Dr. Benny's Heartsmart

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Dr. Benny's Heartsmart

Be aware of your heart! Heart diseases especially Coronary Artery Disease is rising globally and is the number one cause of death worldwide.

Be heart smart! This page is created to increase the awareness of this disease, ways and lifestyle changes that can prevent this disease and various treatment options for this disease.

09/10/2026

❤️ Heart health begins with awareness—and grows through everyday action.

Today, I had the pleasure of delivering a Meditalk on “Modern Lifestyle & Heart Health” at CSI St. James Church, Muscat, organised by the Almaya Fellowship.

Carrying forward the spirit of World Heart Day, we discussed recognising the early warning signs of heart disease, seeking timely medical attention, and reducing cardiovascular risk through healthier habits and effective control of blood pressure, cholesterol and diabetes.

My message was simple: know your risk factors, listen to your heart’s warning signs, and make prevention part of daily life.

Thank you to the organisers and church community for the warm welcome and thoughtful memento of appreciation. Taking heart health awareness beyond the hospital and into our communities is a privilege I deeply value.

Dr. Benny Panakkal
Dr. Benny’s Heartsmart ❤️

05/10/2026

☕ Coffee and your health: what does science say?

Your daily coffee can fit comfortably into a healthy lifestyle. Research links moderate coffee drinking with lower risks of type 2 diabetes, liver disease, cardiovascular disease and premature death.

But there is an important distinction: most long-term evidence is observational. These associations do not prove that coffee itself prevents disease.

A few practical tips:

✅ Paper filters reduce coffee oils that can raise LDL cholesterol.
✅ Cup size and strength matter—four cups can contain very different amounts of caffeine.
✅ For most adults, keep total caffeine within about 400 mg daily; this is a limit, not a target.
✅ Reduce caffeine if it disturbs sleep, causes palpitations or raises your blood pressure.

And those headlines about more muscle and higher testosterone? The evidence does not justify increasing your intake for those reasons.

Enjoy your coffee alongside the habits that matter: regular exercise, balanced nutrition and good sleep.

Dr. Benny Panakkal
Badr Al Samaa Royal Hospital

30/09/2026

Richard Asher (1912-1969) was a
British physician, teacher, and medical writer admired for his wit, clear thinking, and deep concern for patients. He challenged accepted medical habits and championed simplicity in communication. As a physician, I find his writings a lasting reminder that knowledge must be accompanied by judgment, humility, and compassion. His "Seven Sins of Medicine,"

Published in 1949, still invite every doctor to reflect on how we practise.

SEVEN SINS OF MEDICINE
Reflections on Richard Asher’s enduring wisdom

As a physician, I have long admired Richard Asher for his clarity, humanity, and willingness to question medical habits. His “Seven Sins of Medicine,” published in The Lancet in 1949, remain remarkably relevant today.

Here is my interpretation of his message for modern practice:

1. Obscurity
Explain clearly. Medical knowledge should help patients understand, rather than leave them intimidated by jargon.
2. Cruelty
Be thoughtful with words and interventions. Honest conversations require compassion, and every investigation should have a meaningful purpose.
3. Bad manners
Listen patiently and treat patients, families, nurses, and colleagues with respect. Courtesy is part of clinical competence.
4. Over-specialisation
Develop expertise without losing sight of the whole person. Patients’ needs extend beyond the boundaries of our specialties.
5. Love of the rare
Consider uncommon diagnoses, but keep probability in perspective. An intriguing diagnosis is not necessarily the most likely one.
6. Common stupidity
Avoid treating by habit. Evidence and guidelines are essential, but their application requires judgment and attention to the individual patient.
7. Sloth
Remain curious and thorough. Examine, question, reassess, and keep learning. Neither a previous diagnosis nor an AI-generated answer should replace independent thought.

For me, Asher’s message is a reminder that progress in medicine must include progress in how we listen, think, explain, and care.

Technology expands what we can do. Wisdom helps us decide what we should do—and compassion guides how we do it.

Dr. Benny Panakkal

Inspired by: Asher R. The seven sins of medicine. The Lancet. 1949;2(6574):358–360.
https://doi.org/10.1016/S0140-6736(49)90090-2

23/09/2026

YOUR COOKING OIL MATTERS—AND SO DOES THE AMOUNT!

A recent newspaper report on ICMR–INDIAB research linked predominant use of ghee and coconut oil with higher odds of elevated LDL (“bad”) cholesterol compared with groundnut oil.

