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Articles by Prem Aggarwal
Vision Statement for an AI-Ready Indian Medical System
Artificial intelligence is entering medicine faster than most health systems have been able to prepare for it. It is already influencing clinical documentation, imaging, risk prediction, decision support, education, research and administrative processes. Generative AI has accelerated this transition further by placing powerful tools directly in the hands of students, teachers and clinicians.
Beta-Blockers Chronicle & Implications for Indian Cardiovascular Medicine Practice: India Bisoprolol Ready!
Beta-blockers have been a cornerstone of cardiovascular medicine for more than six decades. From Sir James Black's development of propranolol to contemporary β1-selective and vasodilatory agents, their evolution mirrors a broader transition from uniform class-based prescribing to more individualised cardiovascular therapy.
Beta-Blockers Chronicle & Implications for Indian Cardiovascular Medicine Practice: India Bisoprolol Ready
Beta-blockers have been a cornerstone of cardiovascular medicine for more than six decades. From Sir James Black's development of propranolol to contemporary β1-selective and vasodilatory agents, their evolution mirrors a broader transition from uniform class-based prescribing to more individualised cardiovascular therapy.
Comparing Metoprolol vs. Bisoprolol in Acute Myocardial Infarction (AMI): ESC 2026 Update
Bisoprolol was associated with higher all-cause and cardiovascular mortality compared with metoprolol in patients with Acute Myocardial Infarction, a recent study reported. The findings were presented at the European Society of Cardiology (ESC) Congress 2026, held at Messe München, Munich, Germany, from August 28 to 31, 2026. Why Was This Study Needed? Beta-blockers are Class I recommendations for acute myocardial infarction (AMI).
Medical Negligence Redefined by the Supreme Court Through Its Judgments
Thirty years after V.P. Shantha, medical negligence is no longer an abstract allegation of “deficiency in service”. A series of Supreme Court judgments has developed specific standards for deciding when a doctor is and is not negligent. In 1995, the Supreme Court delivered its landmark judgment in Indian Medical Association v. V.P. Shantha.
Hospital Deficiency v/s Medical Negligence: Understanding the Critical Difference
For nearly three decades, discussions on healthcare under the Consumer Protection Act have often used two expressions almost interchangeably: “deficiency in service” and “medical negligence.” They should not be treated as the same thing. A hospital can be deficient in providing a service without a doctor having been negligent in treating the patient. Equally, an adverse medical outcome does not by itself establish either hospital deficiency or medical negligence.
The Overworked Indian Heart: Risk, Contributors and Interventions in 2026
The human heart is built to work continuously. However, normal physiological activity differs from the sustained workload imposed when the heart must repeatedly pump against elevated blood pressure, beat at a persistently higher rate, or respond to increased autonomic and metabolic demands.
Beta-Blocker Use in HF and AF: Insights from India’s Landmark ROBUST Study
Beta-blockers have long been a cornerstone in the management of cardiovascular diseases, particularly heart failure (HF) and atrial fibrillation (AF). While clinical trials have established their efficacy, data on how these agents are used in routine clinical practice in India have been limited.
β-Blocker Interruption Causes Heart Rate Rebound and Worse CV Outcomes in Post-MI Patients: New Pre-Specified Analysis of ABYSS Trial
β-blocker interruption causes significant heart rate rebound and increased CV risk in patients with elevated baseline heart rate; while heart rate control below 60 bpm is associated with lower mortality (2.9% vs 5.9%) and fewer major adverse cardiovascular events (5.5% vs 9.2%) compared to heart rate ≥68 bpm in post-MI patients with LVEF ≥40%, a pre-specified ABYSS trial analysis has reported.
Role of Beta-Blockers in Hypertension: Learning from the Landmark Indian ROBUST Study
New findings from one of India’s largest real-world clinician perception studies highlight the continued clinical relevance of β-blockers in hypertension management, with metoprolol emerging as the most preferred agent across multiple cardiovascular indications in Indian clinical settings. Published in the Journal of the Association of Physicians of India in February 2026, the Role of β-Blockers Across the Cardiovascular Continuum: A Real-World Perception Survey (ROBUST) study.
