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FREE WELCOME Contents 22 4 News The latest research and heart health stories 6 Behind the headlines We analyse stories about fibre, exercise and a cholesterol-lowering drug 7 Your letters 8 Spotlight on... food banks How charities are supporting low-income families and championing healthy eating 10 Ask the experts Your health questions answered 12 Caring together 26 How can we achieve joined-up care? 14 Cover story: Knockout 90s Old age is no barrier to keeping active 18 Focus on… Atrial fibrillation Mike’s story of living with the condition 22 Drug cabinet: beta blockers An expert answers common questions 39 24 Breath of fresh air Why we’re funding research exploring links WIN between pollution and heart disease An easy-to-use mobile phone 26 World food worth £120 What we can learn from diets around the globe Plus: Recipe cards – tasty and healthy dishes 29 Focus on… salt Advice from our senior dietitian Victoria Taylor 30 Mitral miracle BHF-funded research hopes to develop a new type of artificial valve for the heart that could benefit many patients 32 Let’s talk about sex Real-life stories of how a heart condition can affect your sex life 36 The next chapter Making the most of your retirement Cover photography: Charlie LibraryCover Clift. Science Photography: Photo Laura Hart, Stockfood, 40 Collectibles with a conscience How we’re using Ebay to raise funds 42 Transplant Games Online at bhf.org.uk/heartmattersmag Three inspiring stories n Watch: the Commonwealth n Surprising salt sources: discover Games and Transplant Games the top culprits 46 Walk this way How a walking group could help you competitors swap tips n Holiday pitfalls: foods to avoid

MEDICAL DICTIONARY MEDICAL TERMS Acute coronary syndromes (ACS) A term A used to describe a range of problems a ecting the heart, including unstable the heart and circulation – for example n coronary heart disease (angina and heart angina and heart attack. ‘Syndrome’ means a n attack) and stroke. set of symptoms that happen together, and NEXT ISSUE Top 10: ways to have a fulfilling 48 Join the fight ‘coronary’ means to do with the heart. Acute Coronary Artery Bypass Graft An operation to Has your doctor got the treat coronary heart disease. The arteries right bedside manner? We Watch: a behind-the-scenes tour coronary syndrome is a medical emergency. Angina An uncomfortable feeling, tightness from your chest wall, or veins from your leg, investigate the right approach. or pain in your chest, which can also be felt are used to bypass the blocked or narrowed Plus: Focus on cardiomyopathy, in your arms, neck, jaw, back or stomach. The coronary arteries. This helps to improve the and inspiring stories of symptoms are usually caused by coronary  ow of blood to your heart muscle. fundraisers and their global heart disease. The build-up of fatty deposits Coronary heart disease When the walls of adventures can narrow the arteries, restricting blood the coronary arteries (the arteries that  ow to the heart muscle. It is often brought supply blood to the heart muscle) become on by physical activity, an emotional upset, narrowed due to a gradual build-up of fatty the artery walls. If the atheroma becomes cold weather or after a meal. deposits called atheroma. This can lead to unstable, a piece may break o and lead Angiogram X-ray pictures that show whether angina. If a piece of atheroma breaks away to a blood clot forming. This can block a the arteries are narrowed and, if so, how from the artery wall, it can cause a blood coronary artery, causing a heart attack and narrowed they have become. A coronary clot to form, which could block the coronary A family organises a fundraising bike ride irreversible damage to the heart muscle. A angiogram examines the coronary arteries artery and starve your heart of blood and heart attack is a medical emergency and can retirement – the arteries that supply the heart muscle oxygen. This is a heart attack. lead to a cardiac arrest. of our Ebay warehouse with blood. Angioplasty A treatment to widen a Diabetes A condition in which glucose Heart failure A condition where the narrowed artery. D (sugar) levels in the blood are too high. heart becomes less e cient at There are two main types of diabetes: type See p22 pumping blood around the body. A trial fi brillation (AF) A common 1 where your body stops producing insulin High blood pressure (hypertension) arrhythmia (abnormal heart and type 2 where your body is unable to High blood pressure is when your blood See p18 rhythm) in which the atria (the use the insulin that is produced e ectively, pressure is consistently higher than the upper two chambers of the heart) recommended level. The higher pressure beat in an irregular pattern. Fibrillation usually because excess fat in organs leads puts extra strain on your heart and blood means ‘quivering’ or ‘twitching’. People to resistance to normal e ects of insulin. vessels, and over time can increase your risk with atrial  brillation have an irregular and Having diabetes increases your risk of of having a heart attack or stroke. sometimes fast pulse. developing cardiovascular disease.

