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Adedapo Iluyomade MD MBA FACC FAHA

@dr.dapo

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🫀 Preventive cardiologist
🧬 Cholesterol • Blood Pressure • Metabolic health
📚 Making the science make sense
🍜 @docswhoeat
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As many of you know, I lost my beloved mother on November 8th...🕊️

Navigating this profound grief has been a deeply personal journey, and it has prompted me to reflect on the intricate relationship between emotional well-being and heart health.

Grief and Cardiovascular Health 🫀

When we experience grief, our bodies react as if we’re facing a sudden crisis. This “fight-or-flight” response floods us with stress hormones (like adrenaline), which temporarily raise heart rate and blood pressure. Over time, these changes can contribute to inflammation and strain on the heart and blood vessels, potentially increasing the risk for heart attacks or strokes.

What do the numbers say? 🧮

Research suggests that in the immediate period after a significant loss, the risk of cardiovascular events can markedly increase. For instance, some studies have found that during the first week after bereavement, the risk of a heart attack or stroke may nearly double compared to normal periods (Stroebe, Schut, & Stroebe, 2007).

Another condition linked to severe emotional stress is Takotsubo cardiomyopathy, commonly known as “broken heart syndrome.” This is a temporary heart condition that mimics a heart attack. It occurs when the heart muscle weakens (stunned), usually in response to a surge of stress hormones. While this condition is often reversible with appropriate care, it underscores how powerful the mind–heart connection can be.

Healthy Ways to Cope 🌞

Grief can sometimes lead to unhealthy habits, such as overeating, reduced physical activity, or withdrawing socially.

Stay Active: Even light exercise like walking or yoga can reduce stress and support heart health.

Practice Mindfulness: Meditation and mindfulness help calm the mind and regulate heart rhythms.

Connect: Reach out to friends, join a support group, or consult a mental health professional.

Prioritize Wellness: Balanced nutrition and sufficient sleep are essential during challenging times.

🪽

As I navigate my own grief, I hope these insights encourage others to take proactive steps for their heart and emotional health. Grief is a deeply personal journey, but you don’t have to face it alone.

🫶🏾 Dr. Dapo by @dr.dapo

Can you exercise too much for your heart?

Exercise remains one of the most powerful tools we have for reducing cardiovascular risk and extending healthy life.

But at very high, sustained training volumes, the story may be more complicated.

In a recent Master@Heart analysis, men with the highest training loads had nearly 6x the odds of coronary plaque compared to those with the lowest. The association appeared to be driven more by total training volume than intensity alone.

Important caveat: this was a cross-sectional study. It showed an association with subclinical atherosclerosis, not heart attacks, and it does not prove that exercise caused the plaque.

The new 2026 ESC/ACC consensus statement on Masters athletes puts this into a broader context. Lifelong exercise is overwhelmingly beneficial, but highly trained Masters athletes may have higher rates of certain findings, including:

• atrial fibrillation
• coronary atherosclerosis
• aortic dilation
• myocardial fibrosis in selected populations

That does not mean endurance exercise is “bad for the heart,” and finding coronary calcium does not automatically mean an athlete should stop exercising.

My takeaway is simpler:

Fitness and cardiovascular health are related, but they are not the same thing.

You can have an exceptional VO₂ max and still develop atherosclerosis.

LDL/ApoB still matters.
Blood pressure still matters.
Lp(a) still matters.
Diabetes, smoking and genetics still matter.

Exercise is medicine. But exceptional fitness (>300mins per week) is not immunity from cardiovascular disease.

Current recommendations are still for ~150min per week of moderate intensity aerobic exercise and 2-3x per week of resistance training.

#PreventiveCardiology #HeartHealth #Exercise #Longevity by @dr.dapo

We all have a story to share. Here's a bit of mine.