Loneliness in Healthy Aging - A Perspective
Forty years of medical practice have taught me to recognise many diseases. A patient walks into my clinic with chest pain, breathlessness or fatigue, and my mind immediately begins searching for coronary artery disease, heart failure, arrhythmia or lung disease. That is how doctors are trained, and rightly so. We must never miss a serious illness. But growing older as a physician has taught me something equally important. Not every suffering has its origin in the body.
Articles By : Dr. Prem Aggarwal
Dr. Prem Aggarwal
Beta-Blocker Therapy in CAD: Insights from India's Largest ROBUST Clinician Survey
New findings from one of India’s largest real-world clinician perception studies reaffirm the continued relevance of β-blocker therapy in coronary artery disease (CAD), with metoprolol emerging as the most preferred agent across post-myocardial infarction (post-MI), chronic coronary syndrome (CCS), and atrial fibrillation (AF) care in Indian cardiology clinical settings.
Managing CKM Stage 2: The Critical Window to Prevent Heart and Kidney Disease
In the newly released 2026 AHA/ACC/ADA/ASN Guideline on Cardiovascular-Kidney-Metabolic (CKM) Syndrome, Stage 2 represents a turning point in the natural history of chronic disease. At Stage 1, excess body fat initiates metabolic dysfunction. At Stage 2, the consequences begin to appear. Patients develop one or more metabolic abnormalities such as diabetes, hypertension, dyslipidemia, or chronic kidney disease (CKD).
Managing CKM Stage 3: Detecting Silent Cardiovascular Disease Before It Becomes a Heart Attack
The newly released 2026 AHA/ACC/ADA/ASN Guideline on Cardiovascular-Kidney-Metabolic (CKM) Syndrome introduces a powerful concept in preventive medicine. Many patients do not suddenly develop a heart attack, stroke, or heart failure. Years before these events occur, silent disease is already progressing within the arteries, heart, kidneys, and metabolic system. This phase is recognized as CKM Stage 3.
From Obesity to Heart Failure: Understanding the New CKM Staging System
For decades, medicine has treated obesity, diabetes, kidney disease, and heart disease as separate conditions. A patient would visit one specialist for diabetes, another for kidney disease, and a third for heart disease. However, modern science increasingly shows that these conditions are deeply interconnected and often represent different stages of the same disease process.
NAIDM: A Vision to Make India AI-Ready in Healthcare
India stands at the threshold of one of the greatest transformations in the history of healthcare. Artificial Intelligence is rapidly entering every layer of medicine—from diagnostics and imaging to hospital operations, clinical decision-making, research, and public health. The question is no longer whether AI will enter healthcare. The real question is: Will India be prepared to use it responsibly, ethically, and effectively?
Coronary Calcium Score: The Investigation that Reduces Mortality
In modern cardiology, one of the greatest challenges is not treating heart attacks — but identifying silent coronary artery disease before the first event occurs. Many individuals appear healthy, have no symptoms, and yet carry significant atherosclerosis silently within their arteries.
From Policy to Practice: Why India Needs a National AI Doctors Mission (NAIDM) Now
Artificial Intelligence is no longer a future concept in healthcare—it is already influencing diagnosis, clinical decision-making, hospital workflows, and public health systems. India, with its vast population, uneven distribution of medical resources, and expanding digital health infrastructure, stands at a defining moment. The policy momentum is encouraging.
AI in Health Services: Why Staying Updated is No Longer Optional for Healthcare Professionals
Healthcare is undergoing a structural transformation driven by digital technologies, with Artificial Intelligence (AI) emerging as a key enabler. What traditionally relied on clinical experience and manual processes is now increasingly supported by data-driven systems capable of analysis, prediction, and real-time clinical assistance. For healthcare professionals (HCPs), staying updated with these developments is no longer optional but essential for maintaining quality of care.
AI in Healthcare: From Power to Responsibility
A Change Unlike Any Other I have spent more than four decades in medicine. I have seen the transition from clinical intuition to evidence-based protocols… from handwritten notes to digital records… from limited diagnostics to technologies that can visualize the human body with astonishing precision. Each advancement changed how we practiced. Each one improved patient care. But what we are witnessing today is different. Artificial Intelligence is not just another advancement.
