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As a 60 year old man with heart problems, can I avoid early cBAG with medication?

Dr Karthiyayini

Dr Karthiyayini Mahadevan  |1145 Answers  |Ask -

General Physician - Answered on Jul 06, 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
anil Question by anil on Oct 31, 2023Hindi
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sir i got my cardio ct scan and the radiologist have put an remark early cbag suggested can it be avoided by medicines . can i upload the reports to you for ur advise.

Ans: How old are you and why did you need to meet a Cardiologist in the first place?
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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General Physician - Answered on Jun 07, 2023

Asked by Anonymous - Jun 01, 2023Hindi
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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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Asked by Anonymous - Apr 22, 2025Hindi
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Dear Sirs Please review my investment towards 7.5 CR. There are 2 components towards it , 1) Generate monthly income post tax of 4 lakhs, 2) Investment Corpus Towards Capital appreciation Towards option 1 : Investing in the following - a) Tata Motors or Chola Perpetual Bonds 1.4 cr , b) ICICI Balanced Advantage Fund 1cr, c) Kotak Balanced advantage fund 1 cr Towards option 2 ie Capital Appreciation investing in the following - a) HDFC Flexi Cap Equity fund 1.25 cr , b) Parag Parikh Flexi Cap Equity Fund 1.25 cr, c) ICICI Prudential India Opportunities Fund 80 Lakhs, d) ICICI Prudential Multi asset fund 80 lakhs I am looking at a 5 - 7 year investment timeline. Have taken early retirement at 50 years and need the funds to sustain myself. Please also advise if Perpetual bonds is a good option Thanks
Ans: Your investment strategy is thoughtfully constructed. You’ve clearly defined two components:

Monthly income of Rs. 4 lakhs

Capital appreciation with a horizon of 5 to 7 years

Let’s assess each component carefully and suggest improvements.

 

 

Monthly Income Generation Plan – Review and Insights
 

You’ve allocated the following towards income generation:

Perpetual Bonds – Rs. 1.4 crore

Two Balanced Advantage Funds – Rs. 2 crore

 

Let us look at the key strengths and areas to optimise.

 

Perpetual Bonds – Risk and Suitability

These bonds are issued with no maturity date.

Issuers can delay interest payments if they face pressure.

Tata Motors or Chola bonds offer high interest, but risk is also higher.

You need dependable income. Perpetuals may cause delays or cuts.

If rated ‘AA’ or lower, risk becomes even higher.

For safety, consider shifting part to high-rated corporate bonds.

Choose instruments with a defined maturity or high credit rating.

 

 

Balanced Advantage Funds – Regular Payout Source

You have allocated Rs. 2 crore to two funds here.

These are suitable for monthly SWP (Systematic Withdrawal Plan).

They reduce risk by shifting between equity and debt.

This provides smoother return and helps handle market volatility.

Ideal for your need of steady income.

Choose funds with a good track record of 5+ years.

Go for regular plans through a Certified Financial Planner.

They provide guidance and documentation support.

 

 

Key Adjustments to Consider for Income Plan

Don’t depend only on one instrument for income.

Keep part in ultra-short debt funds to manage emergency needs.

You may also allocate a small amount to floating rate funds.

Avoid riskier perpetuals if your lifestyle depends on this cash flow.

 

 

Capital Appreciation Portfolio – Review and Suggestions
 

You have allocated Rs. 4.1 crore across four funds:

Two Flexi Cap Funds – Rs. 2.5 crore

One Thematic Fund (Opportunities) – Rs. 80 lakhs

One Multi Asset Fund – Rs. 80 lakhs

 

This section looks well-structured. Still, here are some observations.

 

Flexi Cap Funds – Long Term Growth Drivers

These offer a mix of large, mid and small cap stocks.

Flexible allocation helps in market ups and downs.

You have spread Rs. 2.5 crore across two flexi caps.

It gives diversified equity exposure.

Good for your 5–7 year horizon.

Continue this investment.

 

 

Thematic Opportunities Fund – Aggressive but Focused

Thematic funds bet on specific trends.

They can perform well in short cycles.

But they are more volatile.

Rs. 80 lakhs is a high amount in one theme.

Reduce this to Rs. 50 lakhs.

Redirect balance to diversified equity or large-cap funds.

