Preventive Cardiology & Lipid Management | Naas

Cardiology · Naas, Co. Kildare

Preventive Cardiology & Lipid Management

Comprehensive cardiovascular risk assessment, lipid management, familial hypercholesterolaemia and personalised prevention strategies — before a cardiac event occurs.

Dr Imtiaz Ali Kalyar — Consultant Cardiologist IMC: 102093 Sunday Clinics Available

Prevention Before Events

Cardiovascular disease remains the leading cause of premature death in Ireland and across Europe, yet the majority of events are preventable. Preventive cardiology focuses on identifying individuals at elevated risk, modifying that risk through lifestyle change and pharmacological therapy, and monitoring progress over time.

A preventive cardiology assessment begins with a comprehensive evaluation of all modifiable cardiovascular risk factors — blood pressure, lipids, glucose, smoking, body composition and family history — and applies validated risk prediction tools to estimate absolute cardiovascular risk. This risk estimate then drives the intensity of intervention.

Prevention is relevant at two distinct stages. Primary prevention aims to reduce risk in individuals who have not yet had a cardiovascular event. Secondary prevention — often more intensive — aims to prevent recurrent events in those who have already experienced a heart attack, stroke or other atherosclerotic disease. Dr Kalyar has expertise in both contexts.

This page is for educational purposes only and does not constitute medical advice. Consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999 or 112.

Who should consider a preventive cardiology assessment? Individuals with a strong family history of premature heart disease, those with multiple cardiovascular risk factors, patients with known high cholesterol that is difficult to control, and anyone who has had a cardiovascular event and wishes to minimise recurrence risk.

Modifiable Risks

  • Hypertension
  • Dyslipidaemia
  • Smoking
  • Diabetes / prediabetes
  • Obesity
  • Physical inactivity
  • Poor diet
  • Excess alcohol

Non-Modifiable

  • Age
  • Male sex
  • Family history
  • Ethnicity
  • Previous CVD
  • Chronic kidney disease

Cholesterol & Lipid Disorders

Elevated LDL cholesterol is the single most important modifiable risk factor for atherosclerotic cardiovascular disease. The relationship between LDL and cardiovascular risk is continuous, causal and lifelong — lower is better, and the benefit of reduction applies across the entire risk spectrum. LDL targets are set according to individual cardiovascular risk, with more aggressive targets for those at highest risk.

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Familial Hypercholesterolaemia (FH)

FH is a common inherited condition causing very high LDL cholesterol from birth. It is significantly underdiagnosed. Untreated FH carries a greatly elevated risk of premature coronary artery disease. Diagnosis involves Dutch Lipid Clinic criteria, and early treatment with high-intensity statin therapy (and often additional agents) is essential.

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Statin Therapy

High-intensity statins are the cornerstone of LDL-lowering therapy and have one of the strongest evidence bases in cardiovascular medicine. They reduce LDL by 40–55% and significantly lower the risk of heart attacks, stroke and cardiovascular death across a broad population.

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Non-Statin Options

Ezetimibe, PCSK9 inhibitors and bempedoic acid are used where statin therapy alone is insufficient or not tolerated. Combination therapy can achieve LDL reductions far beyond what statins alone can provide, and is particularly important in high-risk patients.

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Metabolic Syndrome

Metabolic syndrome — the combination of central obesity, hypertension, elevated triglycerides, low HDL and impaired fasting glucose — represents a cluster of risk factors that substantially increases cardiovascular and diabetes risk. Identifying and addressing all components simultaneously is central to effective prevention.

Risk Assessment & Lifestyle

SCORE2 & Lifestyle Medicine

Validated risk prediction models provide an objective framework for decision-making in primary prevention. Dr Kalyar uses current European guidelines including the SCORE2 algorithm to calculate your 10-year risk of a first fatal or non-fatal cardiovascular event, and uses this to guide the intensity of preventive intervention.