Pacemaker A small device that is Bypass surgery See Coronary Artery Echocardiogram A test to examine n E P implanted just under the skin on B the structures within the heart, for n Bypass Graft. the chest and is connected to your heart example the heart valves, and to see how well the heart is pumping. by one or more wires. It monitors the Video: erectile dysfunction and Cardiac arrest The ultimate medical C Electrocardiogram (ECG) An ECG is a simple electrical signals within your heart and can Tips: clever ways to reduce your emergency. This is when a person’s stimulate the heart to contract and produce heart stops pumping blood round their and painless test to record the electrical activity of the heart. Small sticky patches a heartbeat. body and they stop breathing called electrodes are put onto your arms, normally. Many cardiac arrests legs and chest. These are connected to Sinus rhythm The normal electrical in adults happen because the S 49 Medical dictionary See p16 a machine that picks up and records the pattern of your heart. person is having a heart attack. Stent A short tube of expandable Cardiomyopathy A disease of the heart electrical signals that make your heart beat. stainless-steel mesh, which is inserted muscle in which the heart muscle becomes into an artery to hold it open after an weakened. The heart muscle may become Heart attack The medical term for a angioplasty. This improves the  ow of blood thickened, enlarged and/or sti , depending H heart attack is a ‘myocardial infarction’, through the artery. on the type of cardiomyopathy. It a ects or ‘MI’ for short. This is when there is a Stroke An interruption of blood  ow to part people of all ages and is usually inherited. sudden loss of blood  ow to a part of the of the brain, that causes brain cells to die Cardiovascular disease (CVD) All disease of heart muscle. Most heart attacks are caused by atherosclerosis, which is the gradual or become damaged. This happens if an sex after a heart attack build-up of atheroma (fatty material) within artery carrying blood to your brain becomes food waste Call the Heart Matters Helpline on 0300 330 3300 blocked, or if an artery bleeds into your Medical terms demystified brain. A stroke is a medical emergency. bhf.org.uk if you want to know more n My story: Tom Riley’s story of n Listen: Ada Vincent talks about her 49 heart disease and surgery role in the Dutch Resistance 50 Information and support Helping you live a heart-healthy lifestyle bhf.org.uk 3 NEWS NEWS

BHF lobbies Dates for your diary BHF calls for more 18–19 July Bristol Harbour Festival – Downing visit our stall in the Charity Village. ECG tests in ambulances 20 July Heart of England Bike Ride 2014 – choose between 13-, 19- or simple test carried out by ambulance hospitals in England and Wales. The Street to get 31-mile routes through beautiful A crews on suspected heart attackD number of patients who died within Warwickshire countryside. Visit patients can help save lives, according to 30 days was significantly lower when an bhf.org.uk/hoebikeride2014 research funded by your donations. electrocardiogramD (ECG) had been carried kids moving or contact Donna Stokes on Researchers at the University of Surrey out by ambulance crews. 0121 353 2087. analysed data from almost half a million The study found that patients who had e’ve been to Downing Street to tell 1–8 August National Eisteddfod, adults admitted with a heart attack to an ECG in the ambulance were the most Wministers why it’s vital to get our Llanelli, South Wales – meet BHF likely to receive angioplastyD treatment to young people active. Cymru and learn what they do. reopen a blocked coronary artery. Use of The BHF has joined forces with politicians this treatment is proven to reduce heart 16 August Greenwich Park Run – from each of the political parties and a choose between a 5k or 10k route. damage and improve survival rates. host of organisations such as the Lawn Visit bhf.org.uk/greenwichparkrun Our Associate Medical Director, Dr Mike Tennis Association, Nike and the Premier or call 0845 130 8663. Knapton, said: “This research suggests that The BHF and fellow League. We’ve done this because today’s if someone suffering a suspected heart campaigners on a visit children are the least active in history, with 16 August Swim and barbecue, David attack has a simple ECG test before they to Downing Street in April Lloyd Leisure, Chorley, Lancashire, around one in three UK children classed as reach hospital, it can help save their life. 5pm–8pm. To register contact Sanam overweight or obese, increasing their risk Ogden on [email protected] The results, made possible by studying of heart disease in the future. He said: “Physical activity is a vital way are: create a National Action Plan with the or 07792 467041. huge numbers of medical records, clearly Physical inactivity leads to 37,000 of helping lower our risk of coronary heart support of all political parties, which will support existing guidelines on using an premature deaths every year in England diseaseD, the UK’s single biggest killer. be a strong framework for action; raise 30 August Loch Ness Bike Ride – ECG test before patients reach hospital. So alone, according to figures from the “A simple way to create lifelong healthy awareness with a public health campaign; choose from 50- or 70-mile routes it’s vital that all patients who show signs of from Inverness through the Scottish Network of Public Health Observatories. habits is to build physical activity into develop a standardised measure of activity a heart attack have this simple test.” Highlands. Visit bhf.org.uk/lochness Our Chief Executive, Simon Gillespie, everyday routines in childhood. If we make across the UK to track progress; design or call 0845 130 8663. helped deliver