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SEPTEMBER 2016 WWW.HEALTHNEWS.IE

Cardiovascular healthWWW.HEATLTHNEWS.IE

STATISTICS Cardiovascular Disease statistics from the BHF P4

COUNTRY PROFILE Atrial fi brillation in Ireland - the facts P8

PEACHY KEEN Lifestyle tips for a healthy heart P10

Professor Ken McDonald

What is heart failure and why should you

know about it?

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Call to actionThe World Heart Federation calls for an increase in efforts to prevent, treat and control cardiovascular disease P4

Atrial fibrillationDr Joseph Galvin takes a look at promising new prevention and treatment techniques for atrial fibrillation (AF) P8

Know Heart Failure NowLearn about heart failure in an exclusive video supported by The Heartbeat Trust

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IN THIS ISSUE

The harsh reali-ty is that every hour someone in Ireland suf-fers from a stro-ke. Every day, hundreds of

Irish people – people we all know - are diagnosed with heart disease. Too often the lives of people we lo-ve are cut tragically short or many are left disabled. The harsh reali-ty is that up to 10,000 lives are lost to cardiovascular disease each year here in Ireland which makes cardi-ovascular disease Ireland’s biggest killer. Indeed it is the number one killer worldwide.

But the good news is that some 80% of premature heart disease and stroke is preventable. World Heart Day, is an important annual

reminder that there is a lot we can do to look after our health and redu-ce our risk of heart attack and stro-ke. Positive steps to take include: eat well, be active, watch your weight, quit smoking, cut down on alco-hol, de-stress, have a regular blood pressure and cholesterol check and know your family history.

At the Irish Heart Foundation we empower people in Ireland to ma-ke their health last longer through our community prevention servi-ces such as mobile blood pressure checks, our freephone, nurse-led helpline, free information and tailo-red patient support.

We know more than 60% of adults over 45 years have high blood pres-sure in Ireland, placing them at greater risk of stroke or heart at-tack and preventing and managing

Put your heart first this World Heart DayWorld Heart Day, 29th September, is both an international and national day of awareness to promote positive steps to prevent heart disease and stroke which is the number one killer both in Ireland and worldwide

hypertension is at the core of our work as we, together with the World Heart Federation, strive for a 25% re-duction in premature deaths from heart disease and stroke by 2025.

Prevention has never been mo-re crucial as we consider the lands-cape of heart disease and stroke in Ireland. For instance, the burden of chronic heart failure has increased due to the expanding elderly po-pulation and management of this condition, which affects 90,000 pe-ople living in Ireland and is respon-sible for 20,000 hospital admissions annually, is now one of the major challenges. Long term high blood pressure that has not been control-led can weaken the heart muscle and result in heart failure.

Meanwhile Atrial Fibrillation is the most common heart rhythm

disorder, estimated to affect about 40,000 adults in Ireland aged 50 years plus. This condition often go-es unnoticed but it carries a five-fold additional risk of stroke. It is a gro-wing problem in all adult age groups and it requires careful monitoring and proactive treatment. The causes of Atrial Fibrillation are not always clear but the chance of developing it can increase if a person has one or more medical conditions, such as high blood pressure, diabetes and heart disease. Regular pulse checks can help detect it.

As the Irish Heart Foundation ce-lebrates 50 years at the heart of the nation fighting the biggest disease of our time, this World Heart Day 29 September we encourage the public to take positive action to look after their heart health.

Dr Kate McGarryPresident, Irish Heart

Foundation, the national charity fighting heart disease and stroke

PHOTO: MATER PRIVATE

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World Heart Day on September 29th is the day when people across the globe gather on and offline to rai-se awareness of cardiovascular di-sease (CVD), which causes a stag-

gering 17.5 million deaths a year, and the simple indivi-dual steps we can take to prevent it.

“If you look after your heart, you look after your who-le health,” says Johanna Ralston, CEO of the World Heart Federation (WHF), which organises the world-wide event. “And it’s simple (even if it is not always necessarily easy)! Stopping smoking, cutting down on alcohol, exercising, and eating more healthily can measurably improve your heart health and general well-being.”

It’s a simple, vital message – 80 per cent of premature (under the age of 70) deaths from CVD are preventable.