These findings deserve attention. However, observational studies show associations; they cannot prove that a particular oil caused high cholesterol. Higher odds of elevated LDL also do not translate directly into the same increase in heart-attack risk.

What does this mean for our kitchens?

CHOOSE UNSATURATED FATS
Olive, canola, groundnut and sesame oils are practical options. Use them to replace saturated fats rather than simply adding more oil to your meals.

LIMIT SATURATED FATS
Ghee, butter, coconut oil and palm oil contain more saturated fat, which can raise LDL cholesterol. Use smaller amounts for flavour rather than making them your main cooking fat.

MEASURE YOUR PORTIONS
Even healthier oils are calorie-dense. Pouring freely can add substantial calories to your meals.

COOK WISELY
Avoid repeatedly heating or reusing frying oil, and do not heat oil until it smokes. Choose steaming, baking or sautéing more often than deep-frying.

LOOK BEYOND THE LABEL
“Natural,” “traditional” and “cold-pressed” do not automatically mean an oil lowers cholesterol. Its fat composition, the amount used and your overall diet matter.

My practical advice: choose an unsaturated oil that suits your cooking and budget, use it modestly, and build meals around vegetables, pulses, whole grains and other nutritious foods.

Changing your cooking oil is one useful step towards better heart health. It complements—rather than replaces—cholesterol monitoring and prescribed treatment.

Useful References:

1. ICMR–INDIAB study abstract: Cooking Oil Choice and Cardiometabolic Risk Among Asian Indians: Evidence from the Indian Council of Medical Research–India Diabetes (ICMR–INDIAB) National Study. Circulation. 2026;153(Suppl 1):Abstract 22. Conference abstract⁠. This is the study corresponding to the newspaper report; its full text was inaccessible, so I have avoided reproducing unverified numerical estimates.

2. American Heart Association: Healthy Cooking Oils⁠. Supports olive, canola, groundnut and sesame oils as options, alongside advice on avoiding overheating and reusing oil.

3. Sacks FM, et al. Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation. 2017. doi:10.1161/CIR.0000000000000510⁠. Reviews evidence supporting replacement of saturated fats with unsaturated fats to reduce cardiovascular risk.

21/09/2026

It was a pleasure to host a Lunch Roundtable Meeting at Badr Al Samaa Royal Hospital, bringing together physicians and cardiologists from neighbouring hospitals and clinics for an engaging exchange of knowledge and experience.

I had the opportunity to present a focused session on contemporary coronary intervention, highlighting:

• Intravascular imaging, particularly Optical Coherence Tomography (OCT)
• Calcium modification using Intravascular Lithotripsy (IVL)
• Emerging concepts in metal-free coronary angioplasty

Following the presentation, participants visited our new AI-enabled Cath Lab, where selected OCT-guided cases were reviewed. They also had the opportunity to examine OCT and IVL catheters and better understand their design, function, and practical application in complex coronary interventions.

Such interactive academic meetings strengthen collaboration between institutions and help translate advances in cardiovascular technology into safer, more precise, and patient-centred care.

My sincere thanks to all the participating physicians and cardiologists for their enthusiastic involvement and valuable discussions.

18/09/2026

❤️ A Landmark That Changed Cardiology Forever

This week marks the anniversary of a defining moment in medical history.

On 16 September 1977, Dr. Andreas Grüntzig performed the world’s first successful coronary balloon angioplasty in Zurich—opening a narrowed coronary artery without open-heart surgery.

That pioneering procedure laid the foundation for modern interventional cardiology. Nearly five decades later, coronary intervention has evolved remarkably—from balloon angioplasty to drug-eluting stents, intravascular imaging, physiological assessment, calcium-modification technologies and increasingly precise, patient-centred treatment.

Yet the fundamental purpose remains unchanged: to restore blood flow, protect the heart and improve lives.

As we approach the 50th anniversary of this historic achievement in 2027, we honour the vision and courage of the pioneers—and the generations of cardiologists, scientists, nurses, technologists and cath-lab teams who continue to advance cardiovascular care.

Dr. Benny’s Heartsmart

10/09/2026

A new era of precision cardiac care in Oman. ❤️

Our AI-powered Cathlab—the first of its kind in Oman’s private healthcare sector—brings together advanced technologies including Optical Coherence Tomography (OCT) for detailed intracoronary imaging and Intravascular Lithotripsy (IVL) for treating heavily calcified coronary blockages.

Advanced technology. Greater precision. Better patient care.