a copy of the report from schools and workplaces more active we can physical activity into everyday life and the All Party Commission on Physical help today’s children move towards make ‘active workplaces’ the norm; and 31 August London to Southend Off- Activity to ministers at Downing Street a healthier future.” provide early access to positive active Road Bike Ride – 40 miles, perfect for on 8 April. The report makes five major points. They experiences for children. newcomers to mountain biking. Visit Thank you bhf.org.uk/london2southendoffroad A celebration evening was recently held or call 0845 130 8663. at our London head office to recognise 13 September First Blackburn with and thank just some of the 90,000 use their card within the first 90 days of IN Darwen Heart Town Walk – Start at event participants and volunteers who Peter Wilkinson Raise funds and Louise Hazel the account being opened, MBNA will SEASON Witton Park, Blackburn, at 11am, helped to raise over £9.8m in 2013. contribute up to £50 (£7.50 minimum, 4 miles. Contact Barbara Dunn on They included Peter Wilkinson, 67, with plastic £50 maximum – successfully apply [email protected] or 01772 641870. from Windsor, a cardiologist who has 28, from Cambridgeshire, was there to We are thrilled to have continued using the link below and MBNA will 14 September Pete Hayes taken part in nine overseas cycling give out the awards, and spoke movingly support from MBNA in our fight for contribute £50), plus 35p for every £100 Handsworth 10k Fun Run in challenges. He gave a presentation on about what taking part in one of our every heartbeat. spent on card purchases for as long as Handsworth Park, Birmingham. the developments in cardiology in the events meant to her. When customers open a British Heart the account is open – at no extra cost Contact Donna Stokes on past 20 years and received an award. Foundation Credit Card account and to you. [email protected] or call Commonwealth Games heptathlete ≠ See page 45 for more on Louise and These contributions will provide vital 0121 353 2087. and BHF running champion Louise Hazel, how she supports the BHF. funds that will help us continue our 20 September Second Blackburn research, support and care for those with Darwen Heart Town Walk – living with heart disease. starts from Darwen Leisure Centre, Courgettes, onions, peppers, spring Lancashire at 11am, 4.5 miles. Contact Help us grow our Heart Voices network for by heart disease to developing a new ≠ Representative 18.9% APR (variable) onions, tomatoes, raspberries. Barbara Dunn, as above. people affected by heart disease, who want resource for patients, or joining a national

VALID FROM UNTIL END ≠ For more product information and to ≠ to influence heart health services. committee to influence health strategies. 5407 Check out our recipe cards (inserted 27 September Oxford to Cambridge apply, visit: mbna.co.uk/bhfcreditcard or on page 26) for recipe ideas using Bike Ride – enjoy the scenery on our There’s a huge range of activities; from call 0800 028 2440. some of these ingredients. 90-mile route. Visit bhf.org.uk/oxcam getting involved with your local NHS and ≠ Visit bhf.org.uk/heartvoices or email

Photography: iStock or call 0845 130 8663. championing the views of people affected [email protected].

4 Heart Matters bhf.org.uk 5 LETTERS BEHIND THE The winner of HEADLINES YOUR LETTERS our star letter We love to read your emails and letters, so keep writing: will receive a [email protected] or Heart Matters, British Heart Foundation, The Express 14 May 2014 British Heart Can fibre help you live longer Greater London House, 180 Hampstead Road, London NW1 7AW Foundation "Experimental jab can reduce the To read more of your letters online, water bottle after a heart attack? risk of heart attacks for millions" visit bhf.org.uk/HMjulyletters An experimental drug can lower levels of cholesterol by up to 75 per cent when Daily Mail 30 April 2014 combined with a statin, researchers "A bowl of breakfast cereal have found. you were able to put me in Tests showed that patients given the touch with her. We have been STAR every day increases heart attack powerful new jab, evolocumab, alongside friends ever since. Although we survivors’ chances of living longer, their normal statin, saw a major reduction. live a long way apart, we keep in LETTER claim researchers" touch regularly. Making a difference is fulfilling The BHF says: This was a relatively I’ve lived a normal life and I I would like to thank you for Heart Matters magazine, it is a very The BHF’s view: This study short study, so further research is have a 15-year-old daughter. useful and interesting read. I particularly enjoyed ‘Day in the life made headlines in the Guardian, Daily needed to assess the safety of these After Niamh was born I was of a British Heart Foundation volunteer’ in the Mar/Apr 2014 Star, BBC News and others. It found that additional treatments. recommended not to have any issue. I found this article extremely positive and encouraging heart attack survivors who ate more fibre It is also worth remembering the more children, because of the to people who are unemployed and have had loved ones after their heart attacks tended to live other ways we can try to lower our Friendship formed through extra strain childbirth puts on that have suffered from heart problems. About a year ago my longer than those who didn’t. cholesterol levels. Lifestyle changes like Heart Matters your heart. Rachel has a son uncle suffered from heart problems and underwent several Compared with fibre from pulses, fruits stopping smoking, eating healthily and I was born with transposition of a year younger than Niamh, operations. Unfortunately he did not survive. and vegetables, fibre from cereals (wheat, doing at least 150 minutes