HEART DISEASE PREVENTION : THE BAD AND THE GOOD

Last week and early this week have seen the publication of three reports, two of which are very worrying and the third a piece of good news. It is all about lifestyle changes and prevention of coronary heart disease.
Dr M O'Flaherty of Liverpool reported in the July 14th issue of BMJ, that there is a growing trend in Scotland, that cardiac mortality and morbidity in the younger age group, 30-50 years, seem to be flattening, more so in the lower social economic groups, in the last 10 years or so. They seem not to eat healthily and exercise regularly. The poorer young people seem to have gone back to smoking and also eating the less healthy foods, including those with high trans-fat levels.
Dr Lee of Toronto, in the 20th July issue of the Canadian Medical Association Journal, also reported that in Canada, they have noticed that there seem a trend in their younger age group, for a flattening of the risk factor modification curve, especially in the pooere young, from 20-50 years range. There seem to be a rising incidence of risk factors again, including hypertension and obesity.
The good news is that the Dr Forman, of Peter Bringham and Women's ( Mass. USA ), published in the 22nd July issue of the Journal of the American Medical Association, that in a followup substudy of the Nurses' Health Study ( 83,882 nurses, mean age 27-44 years, followed up for the last 14 years, showed that those nurses ( mainly females ) who observed a heathy lifestyle ( Green veges, fruits and low salt diet-DASH diet, folic acid suplements ), together with moderate exercise, had a 80% lowewrr incidence of hypertension.
This paper was followed in the coming 29th issue of JAMA, by another paper by Dr Djousse also of Bringham and Women's, who followed up 20,900 males in the physician Health Study, over a mean of 22 years, and found that there was a significant reduction in the incidence of heart failure in those who followed a healthy cardiac lifestyle, namely ideal body weight, low salt, low cholesterol diet, greens veges and fruits, regular exercise, stop smoking.
It does appear that a healthy cardiac lifestyle is good, but can be difficult to observe and also to maintain. The young especially the pooere part of society, may find that basic day to day survival does not allow them to be so " Ideal ". They had to compromis significantly on their exercise and food, resulting in the increase in coronary risk factors, observed in the UK and Canadian study.
It may be iportant for the government, in their eternal quest to lower the healthcare budget, to offer incentives to the people, especially the less wealthy, to encourage them to kee to their healthy lifestyles and in so doing, lessen the incidence of heart disease, thereby reducing the healthcare budget. I see a small attempt at that in the new" US Healthcare reform " proposed by President Obama. I do hope that he succeeds, thereby giving us an example to follow.