Making a global differenceThis year, the WHF is ramping up World Heart Day to a whole new level with the launch of a global po-licy call to governments to implement reliable and fit for purpose surveillance and monitoring systems for CVD. The policy call is being supported by: a po-licy brief, which looks at how countries and regions collect data on cardiovascular disease with a focus on premature mortality caused by CVD; and the launch of the CVD World Monitor, an online data visualisa-tion tool that tracks 150+ countries’ progress against the World Health Organization Global Action Plan

World Heart Federation calls on governments to increase efforts to better prevent, treat and control cardiovascular disease, the world’s No 1 killer

Fuel your heart, power your life

By Tree Elven

STATISTICS

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INSPIRATION

• Cardiovascular (heart and circulatory) disease causes more than a quarter (26 per cent) of all deaths in the UK; that’s nearly 160,000 deaths each year – an aver-age of 435 people each day or one death every three minutes.

• Around 42,000 people under the age of 75 in the UK die from CVD each year.

• Since the BHF was established the annual number deaths from CVD in the UK has fallen by more than half.

• In 1961, more than half of all deaths in the UK were attributed to CVD (320,000 CVD deaths).

• Since 1961 the UK death rate from CVD has declined by more than three quarters. Death rates have fallen more quickly than the actual number of deaths because people in this country are now living longer lives.

Cardiovascular Disease(CVD; Heart and Circulatory Disease)Cardiovascular disease (CVD) is an umbrella term that describes all diseases of the heart and circulation. It includes everything from conditions that are diagnosed at birth, or inherited, to developed conditions such as coronary heart disease, atrial fibrillation, heart failure, and stroke.

Source: British Heart Foundation

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Targets, which are aimed at achieving the overall goal of a 25 per cent global reduction in premature mortality from CVD by 2025.

“This year, we’re very ambitious for World Heart Day,” explains Ralston. “World Heart Day is vital for raising awareness among the general public, but now we’re also using this platform to push for change at policy and advocacy le-vel. We’re calling on governments to strengthen monitoring and surveillance of CVD and sugges-ting the priority actions they need to take.”

The global policy call focuses on three points: better recording of statistics on births and causes of death; including details of CVD key interven-tions (for example services provided, numbers

of people being treated) in national health infor-mation systems; and developing accurate and representative data collection systems that can provide reliable evidence about the preva-lence, prognosis and quality of care for people with CVD.

Know your numbersAround 80 per cent of CVD deaths are in low- and middle-income countries where human and financial resources are least able to address the issue. “People are dying unnecessarily, very often through sheer circumstance,” says Rals-ton. “They don’t have the options to make heal-thy heart choices. In some countries, there are

no non-smoking areas in communal areas, or education in rural parts, or access to sidewalks and roads just for walking. We’re also seeing CVD problems arising from the use of indoor paraffin cooking.”

Here in the UK, “it’s important to ‘know your numbers’ – blood pressure, pulse rate and so on – and be aware for families and those around you, too,” Ralston reminds us.

“Join in on World Heart Day – there are thou-sands of events online and in communities, and it does make a difference. If we act together now, we can reduce premature deaths from CVD, and help people everywhere to live long-er, better, heart-healthy lives.”

Johanna RalstonCEO, World Heart Federation

TODAY435 people will lose

their lives to CVD

…more than

people will beyounger than

7 millionpeople fight their dailybattles with CVD

515people will go to hospital due to a heart attack

190people will die from a heart attack

12babies will be diagnosed with a heart defect

110 75

PHOTO: THINKSTOCK

Source: British Heart Foundation

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Annette has an evo-cative descrip-tion for the impact of her heart fai-lure (HF) diagno-sis. “It’s like get-ting on a plane, and

you know that you’re going to Barcelona. You’ve got your plans for that – but then suddenly you fi nd you’re in Amsterdam. All your plans have to change.”

A busy nurse, wife and mother in her 40s, Annette did not seem like someone at risk of a heart attack – and yet she suff ered one in 2015.

“As a consequence, I developed HF. It’s had a huge impact on me, physically, psy-chologically, fi nancially. I had to leave my job. I’ve gone from being independent and active to needing assistance with dres-sing, bathing, showering.”