of physical the great arteries, a condition so she has been through the I am currently unemployed and following my uncle’s death I rice, oats, corn and rye) had the strongest activity per week all play a crucial role in where the heart’s two major same as me. decided to volunteer at my local BHF shop because it is working link with living longer. But not all cereal- keeping our cholesterol levels in check. arteries are switched round. As Thanks for putting us in touch. for a charity that helps the study of heart disease. based foods are high in fibre and it’s not a baby I had surgery to correct Louise Sharp, Hawick, Scotland I cannot emphasise enough how rewarding and fulfilling it necessarily the case that a daily bowl of this, which was a relatively new is to be a volunteer and work for a charity that is so close to my breakfast cereal will help you live longer. procedure at the time. Editor Sarah Kidner replies: heart. It really feels that one is making a positive difference in Some cereals are low in fibre (most rice vitamins, minerals and other nutrients, The Independent 9 May 2014 I had never met anyone else That’s lovely to hear. As your story the world. and corn-based cereals) and many contain so it’s not certain that the fibre itself is with that condition until I read shows, Heart Matters is more than Maria Davis, Birmingham added sugar or salt. responsible for the effect seen. "Heart disease warning: Lack of Heart Matters back in 2008. a magazine – it’s a membership The study was led by researchers from Victoria Taylor, our Senior Dietitian, said: exercise is worse risk for over-30s Rachel Jelbert is a similar age service where members can help Harvard School of Public Health, and “High-fibre foods are a key part of a healthy women than smoking or obesity" to me and after I read the story each other by sharing stories. Log was funded by the US National Institutes balanced diet and this study suggests they Sedentary lifestyles pose a greater heart I contacted Heart Matters and on to community.bhf.org.uk to surgery. The pain is in the heart May/June issue of Heart Matters. of Health. Researchers analysed data may have a particular benefit for heart disease risk to women over 30 than smoking, join the discussion. and is only slightly different I found some in Argos for from more than 4,000 Americans who attack survivors. obesity or high blood pressure, new health Share your story to CHD angina and hard to £12.99, which included three participated in two large studies of “We can’t say for sure what caused the data from Australia has shown. Microvascular angina differentiate without tests. It bands and a manual. I found health professionals. fibre benefit. But we do know that, on Sharing personal experiences I was very interested to see an all had a very bad effect on my this very handy and also used Each person was followed for an average average, we’re not getting enough fibre in The BHF says: We already know of your condition or article on Cardiac Syndrome X ability to exercise and only short the guide from Heart Matters. of nine years. They calculated dietary fibre our diets. Most people get around 14g a physical inactivity is a major risk factor treatment, or of how BHF – also called microvascular flat walks were possible. As I have heart failure, this is a intake before each person’s heart attack day – we should aim for at least 18g. for heart disease. This study showed that resources have helped you, angina – in the Sep/Oct 2013 But a tailored medication simple way to keep fit and not and looked at their survival rates. The “Fibre comes from a range of foods, it’s the biggest risk on a population level can be a big help to others. issue of Heart Matters. Although programme has transformed my overdo it. group that ate the most fibre had a 25 per including fruit and veg, beans and lentils (probably because it’s the most common If you’d like to share your the query was in relation to a capabilities and I am now much Once again, thanks. cent lower risk of dying compared with the and also from cereal products, which this risk factor across the population), which story with Heart Matters, possible connection with the fitter and slimmer, increasing my Derek McDonald, Norwich group that ate the least fibre. study found to be particularly beneficial. To isn’t the same as saying it’s the biggest email [email protected] menopause, this condition chances of a healthier future. One possible flaw in the study is that get more fibre, you can make simple swaps risk factor for you as an individual. or write to Sarah Brealey, can occur earlier and to men Jennifer Waller, London Deputy editor Sarah Brealey it was based on what people recorded such as trading white bread for wholemeal Smoking still carries the greatest risk Heart Matters, British Heart as well as women. It can also replies: To watch a video showing about their diet when they filled in or granary versions, white rice for brown to your heart. It’s important to remember Foundation, Greater London occur alongside coronary heart Resistance bands how to use resistance bands, visit that heart disease is also linked to other questionnaires twice a year, so it may not rice or pasta, and opting for higher fibre House, 180 Hampstead Road, disease (CHD)D. I was delighted to see the article bhf.org.uk/HMresistance. Or to factors, such as obesity, high blood have been completely accurate. Also, foods breakfast cereals like porridge or muesli London NW1 7AW. My diagnosis came as a follow 'Your flexible friend' about how order the May/June issue with the pressure and high cholesterol.

that are high in fibre often also contain without added salt or sugar.” Illustration: Carlo Giambarresi up to my quadruple bypass to use resistance bands in my article, call 0870 600 6566.

