Almost 9,000 people die from heart disease every year in Ireland and over 7,000 of those deaths are preventable. That's the arresting opening to Ray D’Arcy’s conversation with the Mater Private Network’s Director of Cardiology, Professor Robert Byrne.
Friday 29 September is World Heart Day and, given Prof Byrne’s summary of the state of heart health, it’s not hard to see why it needs a day of its own:
"Heart disease is – and cardiovascular disease – is the leading cause of death in Ireland and most of the western world. I mean, you might say in Ireland, probably there’s about 30,000 deaths a year. We’re all kind of familiar with these figures from looking at it over the Covid years and probably about 10,000 are cardiac, heart disease, heart-related."
Prof Byrne tells Ray that it was probably in the 1980s that we started to learn a lot about what we now know about the risks for heart disease like cholesterol.
Blood pressure and smoking we already knew about, and although health professionals and governments around the world have been banging on about the dangers of smoking for decades, people still take up the habit. And it still puts them at high risk:
"Cigarette smoking is a big one because cigarette smokers tend to present about 9 years earlier than non-cigarette smokers. Cigarette smoke causes the blood to become sticky. If there’s cholesterol there, it can be the straw that breaks the camel’s back."
Although the figures suggest that about 70% of the risks are modifiable and roughly 30% are genetic, there are some people who will do everything right in terms of lifestyle and still get heart disease. They are the unfortunate ones.
But the treatment for people who do suffer from heart disease has greatly advanced in the last few decades:
"The most common cause of a heart attack is an abrupt occlusion of one of the three main heart arteries, a blockage in the heart arteries. And we have ways and means of getting up to the heart arteries and reopening them, restoring flow and then putting in a stent, or a scaffold, to keep it open. So, this has been a revolution."
It’s not the only revolution that Prof Byrne brings up in the treatment of heart attacks in Ireland, because the development of heart treatment hub centres has, in his opinion, been a game changer:
"This has been a revolution in the treatment of heart attacks over the last 10 years in Ireland and it’s led to a very significant reduction in death from heart attack. Nowadays, you know, probably your chances of dying if you make it to hospital are about 5% or 6%, which is a really good survival rate."
Treatment has improved pretty dramatically in recent years, but what about prevention? Lifestyle is often cited as a major factor in the prevention of many serious illnesses, including heart disease and Prof Byrne stresses that exercise is a key factor in preventing heart disease – and it has to be a proper workout.
The mild exercise most people get from their daily routine isn’t enough to generate the elevated heart rate that real exercise brings:
"Lots of people come in and say, 'Listen, I’m rushing about the whole time.’ That’s not the same as getting out, getting 30 minutes of exercise most days of the week. It needs to be enough to get up a light sweat, otherwise you’re not deriving heart benefit from it. So we say 30 minutes five days a week at a minimum. I mean, that’s 150 minutes a week – if you could do 300 minutes a week, even better."
That’s a lot, as Ray points out. But exercise is key, Prof Byrne insists. And then there’s diet. Again, it’s not really anything we haven’t heard before, but, yes, avoid processed foods and focus on the Mediterranean diet, as it’s been proved to be the one that’s the best for heart health.
"The Mediterranean type of diet is definitely the best one from a heart point of view. Which is good news because it means not avoidance of food, but things in moderation. Plenty of fresh fruit and vegetables.
"If you like meat, fine, but maybe try once or twice a week, otherwise white meat, fish, olive oils, seeds and nuts. As little processed food as possible. If you like carbohydrates, high fibre carbohydrates are the ones."
Exercise, a good diet, and no smoking should mean excellent heart health. And everyone over the age of 40 should know what their blood pressure is and what their cholesterol levels are.
Sounds reasonably simple and it’s something that could go a long way to reducing that 7,000 preventable deaths statistic.
You can hear Ray’s full conversation with Professor Robert Byrne by clicking above.