The facts about heart disease
 April 11, 2004

Ever fallen in love? Then you know where your heart is. But how is it really doing? Bronwyn McNulty reports on our biggest health threat - heart disease.

When Lucia Nardo was in her 30s, her biggest health fear was breast cancer. Some 10 years later, she is lucky to be alive after major surgery to correct a serious heart condition.

"I wasn't aware that heart disease is the number one killer of women," says Nardo, now 48. "Like most 35-year-olds I thought I was pretty indestructible." Then she accompanied her mum on a visit to the cardiologist.

"He listened to my heart and sent me for an echocardiogram, and I was told I had a regurgitant valve - which basically means it leaks. He monitored it for about 10 years, and it didn't get any worse, so I stopped seeing him."

Three years later though, Lucia wasn't feeling well and had another echocardiogram. "The next minute the specialist said he was sending me to a cardiologist, but he didn't know if he could fix it," she says.

Fortunately for the mother of two, the eight-hour surgery was a success. The only reminder she now has of her life-and-death crisis is the click of the prosthetic valve that the surgeons put in her heart. A click that she can hear every day. (In fact, she goes to sleep listening to the radio in order to drown it out.) Cardiologist Dr Lynne Pressley, national deputy president of the National Heart Foundation Of Australia, says that heart disease is the biggest killer of men and women in this country.

"Something like 90 per cent of Australian women over the age of 18 have at least one risk factor," says Pressley. "And one in five have three or more risk factors. Heart disease kills five times as many women as breast cancer."

The threat is global. Dr Robert Superko, co-founder of the Berkeley HeartLab in California and author of Before The Heart Attacks (Pan Macmillan), says heart attacks are the leading cause of death in the developed world.

"But there's a surprising amount you can do to prevent, treat and even reverse coronary heart disease," he says. "Truly incredible results can often be achieved just by making sensible lifestyle changes like stopping smoking and losing weight."

1 quit blowing smoke
Coronary heart disease kills more smokers than cancer does, says Dr Superko. "The toxic agents in tobacco literally poison the cells in the walls of the arteries, making them more susceptible to plaque and to rupture," he says.

Pressley explains that smoking at least doubles your risk of heart disease. "And for women on the pill who smoke, their risk of heart disease is increased 10 times," she adds. The good news, however, is that after one year of quitting, the risk of heart disease will be half of what it was, and after two years, the risk will return to normal.

2 ditch the fat
"Avoid saturated fats, such as chicken skin and the fat on meat," says Dr Pressley. "There is nothing wrong with meat, you just need to choose lean cuts and have modest servings. Also, switch to low-fat yoghurt, low-fat cheese, low-fat milk, and avoid coconut oil and palm oil."

Dr Superko says that numerous studies have shown the link between diets high in saturated fat and coronary heart disease.
"You don't have to cut saturated fats out of your diet completely, but we suggest that you limit the foods that contain them," he says.

3 move it or lose it
Exercise is one of the most significant lifestyle factors that can prevent coronary heart disease, says Dr Superko. "In fact, there is even some evidence that vigorous regular exercise can alleviate existing heart disease."

Dr Pressley recommends walking or engaging in some sort of activity for half an hour a day on most days. "This reduces your risk of heart disease by 30 to 40 per cent," she explains. "You don't necessarily have to do it in 30-minute packages; 10-minute bursts of activity count too."

4 weigh it up
"Something like 60 per cent of Australians are overweight," says Dr Pressley. "And about 25 per cent of women in Australia are overweight."

In fact, being overweight is a risk factor for both coronary heart disease and for diabetes, and it also contributes to having high blood pressure.

5 in the red
Dr Superko says that high blood pressure is directly linked to coronary heart disease and stroke. "Mildly elevated blood pressure can often be controlled through lifestyle measures such as diet and exercise, " he says.

To properly monitor the health of your blood, you should make sure that your GP checks your blood pressure on every visit, and your blood cholesterol every couple of years until menopause, and then after that, every year, says Dr Pressley. "Also make sure you don't have diabetes, or if you do, that it is treated," she says. People with untreated diabetes are four times more likely to have a heart attack."

6 stay in touch
"If you are socially isolated and depressed, you are more likely to develop heart disease," says Dr Pressley. "You should seek proper counseling and treatment."

7 all in the family
If you have a family history of heart disease, you must take preventative measures and have regular check-ups. "A first-degree relative - father, mother, sibling - with heart disease is one of the strongest indications that you may be at risk," says Dr Superko.

For a free copy of the National Heart Foundation Of Australia's Women and Heart Disease booklet, call the national information service Heartline on 1300 362 787.
Lucia Nardo's book, Heart to Heart (Michelle Anderson Publishing) is in bookstores now.

Dr Robert Superko's book Before The Heart Attacks (Pan Macmillan) is in bookstores now.

tip-top tickers
In his book, 50 Ways To A Healthy Heart (HarperCollins) pioneering heart surgeon Dr Christian Baarnard lists ways to keep your heart in tip-top shape. Here are some of our favourites.
• Eat with passion.
• Forget about diets.
• Drink red wine.
• Live naturally.
• Sleep well.
• Let the sun shine in.
• Believe in something.
• Work on your relationships.
• Enjoy sex.
• Show your feelings.
• Learn to manage your anger.
• Keep laughing.