#ilooklikeacardiologist #thefaceofcardiology by @dr.dapo

🫀 Know Your Numbers: 5 Key Labs for Heart Health 🩺

Ever wonder what your doctor is really looking for in your bloodwork? These 5 lab tests are crucial for assessing your cardiovascular risk:

1️⃣ CMP (Comprehensive Metabolic Panel)
2️⃣ Lipid Panel (including non-HDL)
3️⃣ ApoB
4️⃣ Lp(a)
5️⃣ hsCRP

Swipe through to learn how each test informs your heart health risk! 👉

Remember, knowledge is power when it comes to preventing heart disease. Talk to your healthcare provider about these tests at your next check-up.

❓ Which of these have you had checked recently? Let me know in the comments!

#HeartHealth #PreventiveHealth #Cardiology #LabTests #MedicalEducation #blackdoctors #medicine by @dr.dapo

🫀 MIND-HEART CONNECTION ALERT 🧠

Did you know that elevated stress hormones can increase your cardiovascular disease risk by 63%?

A new 2024 meta-analysis of 43,641 participants found that higher levels of stress hormones (cortisol, norepinephrine, epinephrine) significantly increase CVD risk compared to lower levels.

The breakdown: • Norepinephrine: 68% ↑ risk • Epinephrine: 58% ↑ risk
• Cortisol: 60% ↑ risk

As a preventive cardiologist, I see this daily - chronic stress isn't just "in your head," it's literally affecting your heart.

What you can do: ✅ Practice stress management techniques ✅ Regular exercise (even 10 min walks!) ✅ Prioritize sleep quality ✅ Consider counseling/therapy ✅ Build social connections

Your mental health IS your heart health. Don't wait for symptoms to take stress seriously.

Source: Zhang et al. "Association of stress hormones and the risk of cardiovascular diseases: systematic review and meta-analysis." Exploration of Cardiology, 2024.

#PreventiveCardiology #StressAndHeart by @dr.dapo

by @dr.dapo

Fit. Big muscles. High blood pressure. But is it actually hypertension? 💪🏾🫀

Context matters. Recent exercise, an improperly sized cuff, and certain supplements or medications can all affect blood pressure readings.

But being fit doesn't make you immune to hypertension.

Measure it correctly, confirm persistent elevations, and investigate potential causes.

Normal: <120/80 mmHg
Rx starts: >140/90 mmHg for most
Goal on Rx: <130/80 mmHg

Use ambulatory blood pressure monitoring (i.e. 24hr BP monitor) for confirmation.

🎥 Original video: @erickanevsky_

#BloodPressure #Hypertension #HeartHealth #PreventiveCardiology by @dr.dapo

Retatrutide is getting a lot of attention. But do we already have a medication that's just as effective for sleep apnea?

New studies published in the New England Journal of Medicine found that retatrutide significantly reduced breathing interruptions during sleep, alongside substantial weight loss.

Impressive results. But here's what caught my attention.

At higher doses, retatrutide reduced breathing interruptions by approximately 22–24 events per hour compared with placebo in patients without diabetes. Tirzepatide (Zepbound) achieved approximately 20–24 fewer events per hour in its own trials, with weight loss also in a similar range.

A few important caveats: Different study populations, different treatment durations (80 vs. 52 weeks), and no head-to-head comparison. We can't conclude that the medications are equally effective.

But while retatrutide remains investigational, tirzepatide is already FDA-approved for moderate-to-severe obstructive sleep apnea in adults with obesity.

And that's encouraging. Sleep apnea is common, frequently undiagnosed, and associated with important cardiovascular risks, including hypertension and heart failure.

The next generation of medications is exciting. But newer doesn't automatically mean better.

Sometimes we already have a very effective treatment available.

📚 Sources: Grunstein et al., NEJM 2026; Malhotra et al., NEJM 2024.

#SleepApnea #Retatrutide #Zepbound #HeartHealth by @dr.dapo

“I'm 40, exhausted, and thinking about testosterone. But my dad had a heart attack at 45. Is it safe for me?”

This is a question I get more now, especially given how aggressively testosterone therapy is being marketed to men.

📚 Here's what the evidence tells us.

In TRAVERSE, a randomized trial involving 5,246 men with symptomatic, confirmed low testosterone and existing or elevated cardiovascular risk, major cardiovascular events occurred in:

• 7.0% receiving testosterone
• 7.3% receiving placebo

These reassuring results prompted the FDA to remove its previous cardiovascular boxed-warning language in 2025.

