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Chapter 1: What are the leading causes of cardiovascular disease and its preventability?
Cardiovascular disease is still the leading cause of death worldwide, but doctors say many cases are preventable. There's now a growing focus on catching risks early through blood pressure, cholesterol and lifestyle checks before serious problems develop. Joining me now is Dr Matthew Barrett, consultant cardiologist and clinical governance lead for heart health check at Afidia Ireland.
Morning, Matt.
Morning, David. Thanks very much for having me. I'm sorry I'm not there in the studio, but I'm down here in clinic in Dun Laoghaire, seeing people who haven't been lucky enough to catch their heart problems before causing some issues. So I'm down here looking after that.
Chapter 2: How can early detection of heart health risks be achieved?
And I suppose, you know, very, very normal what you said about trying to get ahead of these things is really the message you're trying to get out here. You know, we're well used to the message of if you have chest pain or breath issues, you know, that suggests you might have a heart problem already. We're all very good at getting that checked out.
But that's also what we're trying to do is move the dial maybe a little bit earlier and actually get ahead of all that happening in the first place.
So try and catch it before you end up with the chest pain and everything. Preventative heart health. Talk to me about that.
Well, I mean, we often say as cardiologists that people look after their cars an awful lot better than they look after their bodies. And the time you want to be getting a car check done is your annual service to get it kind of tuned up and ready so that you're not then all of a sudden broken down to the side of the road.
Preventative heart health is very much identifying those things that could potentially cause you bother down the line and sort of course correcting before you end up running into a major problem. And I suppose when you look at the data, and we're fortunate in cardiology now that we have it out there,
70 or 80 years of very, very good data following up people who've got these conditions like blood pressure, cholesterol, et cetera, and how they do over time. And what we know is roughly about half of people will be walking around with something in their bodies, be it blood pressure, cholesterol, undiagnosed diabetes, et cetera, what we call a risk factor for heart disease.
But half of us will have one of those things, and only about half of us will be aware we have it.
And that's really important because if you're not aware of it, you can't treat it, you can't get on top of it, and then potentially you're putting yourself at risk down the line of something acute happening, so having an acute cardiac problem like a heart attack, stroke, and those things that we know can cause heart disease. lifelong problems going forward.
And in Ireland, about 10,000 people a year will run into some kind of acute heart or cardiovascular issue. And we know that 80% of those are preventable. And that's through identification of these risk factors, as you said, lifestyle modifications in the first instance, and then use of medications and very simple things like blood pressure medications, cholesterol medications.
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Chapter 3: What is the importance of preventative heart health?
And women, classically, have been very good at things that there's a lot of awareness around. I think that self-breast check for breast lumps, going for your cervical screen for cervical cancer, breast check. All those things are very much coded into our psyches, things we know what we're watching out for.
But again, if you look at the data, for every age group in women from young to middle-aged to elderly, heart disease is still the number one killer in women, far above breast cancer or all the things we usually think of women's health conditions. It's typically underappreciated. When you think of a heart patient, you think of a middle-aged man, maybe a little bit unhealthy.
And that's reflected a lot in the research that's been done into heart disease. About 75% of people in studies around heart health and heart treatments are male. So we underappreciate the impact of heart disease on females. But again, as I said, it is the number one killer at every age group for women.
The other thing that we as a medical profession have to be aware of is that we also have our own biases.
So a woman who goes in to visit their GP, see a doctor, the emergency department, complaining of symptoms that could be potentially in the case of cardiovascular heart disease, they're often not identified or picked up because brains aren't as well switched on to being aware that heart disease is a risk in this population.
Not only that, but women tend to present slightly differently in terms of symptoms. So we think of somebody having a heart attack as a typical clutching in the middle of your chest, pain going up to your jaw, going down your arm. That's all very... we think about that as how a heart attack presents, but actually women can come in quite differently.
Sometimes they come in with breathlessness, low energy, nausea, dizziness, palpitations. So again, sometimes we're just not clued into treating or identifying heart disease in women because classically they just have been under-recognized. So really there's a big push now to ensure that we're keeping that level of suspicion for heart disease in women because again, it is the number one killer. And
there are certain conditions that affect women specifically, which again will increase their risk.
So in addition to your usual risk factors, as we call them, women who have had issues with things like blood pressure during pregnancy, diabetes during pregnancy, preeclampsia, even when these conditions fully resolve after the pregnancy is over, those women are going to get higher risk of heart disease going forward.
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