6 Heart Matters bhf.org.uk 7 SPOTLIGHT SPOTLIGHT

SPOTLIGHT ON… things we can learn from FOOD BANKS food banks 51 Reduce food waste Plan what you’re going Food banks are helping to feed in Bromley-by-Bow, London, serving UK. All the food is in date but might have to eat before you go affordable, healthy food in an area with labelling or packaging issues, which means shopping and keep those in need. Sarah Brealey looks high deprivation and poor health. it cannot be sold. Fareshare currently an eye on your fridge at how they’re encouraging healthy supports more than 1,000 charities, contents so you can eating and cutting waste, too Bringing about social change providing mainly fresh fruit, vegetables use up fresh produce Shirley, 62, who has used FoodCycle and meat. before it needs to be ood banks have rarely been out of the in Bristol, said: “It helps financially but thrown away. headlines in recent months. Although there’s also the social side. There are a lot Community cookery classes 2 Get your 5-a-day Frozen or tinned F the reasons for their growth are hotly of people who live on their own and it’s Having skills to buy and cook affordable fruit and veg can be cheaper than debated, the charities involved agree that nice to sit around a table and have a meal food is an important part of dealing with fresh – and count as your 5-a-day. there has been a surge in demand. together instead of staying in alone with a food poverty, and helps people to eat 3 Cook your own Home-made The Trussell Trust, the biggest provider TV dinner.” more healthily, too. food is usually cheaper and tastier of food banks in the UK, gave emergency Virginia, 87, who has used FoodCycle Since last year, Fareshare has been than convenience food, and you food parcels to 346,992 people in 2012–13 Cambridge, agrees: “Since my husband running pilot projects with some of the can control the amount of sugar, fat and 913,138 in 2013–14, more than Fareshare supports the died I don‘t like to cook just for myself, so organisations they work with, to give and salt that goes into it. Our recipes two-and-a-half times the number for the Central Street Cookery this is perfect and I am grateful.” charity workers the skills to enable them (inserted on page 26) are easy to previous year. School in London According to the charity, 67 per cent of to run cookery classes. It also supplies food follow or, if you really can’t cook, ask Bottom images: FoodCycle Adrian Curtis, Food Banks Network people say they eat more fruit and veg to community groups, such as the Central your local council if they know of any projects at the London cookery skills courses near you. Director at the Trussell Trust, said: “The School of Economics (left) after coming to a FoodCycle meal. Street Cookery School in London, pictured growth in the number of people being and Bromley-by-Bow (right) Steven Hawkes from FoodCycle said: “We left, which provides cookery classes for 4 Eat with others Loneliness is an referred to us has been phenomenal. try to go beyond the meal to bring about low-income families. “Our definition of issue for many of us, especially older “It is true that the number of food banks James Darling Photo: behavioural change and make people food poverty doesn’t just include not people. And it can sometimes be has increased, but the number of people think about healthy eating. being able to buy food,” Shakira Silvestri hard to feel motivated to cook just for has risen disproportionately, so clearly “For example, if they are serving spinach from Fareshare said. “It is also not having yourself. One way round this is to ask there are other issues.” as a side dish, then they might write on the skills to be able to prepare and cook friends over for a heart-healthy lunch “Some of that can be attributed to the board which vitamins and minerals healthy food.” (you could ask everyone to bring a changes in the welfare system. We have spinach contains.” Meanwhile, the Trussell Trust has run dish) or find out if there’s a lunch club also seen food prices, fuel bills and The charity Fareshare collects surplus two pilot projects teaching people to cook or day centre that would suit you. household bills continuing to rise. Rising food from restaurants and shops and meals on a tight budget and is hoping to 5 Make a difference Volunteering prices and stagnant or falling incomes redistributes it to charities around the roll out a wider programme next year. can be fun, sociable, give you skills have made a lot of families less financially for life and help build your local resilient, so when something goes wrong, Find out more community. Many food banks rely on like a boiler breaking down, it can cause volunteers, so get in touch with a local real problems.” Food bank availability varies across the We’ve got four new short films online, charity if you want to get involved. country. Ask your GP, social worker or in which real people take on different Balanced diet on a budget of meals, don’t contain any fresh food, so diet while cutting food waste and Citizens Advice Bureau, who may be able challenges of eating healthily on a Even if you’re short of cash, it’s still that they are easier to store until they are reducing social isolation at the same time. to refer you. budget. Watch them and be inspired at important to have a healthy and balanced needed, but do contain tinned vegetables They collect surplus food from retailers FoodCycle provides free hot vegetarian bhf.org.uk/budgetfood. diet, which can reduce your risk of coronary and tinned fruit. Tinned fruit and veg still and manufacturers. meals at 17 sites around England without Read our feature about cooking on a heart diseaseD, prevent you gaining weight count towards our 5-a-day, although it’s In the case of FoodCycle, this is mostly a referral – foodcycle.org.uk/locations. budget plus low-cost recipe ideas at and help control your cholesterol levels. best to pick ones that don’t contain added fruit and vegetables, which are turned Go online for 10 handy tips and hints bhf.org.uk/HMfoodforthought or call The Trussell Trust boxes are planned to sugar or salt. into healthy, free vegetarian meals served on reducing your food waste at 0870 600 6566 for a copy of our March/ make sure they are nutritionally balanced. FoodCycle and Fareshare are two in a social setting in 17 locations around bhf.org.uk/HMfoodwaste. April issue. The boxes, which provide three days’ worth charities working to provide a healthy the UK. There is also a community café