This experience of coming to terms with a new reality can be common to suff erers

of HF. Michael, in his 60s, describes a si-milar sense of loss, following his diagno-sis: “I was in France on holiday with my wife, and we were walking up a hill to visit a medieval village. I got halfway up and I just couldn’t make it, I had to go back to the car. As we were going back, a bus pulled up with elderly people, older than me. They all

walked up this hill quite easily. I just sat in the car and cried.”

HF aff ects around 90,000 people in Ire-land. Yet, many suff erers are unaware that they have it, mistaking symptoms such as tiredness or breathlessness for simply fea-tures of getting older, for example. Medi-cation can be required, but much of the

Annette and Michael, two patients with heart failure, and Shirley, a carer, describe the impact of the condition on their lives

Journeys in courage

By Ben Murnane

‘Never give up!’

COLUMN

Anew drug has brought new hope for heart failure patients.

Over 20 years ago, Una, from Sli-go, had two

major heart attacks; she was subsequently di-agnosed with heart failure. Una had an opera-tion in 1999 that improved her life for many years – but then she took a turn for the worse.

“About four or fi ve years ago, I started to fi nd that my breathing was very laboured.

“I used to look after my grandchildren; I had to give that up, I just wasn’t able to do it. I had to give up dancing, which I loved!”

There followed many trips to the hospi-tal; Una’s quality of life went downhill dra-matically. The doctors felt another operation wasn’t feasible, given her condition.

“They decided to try this new medication. Before that, I couldn’t get off the couch to go to the front door. But within two weeks – I re-alised that I was doing bits around the hou-se, I was getting up and putting on food for myself; I wasn’t totally exhausted all the time.

“They increased the dose, and I was able to actually get out and drive the car – which was a miracle.

“I’m three months on the drug now. I pace myself, but I’m in the best form.

“As I say to everyone, never give up!”

AnnettePatient with heart failure

ShirleyCarer

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INSPIRATION

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Know Heart Failure NowProfessor Ken McDonald, Consultant Cardiologist, Medical Director of the Heartbeat Trust and National Clinical Lead for Heart Failure, explains what the condition is and recent efforts to raise awareness.

Heart failure (HF) is simply a declining effi ciency of the heart. The heart is a pump, and any pump has two duties – to squeeze and pump, and to relax and prime and get ready for the next squeeze. HF occurs because the pumping or the priming or both become less eff ective; symptoms include breathlessness, tiredness, and fl uid build-up resulting in, for example, ankle swelling.

Despite being very prevalent – one in fi ve people will de-velop HF – the risks and symptoms of HF are not so widely recognised. The Know Heart Failure Now Campaign, which is supported by Novartis Ireland Ltd. along with the Heart Failure Patient Alliance established by the Heartbeat Trust and Croí, aims to change this.

At the Ploughing Championships this year, we laun-ched the Know Heart Failure Now campaign – visitors could speak to healthcare professionals about the symptoms and risk factors, and could also get a free test; they could see how easy it is to rule HF in or out.

The term heart failure can be frightening and is often misunderstood, but if you are experiencing symptoms – go to your GP. The earlier it is diagnosed, the earlier it can be treated, and your quality of life can dramatically improve.

Professor Ken McDonaldConsultant Cardiologist, Medical Director of the Heartbeat

Trust and National Clinical Lead for Heart Failure

COLUMN

Read more on wwwhealthnews.ie

treatment for HF involves lifestyle changes – avoiding salt, monitoring and managing your weight and moderating alcohol.

PositivesOf course, coming to terms with new limi-tations can be the hardest part, as both An-nette and Michael found. But they have al-so drawn positives from their experience.

“Slowly I realised life’s about the simple things,” says Michael, “cooking, garde-ning, walking the dogs.” Michael feels he has reached a new equilibrium. “When I was in business, the people I was en-vious of were gardeners, because they se-emed to be able to go into this zone where they’re not thinking about anything other than exactly what they’re doing. My mind was too busy for that.

“A couple of years back I was in the gar-den, sitting on the side of the raised bed, pulling weeds. I thought, wow, I’m in my zone! It took me 65 years to get there.”