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SCORE2 Risk Scoring

SCORE2 calculates your estimated 10-year risk of cardiovascular events based on age, sex, smoking status, systolic blood pressure and total-to-HDL cholesterol ratio. It is calibrated to the Irish and European population and guides treatment intensity in primary prevention.

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Dietary Modification

A Mediterranean-style diet — rich in vegetables, legumes, whole grains, fish, olive oil and nuts — has the strongest evidence base for cardiovascular risk reduction. Reducing saturated fat, trans fats, sodium and ultra-processed food intake is fundamental.

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Physical Activity

Regular aerobic physical activity improves blood pressure, lipid profile, insulin sensitivity and cardiovascular fitness. Current guidelines recommend at least 150 minutes of moderate-intensity activity per week. Dr Kalyar will advise on appropriate exercise for your individual situation.

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Weight Management

Central adiposity is a key driver of metabolic syndrome and cardiovascular risk. Weight reduction — even modest — produces meaningful improvements across multiple risk factors simultaneously. Our clinic also offers specialist obesity medicine and weight management services.

Frequently Asked Questions

Familial hypercholesterolaemia (FH) is an inherited genetic condition that causes significantly elevated LDL cholesterol from birth. It affects approximately 1 in 250 people and is caused by mutations in genes regulating LDL clearance from the blood. Because cholesterol levels are high from an early age, the cumulative lifetime exposure to LDL is substantially greater than in people without FH, leading to premature coronary artery disease if untreated. FH is diagnosed using a combination of clinical criteria, family history and genetic testing. Treatment typically requires high-intensity statin therapy, often with additional agents to achieve LDL targets.
There is no single universal "safe" cholesterol level — LDL cholesterol targets are individualised based on your overall cardiovascular risk. In general, lower LDL is better across the entire risk spectrum. For very high-risk individuals (those with established cardiovascular disease, diabetes with end-organ damage, or very high SCORE2 risk), LDL targets are substantially lower than for those at low risk. A fasting lipid profile combined with a comprehensive cardiovascular risk assessment is the appropriate way to determine what your personal LDL target should be. Please consult a qualified clinician for guidance specific to your situation.
Statin therapy is recommended in two main contexts. In secondary prevention — following a heart attack, stroke, peripheral arterial disease or other atherosclerotic event — high-intensity statin therapy is recommended for all patients regardless of baseline cholesterol level. In primary prevention, statins are recommended where the estimated 10-year cardiovascular risk (calculated using a validated tool such as SCORE2) exceeds the relevant threshold for the individual's age and risk category, or where LDL is markedly elevated (as in familial hypercholesterolaemia). The decision to start statin therapy should always involve a full discussion of individual risk, benefits and potential side effects with your doctor.
A cardiovascular risk score is a validated mathematical tool that estimates an individual's probability of experiencing a cardiovascular event (such as a heart attack or stroke) over a defined time period — typically 10 years. SCORE2 is the current European Society of Cardiology-recommended tool for estimating the 10-year risk of a first fatal or non-fatal cardiovascular event in adults without established cardiovascular disease. Inputs include age, sex, smoking status, systolic blood pressure and cholesterol levels. The result is used to guide the intensity of preventive interventions, including when to initiate lipid-lowering therapy and how aggressively to manage other risk factors.
Yes, lifestyle modification produces meaningful reductions in cardiovascular risk and is the foundation of prevention at all risk levels. Stopping smoking, achieving and maintaining a healthy weight, following a Mediterranean-style diet, engaging in regular physical activity and moderating alcohol intake can together reduce cardiovascular risk substantially. For some individuals at lower risk, lifestyle changes alone may be sufficient to achieve a safe risk level. However, for those at higher risk — particularly those with familial hypercholesterolaemia, established cardiovascular disease or multiple risk factors — lifestyle modification alone is usually insufficient and pharmacological therapy is also required. A specialist assessment will help clarify what is most appropriate for you.

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Comprehensive cardiovascular risk assessment and lipid management with Dr Imtiaz Ali Kalyar. Sunday clinics available. Naas, Co. Kildare.

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