Find out what you can do to re­duce your risk of heart at­tack

Great Health Guide - - CONTENTS - Dr Warrick Bishop

Coro­nary artery dis­ease re­mains the big­gest killer in the Western World de­spite sig­nif­i­cant ad­vances in the un­der­stand­ing, di­ag­no­sis and man­age­ment of the con­di­tion. Know­ing how to care for your heart is most im­por­tant as sig­nif­i­cant suf­fer­ing could be avoided with sim­ple main­te­nance. If you have al­ready had a heart at­tack, you will have a car­di­ol­o­gist and you should be see­ing your lo­cal GP for on­go­ing mon­i­tor­ing. It is im­por­tant for you to check that you are tak­ing the right med­i­ca­tion and that you are re­ceiv­ing fol­low-up to eval­u­ate your progress. It is im­por­tant to en­sure that med­i­ca­tions are ad­justed, blood pres­sure checked, choles­terol lev­els mea­sured and gen­eral main­te­nance at­tended to. It’s a dif­fer­ent story if you have not had a prob­lem with your heart, but you can cer­tainly en­gage in pre­ven­tion be­hav­iours to cir­cum­vent the de­vel­op­ment of a heart prob­lem.

SO, WHAT CAN YOU DO TO RE­DUCE YOUR RISK OF A HEART AT­TACK? 1. De­cide to look after your heart health.

This is im­por­tant. It is easy enough to say that you will take care of your heart, but un­less you make a de­ci­sion and com­mit to fol­low through, you are kid­ding your­self.

2. See your gen­eral prac­ti­tioner. Your GP will check your blood pres­sure, blood sugar, lipid pro­file (choles­terol

lev­els) and will also as­cer­tain the gen­eral state of your health. In ad­di­tion, they will pro­vide you with gen­eral guid­ance and most im­por­tantly, they will bring you back for fol­low-up to check your progress to­wards re­duc­ing the risk of heart at­tack.

3. Make small, sus­tain­able changes.

It is sim­ply not re­al­is­tic to go from couch potato to Olympic ath­lete. If the changes are not real­is­ti­cally man­age­able in the longer-term, then you sim­ply won’t sus­tain them! In­stead, make small changes by speak­ing with your GP, who will help guide you to set re­al­is­tic, sus­tain­able goals that will help your heart health in the long-term.

4. Just do it. If you are ad­vised to change your life­style or to com­mence med­i­ca­tion for blood pres­sure or high choles­terol, it will be be­cause your doc­tor be­lieves that these changes will make a dif­fer­ence to your health. There­fore, you need to com­mit to mak­ing these changes.

5. Ask the ex­perts. If you have ques­tions or are un­sure about ad­vice, please make an ap­point­ment with your GP for a con­sul­ta­tion and dis­cus­sion about your heart health. My ex­pe­ri­ence is that in­creas­ingly more pa­tients these days seek help from ‘Doc­tor Google’, but this in­for­ma­tion can be un­re­li­able and there is no way to en­sure that this in­for­ma­tion is even rel­e­vant for you.

6. Need more in­for­ma­tion? Mod­ern tech­nol­ogy has evolved so much that we can now look at the ar­ter­ies of the heart us­ing CT (or CAT) scan­ning. This is a fairly new di­ag­nos­tic

tool and it is not yet part of any for­malised guide­lines within Aus­tralia. Nev­er­the­less, the scan can look in­side your ar­ter­ies and pin­point where any plaques may be pre­sent and if there is nar­row­ing or block­age of the ar­ter­ies around the heart. The test pro­vides in­valu­able in­for­ma­tion in cer­tain sit­u­a­tions and it can be use­ful for the in­di­vid­ual and doc­tor to tai­lor their treat­ment.

The ques­tions that imag­ing of the heart ar­ter­ies can help to an­swer are:

1. ‘My choles­terol is high, is there build up in my ar­ter­ies?’

2. ‘I have a fam­ily his­tory of heart at­tacks, should I be con­cerned?’

3. ‘My doc­tor says I should be on a statin, but do I re­ally need one?’

4. ‘I’m on a statin, but I suf­fer side ef­fects. Do I re­ally need a high dose, or would a lower dose be OK?’

7. Man­age your fu­ture car­dio­vas­cu­lar

risk. Heart imag­ing is not yet a rou­tine test for mea­sur­ing your heart at­tack risk and is there­fore not cov­ered by a gov­ern­ment re­bate. How­ever, some pa­tients choose to have this heart scan and pur­sue this ex­tra in­for­ma­tion, so that they can make im­por­tant decisions about man­ag­ing their fu­ture car­dio­vas­cu­lar risk. If in doubt, make an ap­point­ment to speak to your GP. It is up to you to know how to care for your heart - you only have one.

Dr Warrick Bishop is a car­di­ol­o­gist with spe­cial in­ter­est in car­dio­vas­cu­lar dis­ease pre­ven­tion in­cor­po­rat­ing imag­ing, lipids and life­style. He is au­thor of the book ‘Have You Planned Your Heart At­tack?’, writ­ten for pa­tients and doc­tors about how to live in­ten­tion­ally to re­duce car­dio­vas­cu­lar risk and save lives! Dr Bishop can be con­tacted via his web­site.

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