Both Annette and Michael have found meaning in being part of the Heart Fai-lure Patient Alliance, a new initiative to raise awareness. “I’d really like to make a positive impact by describing my ex-perience, what I’ve learned from co-ming through the system,” says Annet-te. “You can have a much better quality of life with the right treatment.”

Shirley, a carer who has looked after both her parents with HF, agrees that the journey can be positive. “The fact that my father was diagnosed, and got the proper intervention, gave me an extra fi ve and a half years with him.

“As a carer you try and look at it as if you were in that situation, how hard you would fi nd it. You look out for symptoms so you can help them avoid a trip to hospi-tal; it’s about managing it.

“It is a positive journey – because once managed, you can live well with heart failure.”

“HF affects

around 90,000

people

in Ireland. Yet,

many sufferers

are unaware that

they have it”

Know Heart Failure Now: Events like tractor football help raise awareness of heart failure

SEPTEMBER 2016 IE02/ENT16-CNF069

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Atrial fibrillation (AFib) occurs when chaotic electrical impulses from the left atrium throw the main pum-

ping chambers of the heart into ir-regular activity, causing an irregu-lar pulse rate.

“Think of stones in a pond,” says Dr Joseph Galvin, cardiologist at Dublin’s Mater Private hospital. “If you throw a stone into a pond every few seconds, you get nice smooth ripples, but if you tip in a bucketful, you get chaos.”

AFib is found in 5 per cent of pe-ople by the age of 65 and 10 per cent of those by 75 in Ireland and the UK, so age is a clear factor. Other main causes are high blood pressure and high alcohol consumption, whi-le an overactive thyroid, infection, family history, or malignancies li-ke cancer or heart disease can also play a part.

“You shouldn’t worry about AFib unless you have an irregular pulse,” says Galvin. “Check at the neck or wrist once a month so that you know what’s normal for you.

A normal pulse is 60-100 beats per minute, and it should be regular for 15 consecutive seconds. People with AFib who’ve had a normal heartrate restored by treatment can check once a day.”

Until about 20 years ago, AFib was just accepted, he explains. That changed when the value of anti-coagulants (like warfarin) was recognised, but there can be an as-sociated stroke risk with these blood-thinning agents.

“If you have an irregular pul-se, don’t panic; go to your GP,” says

Prevention and treatment of atrial fibrillation (irregular heartbeat) has improved dramatically over the past 20 years: we take a look at the latest developments

Atrial fibrillation: Promising new blood-thinners and techniques emerge

By Tree Elven

COUNTRY PROFILE

INSPIRATION

HIGH FIBRE SUPERFOOD LOWERS CHOLESTEROL

Reduces Blood Sugar rise after a meal

Fibre AND CONTAINS

NATURALLY HIGH in

WWW.TRUELIFEHEALTHFOODS.COM TEL: 01 885 0800

AF**-Related Stroke:

COUNTRY PROFILE: IRELAND*

A Growing Economic Burden:

2,500deaths

per year2

6thcause

of adultdisability3

23,000new cases1

38% of the population and 64% of people aged 65-70 years old are unaware of AF …even if the risk of developing AF is 1 in 4 after the age of 40.6;7

(*) This infographic is based on national data where possible. Where national data are not available, international data have been used. (**) AF: atrial fibrillation (1) Institute of Public Health in Ireland. Stroke Briefing 2012. Dublin. http://www.publichealth.ie/sites/-default/files/ documents/files/Stroke%20Briefing%2024%20Sept.pdf (2) Feigin V, et al. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet 2014; 383:245-255. (Figures taken from supplementary data provided) (3) Donnan GA, Fisher M, Macleod M, Davis SM. Stroke. Lancet 2008; 371(9624):1612-1623. (4) Hannon N, et al. Abstract 171: A Population-based Comparison of Total Costs: The Economic Burden of Atrial Fibrillation-Associated Stroke. Stroke. 2013. http://stroke.ahajournals.org/cgi/con-tent/meeting_ abstract/43/2_MeetingAbstracts/A171 (5) Smith S, et al. The cost of stroke and transient ischaemic attack in Ireland: a prevalence-based estimate. Age Ageing 2012; 41:332-338. (6) Frewen J, et al. Factors that influence awareness and treatment of atrial fibrillation in older adults. QJM 2013; 106:415- 424. (7) Lloyd-Jones DM. Lifetime risk for atrial fibrillation. Circulation 2004; 110:1042-1046.

