Heart of the Matter Is Prevention

Western Mail (Cardiff, Wales), March 29, 2004 | Go to article overview
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Heart of the Matter Is Prevention


Byline: By Professor John Cockroft

Could death from heart disease really become a thing of the past? Professor John Cockroft asks if a report into progress in reducing heart attacks gives hope or hype

THE recent coronary heart disease report by Dr Roger Boyle, highlighting the progress made in reducing death from heart attacks in people under 65 years, is extremely encouraging and is to be welcomed as good news. However, the report should be viewed with some caution as it may not tell the whole story.

We still have huge problems with obesity, high cholesterol levels and smoking in Wales - all factors that increase the risks of heart disease. Every two minutes someone has a heart attack and many patients still die before reaching hospital to receive treatment. Perhaps more worryingly, many of these patients do not know that they are at risk before they suffer a fatal heart attack.

Although, as set out in the report, many more heart patients are receiving life-saving drugs and treatment, it is equally important to stop people developing heart disease in the first place.

Indeed, the figures in the Boyle report referred only to a decrease in the deaths from heart disease and not to a decrease in the incidence of heart disease. This is an important issue as the incidence of heart disease may indeed be set to rise, fuelled mainly by an increase in obesity, lack of exercise, unhealthy diet and lifestyle.

It would be unfortunate if some people interpreted the Boyle report as suggesting that they did not have to address these risk factors as treatment was always going to bail them out of trouble at the end of the day.

Obesity in particular is a major risk factor for diabetes, a condition which significantly increases an individual's risk of heart disease. If this and other risk factors remain unchecked, then the improved treatment, as outlined in the Boyle report, may not be able to keep pace with an ever-increasing demand, due to more people developing heart disease.

If an individual came home to their kitchen to find a tap running into a sink that was overflowing, the first, and sensible, instinct would be to turn off the tap and then mop up the floor, rather than start mopping up the water and not bother to turn off the tap.

If we focus exclusively on better treatment of heart disease and ignore strategies for its prevention, then we just carry on mopping the water up without turning off the tap. If the tap runs faster, eventually we may not be able to mop all the water and the kitchen will flood.

Already pressure is building behind the dam in terms of increased levels of obesity, diabetes, high blood pressure and other risk factors leading to heart disease. We therefore need to urgently review the situation before the dam bursts, producing a flood of increased numbers of patients with heart disease.

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