8 Heart Matters bhf.org.uk 9 MEDICAL MEDICAL If you have a heart health concern, the Heart Matters panel of experts is here to help

Doireann Maddock Is genetic testing needed? Dr Mike Knapton is a senior cardiac is the BHF Associate Q nurse with more than My daughter is now 18. Her father Medical Director D 10 years’ experience. died of hypertrophic cardiomyopathy (Prevention and She has worked in and I was told by the coroner that she Care). He oversees areas such as heart needs genetic testing, but when I asked the work the BHF and lung transplant our GP they said she would probably does to help people and cardiothoracic only get an echocardiogramD and an reduce their risk of surgery. ECGD. I’m very worried this isn’t enough heart disease. because her father had these tests in the past and they didn’t show a problem. How to measure your blood A Hypertrophic cardiomyopathy is an Is an angiogram necessary? pressure at home inherited heart condition and its inheritance Q I’m a 58-year-old man and I get a Q I’m a 60-year-old woman, and on pattern means there is a 50/50 chance of tight feeling in my jaw and chest when I my last two visits to my GP my blood inheriting it from a parent. The coroner is exercise. When I saw my GP they did an pressure readings were 160/90 and right as your daughter will require genetic ECG which was normal. They referred 170/85 which I was told is too high. testing to determine if she has the faulty me for a treadmill test which was also I have a family history of strokeD, so I’m gene that can cause the condition. Your normal, but my symptoms are still keen to take medication to lower my GP can refer her to a genetic counsellor there. My GP now wants me to have an blood pressure, but my GP said I need to who will explain the condition, and the angiogramD, but I don’t understand why I have it monitored over 24 hours before consequences of having or not having the need it if the other tests were OK. making a diagnosis. Is this correct? test, allowing your daughter to then make A The symptoms you describe are very A A diagnosis of high blood pressureD a decision, as she is 18. A blood test will typical of anginaD, which often feels like a is not usually made from just one or two be performed if your daughter agrees to heaviness or tightness in your chest (and isolated readings and immediate drug testing. The testing your GP mentioned is may spread to your arms, neck, jaw, back treatment is only considered for severe high known as screening which is to assess the or stomach as well). Angina is due to an blood pressure. Your GP was talking about condition of the heart at this time. Even if inadequate blood supply to your heart ambulatory blood pressure monitoring, the tests are OK, this does not establish if muscle, resulting in a cramp-like pain, changes seen on the ECG trace. In your case, which is when you are fitted with a blood doctor lends you a blood pressure machine she has inherited the faulty gene. much as you would experience if you despite the normal tests, your symptoms pressure cuff that is wrapped around your (similar to the one used in the GP surgery) Doing more I suggest having a chat with your GP were running and got a cramp in your leg are so typical of angina that your GP wants arm, and is connected to a small device and instructs you on how often you should physical again and our Genetics Information Service muscles. The commonest cause is coronary to directly look at the coronary arteries on a belt or strap worn on your body measure your blood pressure at home. (0300 456 8383) can forward details of the heart diseaseD, where the coronary arteries to confirm or rule out coronary artery for 24 hours. The monitor is set up to A diagnosis of high blood pressure will be activity and nearest centre for inherited heart conditions are narrowed by the build-up of fatty disease. This is important as the advice and automatically measure your blood pressure made if your average daytime ambulatory cutting down where your daughter can be referred for deposits. An angiogramD is a procedure to treatment will be very different depending at regular intervals throughout the day, so or home blood pressure is 135/85mmHg or counselling and testing. look directly at the coronary arteries to see if on the findings from angiography. that your average blood pressure can be above. If your blood pressure is found to be on salt is you have coronary artery disease. If you have CHD, treatment can be given calculated. While you are having this type high your doctor will decide if medication beneficial” Have a question for the team? I understand you are wondering why to manage the angina and, importantly, of monitoring you can carry on with all your is appropriate and will also tell you about you have been recommended to have an reduce your risk of having a heart attack Call the Heart Matters Helpline on usual activities apart from having a bath or lifestyle changes that can help. Doing more angiogram, given that the ECG and the later in life. 0300 330 3300 for more information. shower, or going swimming. physical activity and cutting down on salt is treadmill test were both normal. Both If the angiogram is normal it is likely you To submit a question, email us on Another option is home blood pressure beneficial and if you’re overweight, losing [email protected]. these tests can help in the diagnosis of do not have CHD and can be reassured your

ASK THE EXPERTS THE ASK monitoring, which is when your nurse or some weight can also help. coronary artery disease, as there are typical chances of having a heart attack are low.