Stroke is the 2nd leading cause of death2,3

Total direct costof stroke per year

€345 - €557 million5

Total indirect costof stroke per year

€143 - €248 million5

Cost of AF relatedstroke

€25,150 over 2 yearscompared to €12,750 fornon-AF stroke patients4

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Galvin. “If AFib is confirmed, then the stroke risk needs to be assessed to see whether you need a blood thinner.

“New anti-coagulants known as NOACs – novel, oral anti-coagu-lants – can reduce the stroke likeli-hood by 70 per cent and have been shown to be better than or equiva-lent to warfarin in terms of safety and efficiency. And the big advanta-ge is that the patient doesn’t need to go for regular blood tests.”

There are also developments in treating AFib symptoms like shortness of breath and reduced

exercise tolerance.Current treatments are anti-arr-

hythmic drugs, which steady the heart’s electrical activity, cardiover-sions, and ablation.

“Cardioversion is a very routine procedure where the patient’s put to sleep for two or three minutes and re-ceives a specially timed electric shock to restore normal heart rhythm,” ex-plain Galvin. “It’s 99 per cent effecti-ve, but it doesn’t keep the rhythm re-gular, so it’s not good for those who experience frequent AFib episodes.

“Catheter ablation is done under

general anaesthetic. We pass a cathe-ter up from the groin vein into the left atrium of the heart, pinpoint the pro-blem area and use heat (radiofrequen-cy ablation) or freezing (cryoablation) to isolate it – we build a wall around where that ‘bucket of stones’ goes in.

Patients go home next day, and any mild reactions usually settle quickly, says Galvin. Complications are rare (1 per cent) and easily treated. In some 30 per cent of cases, the ablation bar-rier breaks down within a year and a second procedure is needed.

A full-scale trial of ablative in-

tervention versus anti-arrhythmic drugs (CABANA) is underway, with results expected in about 18 months – valuable information towards im-proving safety and outcomes.

“There may be new drugs or even gene therapy on the hori-zon,” says Galvin, “but for now, the focus is on further improving exis-ting treatments.”

A normal pulse is 60-100 beats per minute, and it should be regular for 15 consecutive seconds

Read more on www.healthnews.ie

Dr Joseph GalvinCardiologist, Mater Private

hospital, Dublin

PHOTO: MATER PRIVATE

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HEALTH TIPS

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Matters of the heartIt’s a cliché that exercise is the best medicine – but in terms of prevention, this is actually true

Today is World Heart Day – no better time to take stock of where we stand in our approach to cardiovascular disease, both on a national level and as indivi-duals. Neil Johnson of Croí gives his expert opinion

Cardiovascular disease (CVD) is the most common cause of death and disability in Ireland. CVD is a broad term, encompassing conditions of the heart and blood vessels, from heart attacks and stroke to angina and heart fai-lure. “When we talk about CVD, we’re talking about heart attacks and stroke primarily, but also diabetes and obesity – becau-se they are very significant risk factors,” says Neil Johnson, CEO of Croí, the West of Ireland Cardiac Foundation.

Johnson has been working in this area for many years. So, where does he think we stand in terms of combatting CVD? “On the positive side, in the last 10 – 15 years, far fewer people are dy-ing from heart attacks, thanks to advances in early diagnosis and treatment.” There are signi-ficant challenges, however. “The emerging obesity epidemic, if it continues, and the diabetes epi-demic – could bring us back to square one.”

EmpowermentCulturally we seem to stand bet-ween two extremes in terms of attitudes to health. Never befo-re has there been such a focus on healthy eating and lifestyles. Yet, sales figures show that we still love our junk food, and ex-perts warn of a new kind of STD – ‘sitting to death’ disease. This is not good for our hearts.

“It’s recognised internatio-nally that as much as 80 per cent of CVD is preventable,” says Johnson. “The majority of risk factors, we have control over. We can control our blood pres-sure through diet and lifestyle, and failing that medication. Likewise, we can control cholesterol through diet, lifesty-le or medication.

