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48-Year-Old Man with Heart Issues: Should He Stop Medications?

Dr Karthiyayini

Dr Karthiyayini Mahadevan  | Answer  |Ask -

General Physician - Answered on Jul 09, 2024

Dr Karthiyayini Mahadevan has been practising for 30 years.
She specialises in general medicine, child development and senior citizen care.
A graduate from Madurai Medical College, she has DNB training in paediatrics and a postgraduate degree in developmental neurology.
She has trained in Tai chi, eurythmy, Bothmer gymnastics, spacial dynamics and yoga.
She works with children with development difficulties at Sparrc Institute and is the head of wellness for senior citizens at Columbia Pacific Communities.... more
Nazir Question by Nazir on Jun 27, 2024Hindi
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Sir, i am 48 years old and working in gulf country since 1997, almost 27 years, 2 years before i had heart issue, and doctor did the heart catrization procedure and they put the one stent, i continue taken the BP, calostrol and sugar mediation. i have hi potential, other than no issue, i need to stop the other medicine but doctor told me i have to continue, every day i am taken 5 medicine. please advise

Ans: To get out of the supportive medication, you need to strictly follow certain disciplines in yourlifestyle
1.Timely meals-Atleast early dinner by 6 pm
2.Periodic fasting(varies with your ability and will) , maybe once a fortnight
3.Regular exercise according to your ability, safest-walks 30 mts five days a week
DISCLAIMER: The answer provided by rediffGURUS is for informational and general awareness purposes only. It is not a substitute for professional medical diagnosis or treatment.
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Dr Hemalata

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Hello Doctor, I am 44. I prefer healthy life and all nice in terms of health, except that I was suffering from gastric issues, IBS and related issues. I had covid also in April 2021 and somewhere in Oct 2021, i started feeling anxious and all negative thoughts. In about Aug 2021, i noticed that my heartbeats is high than normal, which initially i tried to control with routine meditation. But somehow, was not feeling that well from within and mind was like getting anxious, as if , something is happening which i could not understand, what. I visited to MD - Medicine, in Oct 2021. As a process, the vitals were taken and BP reading was taken which was 145/90. The concern MD, which after going through the reading, did not tagged me as BP patient and advised me to have changes in lifestyle with yoga, walking, meditation and dietary changes. I throughly followed the advised and started feeling better from Jan 2022 onwards and it was all nice. Again from Sep 2022 onwards, i started feeling the same issues. And i visited the MD in Oct 2022. From Nov 2022, he put me on 25mg dose of beta-blocker , daily in the morning after breakfast. While, i was on beta-blocker, i was still not feeling that nice from within and i unilaterly took the decision to go for complete blood tests in Nov 2022 end. The results were, - Lipid profile - was disturbed. - Sugar : I was in pre-diabetic range. - Uric Acid : I was on borderline high. I visited the MD with the report and he add another dose of 10 mg of Statins from Dec 2022 onwards. I followed the medication along with dietary changes, yoga & meditation routine and took the tests in Jan 2023, which shows the results as under, - Lipid : Normal - Sugar: I was back to Non-Diabtic range from pre-diabetic. - uric acid - normal. And all other parameters improved too like Hemoglobin - 15 and all other paramters of cbc was normal, thyroid - normal , Liver function - normal - when certain times SGPT was bit on higher sides, but normal in this report. With this report the MD stopped the statin drug from Feb 2022 onwards and advised me to continue with beta-blocker of 12.50 mg instead of 25 mg. I followed the same routine for full Feb 2022 and again took the test in March 2023, and results were as under, - Sugar : non-diabetic - all other paramters - normal - Lipid - Not normal. So again from March 2023, the MD started with the same statin dose of 10 mg and beta- blocker of 25 mg. I took the test in April 2023 and again the reports were normal, so now, again he reduce the statin dose to half ie 5 mg and continued with the same dose of beta-blocker 25mg. My questions: 1. AT present, i follow proper diet schedule as prescribed by dietcian , have been doing meditation and yoga on regular basis. 2. Stress level is minimum. 3. I am feeling overall better. 4. BP levels are always normal 5. Gastric issues, IBS seems to have gone. 6. Sleep patern is improved. My question: a. I feel, in the next visit the MD may stop the statin. Can the lipid profile remain in normal range , when i am follwing all diet patterms , with yoga and exercise. Why the lipid profile became abnormal, previously even when i was following all routine very property ? b. Is it okay to consume beta - blocker 25mg regularly, even after doctor told me to stop statin or may stop my statin in next visit? c. Is there any way to know, to find, if i am feeling better normally or due to medicine? as i am feeling normal and unable to check, what after i stopped beta-blocker? Any other care which i should take and lead a healthy life.
Ans: Hello. These are good questions and a lot of people go through the same stages. Cholesterol levels are generally genetically determined and don't change much from dietary or lifestyle changes. It can be reduced by medications. However if it is the only risk factor for heart disease/stroke, then it need not be corrected unless it is very high, LDL> 160. On the other hand the B blocker, if it was taken only for BP, may be stopped if BP comes down and remains normal. A closer monitoring may be required for that. If BP stays normal or low on taking the medicine, reduce the medicine and recheck, if it still stays low or normal, stop and see. Take it slow.