MEDICAL NUTRITION ACTIVITY MEDICAL TERMS

MEDICAL The Spanish are nuts NUTRITION about nuts, which ACTIVITY Soff ritto – fi nely may have heart- MEDICAL DICTIONARY NEXT ISSUE chopped vegetables health benefi ts the heart and circulation – for example Has your doctor got the Acute coronary syndromes (ACS) A term – forms the basis of coronary heart disease (angina and heart many Italian dishes A used to describe a range of problems right bedside manner? We attack) and stroke. investigate the right approach. a ecting the heart, including unstable Coronary Artery Bypass Graft An operation to Plus: Focus on cardiomyopathy, angina and heart attack. ‘Syndrome’ means a treat coronary heart disease. The arteries and inspiring stories of set of symptoms that happen together, and Focus on... from your chest wall, or veins from your leg, fundraisers and their global ‘coronary’ means to do with the heart. Acute are used to bypass the blocked or narrowed adventures coronary syndrome is a medical emergency. coronary arteries. This helps to improve the “What we all have in Angina An uncomfortable feeling, tightness  ow of blood to your heart muscle. Kyle Garlett has or pain in your chest, which can also be felt Coronary heart disease When the walls of competed in the in your arms, neck, jaw, back or stomach. The the coronary arteries (the arteries that the artery walls. If the atheroma becomes Transplant Games symptoms are usually caused by coronary supply blood to the heart muscle) become unstable, a piece may break o and lead common is we cherish as well as two heart disease. The build-up of fatty deposits atrial fi brillation narrowed due to a gradual build-up of fatty to a blood clot forming. This can block a Ironman triathlons can narrow the arteries, restricting blood deposits called atheroma. This can lead to coronary artery, causing a heart attack and World  ow to the heart muscle. It is often brought angina. If a piece of atheroma breaks away of every day” on by physical activity, an emotional upset, irreversible damage to the heart muscle. A from the artery wall, it can cause a blood AF is an irregular and often fast heart rhythm. It is the most every second cold weather or after a meal. heart attack is a medical emergency and can clot to form, which could block the coronary Angiogram X-ray pictures that show whether lead to a cardiac arrest. common heart rhythm disturbance and affects around one artery and starve your heart of blood and Heart failure A condition where the Medical dictionary the arteries are narrowed and, if so, how oxygen. This is a heart attack. heart becomes less e cient at million people in the UK. Doireann Maddock explains narrowed they have become. A coronary This summer’s Transplant Games celebrate the gift of life. pumping blood around the body. FOOD angiogram examines the coronary arteries Diabetes A condition in which glucose See p22 High blood pressure (hypertension) time may pass in between episodes. Over time this Sarah Brealey meets three inspiring people who show how – the arteries that supply the heart muscle D (sugar) levels in the blood are too high. ike Butler, 67, a farmer from Evesham, As British cuisine becomes with blood. High blood pressure is when your blood often changes. We tend to categorise AF into three heart transplants transform – and save – lives There are two main types of diabetes: type pressure is consistently higher than the Worcestershire, had his rst warning increasingly global, can we Angioplasty A treatment to widen a categories, which also relate to the progression of the 1 where your body stops producing insulin recommended level. The higher pressure there might be a problem with his condition. In paroxysmal AF it resolves in less than Suzanne Swinson, 61, competed in Medical words, identified by a small narrowed artery. and type 2 where your body is unable to get the best of all worlds, asks undreds of transplant puts extra strain on your heart and blood heart when he was in his 30s. He was the Winter Transplant Games and says they A trial fi brillation (AF) A common seven days without any treatment; persistent AF is recipients will take part in this use the insulin that is produced e ectively, vessels, and over time can increase your risk scuba diving at night, 80ft under senior dietitian Victoria Taylor gave her something to aim for after her arrhythmia (abnormal heart page 18 when it lasts for longer than seven days (or less when page 26 page 42 summer’s Transplant Games, usually because excess fat in organs leads of having a heart attack or stroke. rhythm) in which the atria (the water. “It came on as a very rapid and transplant. “I was absolutely made up when to resistance to normal e ects of insulin. treated) and longstanding persistent AF is when it has things you n the UK, we’re lucky to have embraced From global to local proving that their life-saving See p18 upper two chambers of the heart) irregular heartbeat but I put it down to being nervous continued for more than a year.” I heard about the games,” she says. “I just Having diabetes increases your risk of Pacemaker A small device that is a broad diversity of cultural cuisine. surgery allows them to live life D beat in an irregular pattern. Fibrillation M Even within the UK, the way we eat saw it advertised by chance and it caught developing cardiovascular disease. from the diving,” he says. “It went away by itself and to the full. P implanted just under the skin on should know The ‘traditional’ British diet is a fusion varies. The Family Food 2012 survey means ‘quivering’ or ‘twitching’. People I put it out of my mind but a few weeks later it came Common causes of AF my imagination.” the chest and is connected to your heart of ingredients and tastes from around looks at food purchases across the The games, taking place from 7 to 10 with atrial  brillation