“It’s a cliché that exercise is the best medicine – but in terms of prevention, this is actual-ly true. Most Irish adults sit for more than eight hours a day. Sit-ting this long could increase your risk of CVD by up to 50 per cent.”

Rather than see it as a burden, we must recognise that there is so much that we as individuals can do to help protect our heart health. Knowledge is power and self-empowerment is a key com-ponent of prevention.

If the patient must be at the centre of a preventative strate-gy for issues like CVD, new re-search highlights the benefit of just such a preventative strategy.

For the past five years, Croí has been delivering in Galway a CVD

prevention and management programme, MyAction. This tar-gets individuals at risk of CVD, who are referred through GPs and hospital departments.

The programme is delivered in the community and family-centred. Co-ordinated by a mul-tidisciplinary team (nurse speci-alists, dietitian, physiotherapist/physical activity specialist and physician), high-risk individuals are provided with a 12–16 week intensive lifestyle and risk factor modification programme. All pa-tients and accompanying family are assessed at the start, on com-pletion and again at one year.

MyAction has resulted in out-comes including a smoking quit rate of 51 per cent; a greater-than-fourfold increase in adhe-rence to the ‘cardio-protective’ Mediterranean diet; an increase in physical activity targets from 13 to 52 per cent; an increase in achievement of blood pressure targets from 55 to 74 per cent; and an increase in achievement of cholesterol targets from 39 to 70 per cent. What’s more, an econo-mic cost-benefit analysis of My-Action, published today, shows that for every €1 invested in such a programme, €8 can be saved on healthcare services over the life-time of an individual.

“We talk about our health ser-vice, but in reality we have a sick service,” says Johnson. “It’s a service for the sick – geared towards people who are ill. But what we need to do is get to pe-ople before they become chroni-cally ill; it is the best way to save lives and money in the long run. Spreading the prevention messa-ge is a priority for Croí because, as I’ve said, such a large propor-tion of CVD is preventable.”

By Ben Murnane

INSPIRATION

Neil JohnsonCEO, Croí

Keep it turning over everyday – be active and use the stairs instead of the lift.

Walk to the shops/station/newsagent. Current recommendations advise adults to have at least 150 minutes of mode-rate excercise a week.

To help keep your arteries unblocked and your blood

circulating normally cut down onanimal fat, palm and coconut

oils. Too much saturated fat is linked to high cholesterol, a risk

factor for heart disease.

Help oil the engine by substituting animal fats for those based on seeds, nuts and olives. These vegetable oils are high in un-saturated fats and low in saturated fat so are heart-healthy. But they are still rich in calories so don‘t have too much.

Help protect your heart by eating plenty of vegetables and fruit, nature’s powerhouse of antioxidants and other bioactive compounds.

Keep its emissions down - don’t smoke. Smoking can speed up the damage to arteries and hasten a heart attack.

Have a daily dose of cholesterol busting foods. Vegetable proteins such as nuts, soya, pulses, beans, lentils all help lower cholesterol. Add in a daily dose of oats and a week portion of oily fi sh, both heart protective foods.

Remember to drink plenty of fluids to keep your engine ticking over.

Listen to it - it will tell you when it needs a rest. Get plenty of sleep.

PHOTO: THINKSTOCK

Irish entrepreneur David Bobbett was fit, well and the CEO and majo-rity shareholder of H&K Internatio-

nal, a successful manufacturing business that supplies stainless steel kitchen equip-ment to 20,000 restaurants in 80 countries around the world. Married with children, life was good.

Bobbett had routine medicals every year in Ireland. He was always in the fittest 10 per cent for his age. In 2011, he had his medical in the US which included a CT scan that measured calcification in his coronary arteries.

CalcificationThe test showed he had a high calcification score, but “The clinic didn’t say to me it was serious,” he says. “But when I did some research, I found out that it was — deadly.” Alarmingly, his results were off the scale.

The average coronary calcification score for a person aged 50 is 15. The average score for a 70-year-old is 475. Bobbett’s was 906, which — even though he was only in his early fifties — meant that he had the coro-nary arteries of an 87-year-old.

“So I went to a clinic in Ireland for an angiogram which confirmed that I had one 99 per cent blocked artery and another that was 70 per cent blocked. I couldn’t understand why I had the problem.”

