio (ARR).

Read more
In Drug Treatment, Hypertension Tags hypertension, renin, aldosterone

What should I do with heart failure with preserved ejection fraction?

September 7, 2019 Andrew To
Homage to Mondrian by Nipan Keawkumdee

Homage to Mondrian by Nipan Keawkumdee

HFpEF stands for heart failure with preserved ejection fraction. Commonly, it is defined as those with an LV ejection fraction of more than 50%, though varying definitions do exist.

This condition is poorly understood and is difficult to diagnose, because it is largely one of excluding other potential non cardiac causes of symptoms suggestive of HF.

Read more
In Drug Treatment, Hypertension Tags heart failure, hypertension, beta-blocker, ACE inhibitor, woman

Hypertension treatment – how should we choose?

September 6, 2019 Andrew To
Billy Apple @ Auckland Art Gallery 2015 (2 Minutes 33 Seconds (Red))

Billy Apple @ Auckland Art Gallery 2015 (2 Minutes 33 Seconds (Red))

First line agents for hypertension are one of three classes:

-       ACE inhibitors or Angiotensin receptor blockers

-       Thiazides

-       Calcium channel blockers

Drug preference is mainly influenced by co-morbidities and contraindications, rather than a simple age cut-off. 

Read more
In Hypertension, Drug Treatment Tags beta blocker, ACE inhibitor, calcium channel blocker, hypertension, thiazide

BP therapy initiation - Combination vs. Single Agent

September 4, 2019 Andrew To
Expected BP lowering with different anti-hypertensive classes and dosages.

Expected BP lowering with different anti-hypertensive classes and dosages.

65M with Type 2 diabetes on oral hypoglycaemics but no proven coronary artery disease, BP 150/95mmHg despite 3 months of intensive lifestyle modifications, not currently on anti-hypertensives. Would you?

-      Introduce low dose ACE inhibitors, with gradual up-titration

-      Introduce combination ACE inhibitor / thiazide, with up-titration later on

Read more
In Drug Treatment, Hypertension Tags hypertension, Side effects, calcium channel blocker, ACE inhibitor, thiazide, beta blocker, primary prevention

Alcohol consumption risk thresholds

August 6, 2018 Andrew To
See below!

See below!

Despite apparent “benefit” for heart attacks, increasing levels of alcohol consumption increase the risk of all-cause mortality and of cancers specifically, meaning that the level of consumption that minimises health loss is probably zero. At most, 100g per week is the absolute maximum before which risk increases significantly.

Read more
In Hypertension, Lifestyle modification, Myocardial infarction Tags alcohol, primary prevention

Nocturnal hypertension

April 20, 2018 Andrew To
Arboria, 2015 @ Aotea Square

Arboria, 2015 @ Aotea Square

65M presented for a general health check, asymptomatic on systems enquiries.  BP was 150/90mmHg with no other abnormalities. You decided to send him for an ambulatory blood pressure monitor to establish if more aggressive intervention is necessary. The report states that he is not a nocturnal dipper. His average diurnal BP was 145/85mmHg. Would medications be necessary? Is there anything else we should consider?

Read more
In Hypertension, Drug Treatment Tags hypertension, obstructive sleep apnoea, obesity
1 Comment

Lifestyle changes for hypertension – exactly how effective is it?!

April 19, 2018 Andrew To
Topolobampo, Chicago, IL

Topolobampo, Chicago, IL

In general practice (and in secondary care), we discuss at length lifestyle modifications that aid blood pressure lowering. But exactly how effective are the various strategies?

There are 5 things we could do to reduce our blood pressure, without medications.

Read more
In Hypertension, Drug Treatment Tags hypertension, Risk assessment, primary prevention

Atrial fibrillation – is there a role for lifestyle modification?

February 9, 2018 Andrew To
Chocolate, camote, coconut @ Topolobampo, Chicago, IL

Chocolate, camote, coconut @ Topolobampo, Chicago, IL

55M presented with first episode of paroxysmal atrial fibrillation proven on resting ECG in the GP practice. Echocardiogram showed structurally normal heart. The cardiologist decided to manage conservatively without starting anti-arrhythmics right now. Which of the following risk factor management should be part of his AF treatment and prevention?

Read more
In Drug Treatment, Lifestyle modification, Hypertension, Atrial fibrillation Tags Atrial fibrillation, weight, obesity, alcohol, hypertension

ACC AHA Hypertension Guidelines 2017 – What’s new?

February 1, 2018 Andrew To
@ AHA Meeting in Anaheim 2017 - taking notes

@ AHA Meeting in Anaheim 2017 - taking notes

The ACC/AHA Hypertension Guidelines 2017 was released in the AHA meeting in Anaheim, Californiain November 2017.

While there were a lot of changes, I think it has simplified a lot of the complexities surrounding treatment threshold and goal.

Read more
In Drug Treatment, Hypertension Tags hypertension, calcium channel blocker, ACE inhibitor, beta blocker

“My cholesterol is almost normal – why do I need statins, doctor?”

January 31, 2018 Andrew To
Baja hiramasa yellowtail, pineapple two ways, achiote infused agave @Topolobampo, Chicago, IL

Baja hiramasa yellowtail, pineapple two ways, achiote infused agave @Topolobampo, Chicago, IL

Traditionally, we are taught that laboratory tests have “normal ranges”, such as in haemoglobin or creatinine.  However, this concept of “normal”, when applied in cholesterol measurement, often creates confusion amongst some clinicians and certainly in most patients.

Read more
In Drug Treatment, Hypertension Tags Statins, Risk assessment, hypertension

Copyright @2024 Cardiology Institute; All photos copyright @2024 Andrew To