CHD risk factors and age: Association of Lipid, Inflammatory, and Metabolic Biomarkers With Age at Onset for Incident Coronary Heart Disease in Women
I have a question on the above-referenced JAMA study from January 2021. While I couldn't access the full study (paywall), I was intrigued by this part of the conclusion: "Most risk factors had attenuated relative [risk] rates at older ages." Why is that? Why would diabetes at 70 pose a lower relative risk than diabetes at 50? If anything, it seems that the relative risk should increase because a woman of 70 likely has had diabetes for more years than a woman of 50. Why would a high apoB at 70 be relatively riskier than a high apoB at 50? And so on. Thank you.
Covid Vaccination for Carriers of Krabbe's Disease
Hi Peter, We found out the hard way that my wife and I are carriers of Globoid Cell Leukodystrophy. Most only remember it as a test question about Cherry Red Spots on the eye exam in Neurology class. Anyway, our second child survived, but is a carrier like us. Do you see any reason why carriers of Krabbe's should refrain from Covid-19 vaccinations due to our underlying Neurological condition?
Super ventricular tachycardia and now ectopic heart beats
Hi Peter, Hope you are well, I realise this won't constitute healthcare advice so I'll try to ask some broad questions and hopefully get a more useful answer for more people. I'm a fairly metabolically inefficient 38 year old and I have been recently exercising much more and going for 3 to 5km run almost every day. Feeling a lot better generally but I've now started getting ectopic beats and general tiredness and as I'm worried about my heart I've decided to stop the running a bit. I'm told that ectopic beats are generally nothing to worry about but I'm slightly concerned they might trigger my SVT and so on. I would say my sleep is pretty poor on average even though I'm trying to be cleaner around sleep hygiene. Should I maintain this level of running or pull back in the hope the ectopic beats recede? I wanted to increase my running and exercise over time, not decrease it. Should I try acupuncture or something more extreme in terms of diet to help alleviate these symptoms? A more general talk around strategies you'd recommend to patients with electro-cardiology issues would be amazing! Thanks for everything you're doing!
Durability of COVID immunity
Could you provide an update on your current view of the durability of immunity to COVID from both natural infection and vaccination? Do you recommend that your patients who have had COVID still get vaccinated given the limited length of safety data/ EUA status of the vaccines? If so does it matter which vaccine, one or two doses, etc? Would your advice vary depending on age and health status? I think the trade-off is potentially more clear if you haven't had COVID (you don't know how it will affect you and the vaccines seem pretty safe so better not to take the chance). But if you've already had it, how do you think about the risk reward? Thanks