Digital Medical Education & Research: Why Healthcare Professionals Must Adapt to an AI-Driven Future
The landscape of healthcare is rapidly evolving, and at the center of this transformation lies digital medical education and research. With the growing integration of Artificial Intelligence (AI), big data, and digital health platforms, the way healthcare professionals learn, practice, and innovate is undergoing a fundamental shift.
National AI Doctors Mission (NAIDM)- Empowering Every Doctor with AI for Viksit Bharat
The National AI Doctors Mission (NAIDM) is a pioneering national initiative aimed at equipping India’s medical fraternity with the knowledge, skills, and ethical framework required for the adoption of Artificial Intelligence (AI) in clinical practice.
Disability and Sexual Health: A Fulfilling Intimate Life Is Still Possible
Sexuality is a natural part of life. Although disability may bring challenges, a healthy and satisfying sexual life is still possible with the right information Sexual life is not limited to physical intercourse. It also includes emotional connection, self-esteem, personal identity, and the depth of relationships. It is a normal and meaningful part of human life. After the onset of a disability, both the body and mind may undergo changes. These changes can create new challenges in sexual life.
Why Is an Angiogram Done? Are You Following the Right Steps for a Faster, Safer Recovery?
An angiogram is an important test that helps doctors see your blood vessels clearly using a special dye and X-rays. It allows them to detect blockages, narrowing, or other abnormalities in blood flow. Although most people feel normal soon after the procedure, careful post-procedure care is essential. Ignoring simple precautions can lead to complications such as infection or bleeding. Even if the report is normal, recovery does not end there.
Had an Abdominal Hysterectomy? Here’s How to Heal Faster and Stay Safe
An abdominal hysterectomy is a surgical procedure in which the uterus is removed through an incision in the abdomen. It is commonly performed for conditions such as fibroids, heavy bleeding, infections, or cancer. Recovery takes time. During this period, it is normal to experience fatigue, mild pain, and weakness. You may also notice changes in your daily routine, energy levels, and mood. With the right knowledge and a few precautions, recovery can become much easier.
After Severe Brain Injury (TBI), Can Your Sex Life Recover? What Really Changes
From low libido to emotional shifts, TBI can impact sexual health—but most challenges can be managed with support and treatment. Traumatic Brain Injury (TBI) is a type of brain injury caused by a serious blow or impact to the head. It can range from mild to severe and may affect parts of the brain that control emotions, behaviour, desire, and sexual response. Following such an injury, a person may experience physical, emotional, and psychological changes.
Can You Have Sex After Joint Replacement? A Simple Guide to Safe Intimacy
Joint (hip or knee) replacement surgery often brings up an important question—Will my sexual life be the same as before? This concern is natural. Intimacy is not just physical; it is closely linked to confidence, emotional connection, and overall quality of life. With proper guidance and open communication with your doctor, you can safely move toward a healthy and satisfying sexual life again.
Relationships and Sex Life After Cancer Important Information for Women
After cancer, many women may experience changes in their sex life. Why do these changes happen, and how can they be managed? Let’s understand it. A healthy sex life is a normal and important part of overall well-being. However, cancer and its treatment can affect a woman’s sexual life by lowering desire, causing pain or discomfort during intimacy, and impacting self-confidence.
Relationships and Sex Life After Cancer: Important Information for Men
A healthy sex life is an important part of overall well-being. Cancer and its treatment may affect not only the body but also a man’s sexual desire, performance, confidence, and relationships. Many men experience problems with erection, sexual desire, or satisfaction after treatment. This is known as Cancer-related sexual dysfunction. The impact varies from person to person. It depends on age, the type of cancer, the treatment received, and previous sexual health.
Talking to Your Children About Sex at the Right Time, Know How and Why!
Many parents feel uncomfortable talking to their children about sex. However, silence often creates confusion and allows misinformation to fill the gap. Providing simple, honest, and age-appropriate information at the right time is essential for a child’s healthy physical and emotional development. When parents communicate openly and honestly, the home becomes a safe space where children can ask questions without fear, shame, or embarrassment. Sex education is not a one-time conversation.
Confused About Sex During Pregnancy? Safe or Unsafe? Know the Facts
It is natural to have questions about sex during pregnancy. Is it safe? When should you be cautious? And when you should consult a doctor? Let’s understand! Pregnancy brings changes not only to the body, but also to emotions and relationships. It is completely normal to feel curious, unsure, or even confused about sexual activity during this time. Some women may notice an increase in sexual desire, while others may feel less interested. These changes usually happen because of hormonal shifts.