 

 

Multi Asset Fund – Helps Manage Volatility

These funds invest across equity, debt, and gold.

They balance returns with risk.

Ideal for medium-term wealth building.

You can continue this allocation.

Add a second multi-asset fund for balance.

 

 

Direct Plan Exposure – Re-evaluate for Personalised Support

Direct plans avoid distribution cost.

But guidance is missing.

Without CFP support, wrong fund choice or exit may happen.

Regular plans through a Certified Financial Planner give tracking.

They help during market swings, taxation and rebalancing.

This becomes very important in large-value portfolios.

 

 

Asset Allocation Review – What’s Working and What Needs Tune-Up
 

Your allocation is roughly:

45% towards income (Rs. 3.4 crore)

55% towards growth (Rs. 4.1 crore)

This mix looks aligned to your goal of current income and future corpus.

Still, consider the following:

 

Review this mix yearly with your Certified Financial Planner

If market rallies too much, shift some growth to income

If interest rates rise, reduce equity withdrawal and increase debt

Keep Rs. 25–30 lakhs in liquid fund for any large emergency

 

 

Taxation on Mutual Funds – Stay Aware of Recent Rules
 

Equity mutual funds:

LTCG above Rs. 1.25 lakh is taxed at 12.5%

STCG is taxed at 20%

 

Debt mutual funds:

Both LTCG and STCG taxed as per your tax slab

Most retirees fall in lower slab but tax planning still needed

Prefer SWP for income, not dividend option

Keep P&L statement ready for advance tax filing

 

 

Tax-Free Cash Flow – Can You Improve It?
 

You can also look at these steps:

Use HUF or family member’s name for part investment

Income from their investment gets taxed in their slab

Helps reduce your tax burden

Invest Rs. 1.5 lakh yearly in PPF for guaranteed, tax-free return

Can also explore Senior Citizen Savings Scheme (SCSS) if eligible

 

 

Avoid Index Funds – Not Suitable for Your Stage
 

Index funds copy the stock market

They don’t adjust based on conditions

There’s no downside protection in falling markets

Actively managed funds give more opportunity to earn and protect

Your current selection rightly avoids index funds

 

 

Avoid Direct Plans Without Support
 

Direct plans don’t include expert guidance

No one checks asset allocation or strategy alignment

You’re investing a large corpus. Mistakes cost more here

Use regular plans via an experienced Certified Financial Planner

They help in paperwork, KYC, taxation, SWP planning, rebalancing

Their personalised help adds more value than small cost savings

 

 

Perpetual Bonds – Should You Continue or Exit?
 

Not the best for regular income seekers

Issuer can skip interest if company faces pressure

Price of these bonds also swings with interest rates

You can’t rely fully on them for Rs. 4 lakh per month

Exit partly and shift to short-duration or banking PSU debt funds

These are better for predictable income with lower risk

 

 

Review of Liquidity and Emergency Planning
 

At least Rs. 30–35 lakhs should be in liquid or overnight funds

This money is for health, family needs or urgent situations

Don’t touch your income or capital funds for this purpose

This buffer will give you confidence and reduce portfolio risk

 

 

Risk Management – How to Prepare for Unseen Events
 

Review health insurance for self and spouse

If you’ve not already done it, get Rs. 25 lakh cover each

Consider critical illness policy to protect against long illness

Update nominations in all funds and accounts

Keep estate plan or Will ready. Talk to your planner on this

 

 

Rebalancing Strategy – Keep it Dynamic
 

Review portfolio every 6 months

Don’t chase top-performing funds blindly

Instead, rebalance as per your income need and age

Reduce equity by 5% every 2 years as you age

This protects corpus and supports steady cash flow

 

 

Finally
 

You’ve structured your Rs. 7.5 crore goal very thoughtfully

You are clear about income and long-term appreciation

Your fund choice is broadly good, with only minor changes needed

Avoid risky bonds like perpetuals as your lifestyle depends on monthly cash flow

Go for actively managed regular funds via Certified Financial Planner support

Keep tax, liquidity, insurance and emergency planning all in place

This will help you enjoy your retirement peacefully and confidently

 

 

Best Regards,
K. Ramalingam, MBA, CFP,
Chief Financial Planner,
www.holisticinvestment.in
https://www.youtube.com/@HolisticInvestment

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DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

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