— Dr. Benny Panakkal
Dr. Benny’s Heartsmart

05/09/2026

❤️ Lipoprotein(a): Lowering the Number Is Not the Same as Lowering the Risk

Most people know about LDL or “bad cholesterol.” But there is another important—and much less well-known—cardiovascular risk factor called Lipoprotein(a), or Lp(a).

Lp(a) is largely inherited, with levels mostly determined by our genes. Unlike LDL cholesterol, lifestyle changes such as diet and exercise usually have little effect on it. Approximately 1 in 5 people worldwide has an elevated Lp(a) level. Higher levels are associated with increased risk of coronary artery disease, heart attack, stroke and calcific aortic valve disease.

Because genetic and epidemiological evidence strongly supports Lp(a) as a causal cardiovascular risk factor, there has been great excitement about new medications capable of dramatically lowering it.

🧬 So, does lowering Lp(a) prevent heart attacks and strokes?

We have just received an important—and somewhat unexpected—answer from the Lp(a)HORIZON trial.

This landmark Phase III study enrolled 8,323 patients who already had cardiovascular disease and elevated Lp(a). They received either pelacarsen, an antisense therapy specifically designed to reduce production of Lp(a), or placebo, in addition to contemporary guideline-directed cardiovascular treatment.

Pelacarsen successfully lowered Lp(a).

But here comes the surprise:

👉 Lowering Lp(a) did not translate into a statistically significant reduction in cardiovascular events.

The trial therefore did not meet its primary endpoint of reducing cardiovascular death, non-fatal heart attack, non-fatal stroke or urgent coronary revascularisation.

Does this mean Lp(a) doesn’t matter?

No.

This is an important distinction. The trial does not establish that Lp(a) is unimportant or that lowering Lp(a) can never reduce cardiovascular events. It tells us that lowering Lp(a) with pelacarsen, under the conditions studied, did not significantly reduce events in the overall trial population.

We now need the complete trial results to understand the magnitude and duration of Lp(a) reduction, baseline Lp(a), subgroup effects and individual cardiovascular endpoints. Novartis has stated that the full data will be presented at an upcoming medical congress.

And the Lp(a) story is far from over. Other powerful Lp(a)-lowering therapies, including olpasiran and lepodisiran, are being evaluated in cardiovascular outcome trials. Their results will help answer the fundamental question:

Can sufficiently profound and sustained reduction of Lp(a) actually prevent heart attacks and strokes?

Until then, elevated Lp(a) remains an important marker of cardiovascular risk, and identifying it can help us recognise people who may require particularly aggressive management of all their modifiable risk factors—LDL cholesterol, blood pressure, diabetes, smoking, weight and physical activity.

Science progresses not only when a trial confirms what we expect, but also when a well-designed trial challenges our expectations.

❤️ Dr. Benny’s Heartsmart
Evidence today for a healthier tomorrow.

03/09/2026

🏋️‍♀️ Strength training may help your heart age better — not just your muscles. ❤️

We often associate resistance training with maintaining muscle, strength and independence as we grow older. This interesting 2-year randomized controlled trial suggests that its benefits may extend to the structure and function of the heart itself.

Researchers followed 64 women aged 60 years or older. Half participated in supervised progressive resistance training three times per week, while the others did not undertake the training program.

After two years, the differences were striking. Compared with the non-training group, women who performed regular resistance exercise showed less thickening of the heart muscle, lower left atrial volume and more favorable measures of the heart’s relaxation and filling function.

In simple terms: the heart, like skeletal muscle, remains remarkably responsive to exercise even later in life.

This does not prove that weight training prevents heart attacks, heart failure or prolongs life—the study examined echocardiographic changes rather than clinical outcomes. But it adds another compelling reason to include appropriately prescribed strength training as part of healthy ageing.

And importantly, the message isn’t about lifting extremely heavy weights. Regular, progressive and appropriately supervised resistance exercise is what matters.

Strong muscles. Stronger ageing. And perhaps a younger-functioning heart. ❤️

Original reference:
Rodrigues RJ, et al. Long-Term Resistance Training Improves Cardiac Structure and Function in Older Women: A 2-yr Randomized Controlled Trial. Med Sci Sports Exerc. 2026;58(6):1288–1299. PMID: 41572515.

For background on age-related cardiac remodeling: Cheng S, et al. Circ Cardiovasc Imaging. 2009;2(3):191–198. PMID: 19808592.

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Badr Al Samaa Royal Hospital , Ghubra
Muscat

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http://badralsamaahospitals.com/, https://www.brhoman.com/doctors/, https://maps.app.goo.gl/eqnQ7b4zEJwzhnD76?g_st=ic

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