What Are Sexually Transmitted Infections (STIs)? How to Recognize Them, and How to Prevent Them?
Sexually Transmitted Infections (STIs) are a significant public health concern worldwide. They can affect people of any age, gender, or background. Many individuals hesitate to talk openly about them due to embarrassment or fear, which often leads to delayed testing and unintentional spread of infection. Sexually transmitted infections (STIs) are infections that spread from one person to another during sexual contact.
Is Your Teen at Risk of Sexting? What Parents Need to Know!
In today’s digital world, mobile phones and social media have become an important part of children’s and teenagers’ lives. Making friends, chatting, and sharing photos and videos is now very common. However, along with this, a new and concerning trend is also growing — called “sexting.” Sexting means sending private or sexually related photos, videos, or messages through a mobile phone or the internet. Many children see it as a joke, a sign of trust, or part of a relationship.
Retirement and Cardiovascular Risk: A Preventive Cardiology Perspective
Retirement is widely viewed as a reward — a period of rest after decades of professional dedication. Yet in clinical practice, especially among high-performing professionals such as physicians, retirement may represent something far more complex: an identity transition with biological consequences. For doctors, work is not merely employment. It provides structure, authority, decision-making power, intellectual stimulation, and daily relevance.
Purpose in Life: A Missing Variable in Cardiovascular Mortality
Cardiovascular disease (CVD) remains the leading cause of mortality globally and in India. We routinely screen for hypertension, diabetes, dyslipidemia, smoking, obesity, and sedentary lifestyle. Yet, an important and measurable determinant of cardiovascular outcomes often escapes clinical attention: purpose in life. Traditionally viewed as a psychological or philosophical construct, purpose is increasingly recognized as a measurable health determinant with cardiovascular implications.
Sexual Health in Older Age: Love, Intimacy, and Balance at Every Stage of Life
As we age, body changes are natural, but love & intimacy do not end; with proper information & open communication, a healthy & satisfying sex life is possible. As we grow older, changes in the body are natural. However, this does not mean that love, affection, and sexual life come to an end. Sexual relationships are not only a physical need but also an important part of emotional connection, self-confidence, and mental well-being.
Artificial Intelligence (AI) in Healthcare: Innovation Without Integration is Inequity
As India hosts the Artificial Intelligence(AI) Impact Summit from February 16 to 20, 2026, artificial intelligence has moved from futuristic ambition to present-day reality. Policymakers, technology leaders, hospital administrators, and startups are gathering to discuss scale, innovation, and deployment across sectors — with healthcare positioned as one of the most transformative frontiers.
Beta Blockers Cut Cardiovascular Events by 25 percent in Post-MI Patients with Mildly Reduced LVEF: Meta-Analysis
Long-term oral β-blocker therapy, including bisoprolol, metoprolol, and carvedilol, reduces the composite endpoint of all-cause death, new myocardial infarction, or heart failure by 25% in patients with MI and mildly reduced left ventricular ejection fraction (LVEF 40-49%), a meta-analysis has reported.
ROBUST Study Released: One of the Largest Beta-Blocker KAP Study Captures Place of Beta Blockers in Indian Real-World Practice
One of the largest Indian KAP studies including doctors in cardiovascular medicine practice has shown that metoprolol continues to be the most preferred beta-blocker across the cardiology care continuum, reinforcing its clinical acceptance in contemporary practice.
Human Intelligence and Artificial Intelligence: Learning, Limits, and the Difference That Still Matters in Medicine
Artificial intelligence is no longer a distant concept in medicine. It reads scans, predicts risk, flags patterns, and assists decisions. Naturally, this has revived an old question in a new form: How similar is human intelligence to artificial intelligence? The answer is neither simple equivalence nor complete separation. How Human Intelligence Develops? Human intelligence does not arrive fully formed at birth. An infant is born with a biologically prepared brain, but with little content.