⚠️ But that doesn't mean testosterone is risk-free.

Atrial fibrillation, pulmonary embolism, and acute kidney injury were observed more frequently in the testosterone group...although still very few events overall. Testosterone can also increase blood pressure, raise red blood cell counts, and suppress sperm production.

And importantly, TRAVERSE enrolled men ages 45–80. We shouldn't automatically extrapolate these findings to younger men or WOMEN.

🗝️ My first question wouldn't be whether testosterone is safe. It would be whether you actually have testosterone deficiency.

Fatigue alone isn't diagnostic. We need compatible symptoms, consistently low morning testosterone measurements, and an evaluation for other potential causes.

🧑‍🧑‍🧒 And that family history?

A father having a heart attack at 45 is a major cardiovascular risk enhancer. I'd want to assess cholesterol, Lp(a), blood pressure, glucose, and other risk factors, regardless of the testosterone decision.

⭐ Bottom line: Testosterone can be appropriate for men with confirmed hypogonadism. But treatment should be individualized, monitored, and never distract from addressing underlying cardiovascular risk.

#TestosteroneTherapy #MensHealth #HeartHealth #PreventiveCardiology by @dr.dapo

“I've lost the weight. Can I finally stop my GLP-1?”

Maybe. But there's more to consider than the number on the scale.

📚 Here's what the research tells us:

In the STEP 1 extension, participants regained about two-thirds of their lost weight within a year of stopping semaglutide. Importantly, their structured lifestyle intervention also ended.

In SURMOUNT-4, participants who stopped tirzepatide regained an average of 14% of their body weight over a year, despite continued dietary and exercise counseling.

❓ Why does this happen?

Because obesity is a complex, chronic disease. Genetics, appetite-regulating hormones, metabolism, and environmental factors all influence our weight. After weight loss, biological adaptations can make maintaining it feel like pushing a boulder uphill.

Some people successfully maintain their weight without medication. Others struggle despite doing many of the right things.

🗝️ But here's the part I find especially important as a preventive cardiologist:

The cardiovascular benefits may extend beyond weight loss itself.

In SELECT, semaglutide reduced major cardiovascular events by 20% in people with established cardiovascular disease and overweight or obesity without diabetes. Subsequent analyses suggest those benefits weren't simply explained by how much weight participants lost.

⭐ Does that mean stopping GLP-1 therapy eliminates cardiovascular protection? We don't know for certain.

💯 Don't make your maintenance decision based solely on reaching a target weight. Consider your cardiometabolic health, underlying risk, tolerability, and long-term goals with your healthcare team.

🎯 Reaching your goal weight is a milestone. Maintaining your health is the real goal.

#GLP1 #WeightManagement #HeartHealth #PreventiveCardiology by @dr.dapo

Being fit and having coronary calcium are not mutually exclusive.

That distinction matters because they’re telling us different things.

Cardiorespiratory fitness reflects your body's physiologic reserve. CAC reflects accumulated coronary atherosclerotic burden and helps quantify the future cardiovascular risk that comes with it.

In this study, both signals mattered. Higher CAC was associated with more dementia risk, while better fitness was associated with lower risk, including among people with higher calcium scores.

That’s useful info.

A high CAC score shouldn't make someone think, “Exercise clarly didn’t work.” And being very fit shouldn't make someone assume, “I can’t possibly have plaque.”

Both conclusions miss the point.

You can be very fit and still have significant coronary atherosclerosis. And having plaque does not erase the benefits of fitness. In fact, if you have CAC, that's as good a signal as any to improve your fitness level/routine.

Different signals. Different biology. Both matter.

#PreventiveCardiology #CalciumScore #ExerciseMedicine #BrainHealth

Ref: Gerber Y, Leonard D, Shuval K, et al. Cardiorespiratory fitness, coronary artery calcium, and risk of later-life dementia: The Cooper Center Longitudinal Study. JACC Adv. 2026;5(9):103079. doi:10.1016/j.jacadv.2026.103079. by @dr.dapo