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What should I do after my bsc in medical
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Where should I invest Rs. 50000 in Index mutual fund or in ETF?
Ans: When deciding between Index Mutual Funds, ETFs, and actively managed diversified equity funds, actively managed funds often stand out. Let’s analyse why active diversified equity funds are a better option for your Rs. 50,000 investment.

Understanding Index Funds and ETFs
Index Funds: These passively replicate an index like NIFTY 50 or SENSEX. They aim to match the market’s performance, not beat it.

ETFs (Exchange Traded Funds): Similar to index funds but trade like stocks on exchanges. They require a Demat account.

Disadvantages of Index Funds and ETFs
Limited Returns Potential
Index funds and ETFs only track the market.
They cannot outperform the benchmark, even when market conditions allow for superior performance.
No Protection in Market Downturns
Index funds replicate the index, so they fall equally during market downturns.
Active funds may reduce losses with better sector and stock allocation.
Lack of Professional Judgment
Index funds follow pre-set rules, ignoring company-specific fundamentals.
Actively managed funds use professional fund managers who adjust portfolios to maximise gains.
Hidden Costs in ETFs
ETFs may seem cost-effective but involve additional brokerage and Demat account charges.
Liquidity issues can lead to price variations between the market price and NAV.
Benefits of Active Diversified Equity Funds
Potential for Superior Returns
Experienced fund managers aim to outperform the benchmark.
They carefully select high-potential stocks across sectors and market caps.
Flexibility in Stock Selection
Active funds are not restricted to index stocks.
They pick companies with strong fundamentals, growth prospects, and attractive valuations.
Downside Protection
Fund managers can reduce exposure to risky sectors during market downturns.
This minimises losses compared to passive funds.
Tax Efficiency with Strategic Planning
Gains can be optimised with periodic review and rebalancing.
Active funds often deliver better after-tax returns over the long term.
Why Rs. 50,000 Fits Well in Active Diversified Equity Funds
A one-time investment of Rs. 50,000 deserves active management for maximised growth.
Over 5–10 years, active funds are better positioned to beat inflation and create wealth.
Suggested Allocation for Active Diversified Equity Funds
Large-Cap Equity Funds (30%-40%): Stability and consistent returns.
Flexi-Cap Equity Funds (40%-50%): Flexibility to invest across market caps.
Mid-Cap Equity Funds (20%-30%): Higher growth potential with moderate risk.
Key Considerations
Stay invested for at least 7–10 years for compounding benefits.
Review performance annually and rebalance if needed.
Avoid chasing short-term trends or reacting to market noise.
Final Insights
Index funds and ETFs are suitable for certain scenarios, but they lack active management benefits. By investing Rs. 50,000 in actively managed diversified equity funds, you can maximise returns, minimise risks, and benefit from professional expertise.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in
https://www.youtube.com/@HolisticInvestment

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