But a problem he most definitely had. Bobbett was told that he had a one in four chance of a heart attack in the next four years. “I thought I was a dead man walking,” he says.

When he was diagnosed, he took six months off work, studied about 1,000 medi-cal papers, and commissioned research to find out what could be done to prevent it. Now he wants to make his findings public.

Calcification of the arteries is a progres-sive disease which results from fatty pla-ques in the coronary arteries rupturing. Most people who have calcification don’t know they have it. “These ruptures won’t necessarily cause a heart attack, but it does indicate a disease process,” says Bobbett. “The more calcified plaque in your sys-tem, the higher your score; and the higher your score, the more active your disease process. So the next time you experience a

rupture, it might cause a blockage that could be fatal.”

How fatal? Well, statistics show that those with any form of a calcification score are 8 times more likely to have a cardiac event than those with a nil score. And that a third of cardiac events are fatal.

MedicationBobbett didn’t need stents because his arteries had developed their own collateral supplies. The answer for him was to move to a low-carb diet and start taking statin medication. “For me, carbs are like pouring petrol onto a fire,” he says. “I now have a scan every two years to check my coronary calcfication levels — and my disease hasn’t progressed at all.” For most people though, it’s only a once off test.

And Bobbett is very clear: this is a disease — albeit one that can’t be seen without the CT scan.

“Like any progressive disease, the earlier you treat it, the better the outcome,” he says. “We have two choices. We can identify those at risk with a scan — because this is a condition that is measurable and it is mana-geable. Or we can wait for someone to have a cardiac event before doing something about it. By that time, though, it might be too late because people in Ireland die every day from heart-attacks without ever reali-sing they had a progressive disease.”

“People say: ‘He’s a businessman, there must be a reason for him doing what he’s doing.’” Bobbett makes the point that he has nothing to gain financially from talk-ing about the importance of the CT scan. He says “it’s a simple, non-invasive test that takes around 10 minutes. And I’m talking about it because it saves lives and it should be available to men of aged 45 and over and women aged 55 and over.”

To help spread the message, Bobbett made a documentary for RTE called “The Heart of the Matter”. He also set up a cha-rity in 2012 named Irish Heart Disease Awareness (www.ihda.ie) and made “The Widowmaker” a movie which was widely acclaimed in the US, and which is available on iTunes.

After what happened to him, he felt he needed to. “It’s a privilege to be able to make

even a slight difference” he says “Because the general perception is that people who smoke and are overweight are the ones at risk of heart attacks. And they may be. But there are a huge number of people who don’t smoke, who aren’t overweight, and who don’t have any symptoms — and they are at risk too.”

He knows many who contacted the charity fitting that exact bill who lived to prevent almost-certain heart attacks after they discovered they had scores that put them at even higher risk than him. And unfortunately, he also knew some who didn’t get the scan before their plaques rup-tured and they died.

He points out that the medical guidelines (European Guidelines on Cardiovascular Disease Prevention in Clinical Practice, version 2012) recommend the Calcification test for asymptomatic middle risk patients.

Bobbett says the calcification test is like a mammogram of the heart. Mammo-grams are used to identify breast cancer in women, so why isn’t the Calcification test used in accordance with the medical guidelines to identify people at risk? As the guidelines state, calcification only arises in diseased vessels.

At present, the scan is only available pri-vately, at a cost of around €200 with a GP referral letter. “The trouble is there’s no money in prevention,” says Bobbett. “And also I think a lot of people don’t want to know if they have a serious problem that involves changing their lifestyles. And some think if they have a problem, it can be solved with a stent, which may be required in symptomatic patients. But a stent doesn’t cure the underlying disease. So it’s a mindset change.”

COMMERCIAL FEATURE

The heart of the matter: how a simple test saved my life

A 10-minute scan proved to David Bobbett that he was at a very high risk of a heart attack. He says the scan should be made available in accordance with medical guide-

lines so that those with progressive heart disease can be treated before it is too late

David Bobbett Founder, Irish Heart

Disease Awareness

By Tony Greenway

“Bobbett is very clear: this is a disease — albeit one that can’t be seen without a CT scan...and like any progressive disease, the earlier you treat it, the better the outcome” For more information visit:

www.idha.ie

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