Beta Blockers Cut CV Events by 25% in Post-MI Patients with Mildly Reduced LVEF: Meta-Analysis
Long-term oral β-blocker therapy, including bisoprolol, metoprolol, and carvedilol, reduces the composite endpoint of all-cause death, new myocardial infarction, or heart failure by 25% in patients with MI and mildly reduced left ventricular ejection fraction (LVEF 40-49%), a meta-analysis has reported.
Pacemaker Pocket Infection: IHJ, 2025 Indian Study Reveals Incidence and Risk Factors
A recent study found permanent pacemaker infection (PPMI) in 2.09% patients, with infections more prevalent in devices implanted over 12 months prior. Diabetes and Hypertension were the most common comorbidities. Culture-negative infections predominated, followed by methicillin-resistant Staphylococcus aureus(MRSA). These findings are published in October 2025, in Indian Heart Journal.
Role of the Collateral Circulation in Stable Angina: Circulation Study Finds
A recent study concluded that coronary collateralization is associated with ischemic burden and may reduce the intensity of ischemic chest pain. The authors highlighted that this may explain the nonlinear relationship between stenosis, ischemia, and angina.
AHA Scientific Statement Highlights Emerging Role of Mitochondrial Genetics in Cardiovascular Disease: Circulation Study Reveals
According to a recent AHA Scientific Statement, despite ongoing limitations, recent advances in genomic sequencing (Next-Generation Sequencing), gene-editing technologies, and the directed differentiation of induced pluripotent stem cells (iPSCs) into cardiovascular cell types are creating new opportunities to deepen our understanding of mitochondrial genetics, its dynamic behavior, and its critical role in cardiovascular pathobiology and disease.
Not All Fibrates Are Equal: Fenofibrate Demonstrates Clear Superiority in Reducing Residual Cardiovascular Risk, Atherosclerosis Study Finds
The management of atherosclerotic cardiovascular disease (ASCVD) requires highly personalized lipid strategies, particularly in high-risk patients who demonstrate residual risk despite optimal statin therapy. Fenofibrate stands out among fibrates due to its unique ability to lower apolipoprotein B (apoB), a measure of total atherogenic particle burden, is important for achieving meaningful cardiovascular risk reduction in patients with atherogenic dyslipidemia (AD) and Type 2 Diabetes (T2DM).
Humanized Medicine in 2026: A Policy Imperative for the Year Ahead for Policy Leaders, Health Systems, and Global Health Forums
As health systems worldwide enter a new year marked by rapid technological expansion, rising costs, and ageing populations, a fundamental question confronts policymakers and healthcare leaders alike: Is modern medicine advancing in wisdom as quickly as it advances in capability? Medicine has always mirrored the era that shaped it. In earlier centuries, philosophy guided medical thought, framing illness through ideas of destiny and meaning, influenced by thinkers such as Plato.
New Study Elucidates Causes and Genetic Drivers of Sudden Cardiac Death in Young Adults: IHJ October 2025
A recent study found that negative autopsy/sudden unexplained death (SUD) constituted the most common observation in sudden young deaths, followed by coronary artery disease (CAD)/myocardial infarction (MI). The authors highlighted that molecular autopsy in sudden unexplained deaths in young will give a definitive molecular yield of 14.3 %. These findings are published in October 2025 in Indian Heart Journal.
Stage B Heart Failure Identified More than Expected in Indian Patients Undergoing Routine Echocardiography: IHJ, October 2025, Study Finds
A recent study revealed a high prevalence of stage B heart failure (HF) in a general clinical setting in India. The authors highlighted that further, larger studies are needed to better define the prevalence and clinical implications of stage B HF in Indian patients. These findings are published in the Indian Heart Journal in October 2025. Identifying and Intervening in the Silent Stage of Heart Failure Heart failure remains a major global health challenge, with five-year mortality rates of 30–50%.
Despite Newer Agents, Clopidogrel Still Holds Strong in Acute Coronary Syndrome Care: IHJ 2025
A recent opinion paper concluded that timely revascularization and dual antiplatelet therapy (DAPT) are crucial in the management of acute coronary syndrome (ACS). Guidelines clearly endorse the use of newer P2Y12 inhibitors, such as ticagrelor and prasugrel, over clopidogrel. However, it is imperative that research addresses several critical issues, including the efficacy and safety of these newer agents in Asian populations, particularly among the elderly.
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