have an irregular and Echocardiogram A test to examine back again. This time I was at home and it didn’t go The exact cause of AF is not fully understood, although The Japanese eat symbol , are explained in plain English by one or more wires. It monitors the the globe, thanks to a history of H about AF a variety of oily UK and identifi es some interesting August in Bolton, have been held since Celebrating the future sometimes fast pulse. E the structures within the heart, for away by itself. The next thing I knew I was in the age is a factor. It also a ects certain groups of people exploration, immigration and travel. electrical signals within your heart and can 51 AF is the most common heart Vegetarian dishes, fi sh, here salmon fi ndings. Although there is little 1978 and are open to anyone who has had All three feel that their heart transplant has example the heart valves, and to see how cardiac unit.” stimulate the heart to contract and produce more than others. Professor Kirchhof explains: “We Variety may well be the spice of life, but on a plate of sushi an organ or bone marrow transplant, or Bypass surgery See Coronary Artery Normally the heart’s natural pacemaker sends rhythm disturbance in the UK, such as this chickpea diff erence in the energy and given them a second chance in life. well the heart is pumping. know that people with cardiovascular problemsD such I B Bypass Graft. a heartbeat. , heart as we incorporate other nations’ cuisine is a living donor. The rst year there were out regular electrical impulses. Atrial brillation (AF) D, coronary heart disease a ecting around one million people, stew, are found in nutrient intakes between the four Wendy was seriously ill for nearly Wendy Lingham took Electrocardiogram (ECG) An ECG is a simple One million people in the as high blood pressure British cuisine is into our own, it’s important to choose Three inspiring 99 competitors on one day; there are now South Asian cuisine D but many more are undiagnosed and nations, there are diff erences in nine years after being diagnosed with part in a volleyball and painless test to record the electrical Sinus rhythm The normal electrical happens when impulses also re o from di erent failure and heart valve disease are more likely to D The ultimate medical don’t know they have it. healthier elements where we can. We know Because the vegetables are chopped so more than 600 across four days, competing shortly after giving birth tournament organised Cardiac arrest activity of the heart. Small sticky patches places in the atria (the top chambers of the heart) in a cholesterol levels. Substituting ghee with our food choices. cardiomyopathy C S pattern of your heart. develop AF, but we don’t really know the exact causes from research that the Mediterranean diet fi nely, soff ritto blends into the dish and in a wide range of sports. by Transplant Games emergency. This is when a person’s 2 It can occur at any age, but When it comes to food at home, to her son, Joshua. She came so close to called electrodes are put onto your arms, Stent A short tube of expandable disorganised way. These impulses override the heart’s of it in di erent patients.” is healthy, but what can we learn from unsaturated oils works just as well and One of them is heart transplant recipient in our dictionary on page 49 heart stops pumping blood round their the risk of having AF increases intake of fruit and vegetables and cut may even go undetected by reluctant households in England buy the death that she made plans for her own legs and chest. These are connected to natural pacemaker, which can no longer control the Genetics may also play a part, especially if you makes recipes more heart healthy. body and they stop breathing stainless-steel mesh, which is inserted substantially as you get older, with diets across the globe? Managing vegetable eaters. Wendy Lingham, 35, from York. “What we a machine that picks up and records the heart rhythm, causing your pulse to be irregular. back on saturated fat. most fruit, while the Welsh buy the funeral and how her son would be looked “I thought, ‘Somebody has made a mistake.’” normally. Many cardiac arrests into an artery to hold it open after an develop AF before the age of 60–65. This is an area that all have in common is that we cherish every electrical signals that make your heart beat. it a ecting about seven in every 100 The South Asian diet makes good use risk factors most vegetables. Looking at meals after without her. “It was hard on Joshua,” Two years passed before she was Exercising after a heart transplant or surgery angioplasty. This improves the  ow of blood A rapid and irregular heartbeat like Mike Professor Kirchhof is currently researching with the South Asia Italy Japan second of every day,” she says. in adults happen because the people over the age of 65. of lentils and other pulses as a source of Improving our diet is only out, households in Northern Ireland she says. “He’d always known me being ill. healed, which will take three See p16 person is having a heart attack. through the artery. experienced is one of the more obvious indicators help of a £1,210,736 grant from the BHF (see box on The dishes we enjoy in the UK, such as The Mediterranean diet is rich in fruit Wendy decided to take part in the admitted to hospital with such a weak Increase your level of activity Heart attack The medical term for a 3 There is currently no cure for AF protein. These have the added benefi t When last surveyed, Japan had one of the eat the most Indian, Chinese and I couldn’t take him out like other mums.” to four months. Stroke An interruption of blood  ow to part of AF and it often prompts people to seek medical page 21). chicken tikka masala, onion bhajis and one way to protect our and vegetables and the people living Transplant Games last year and again this heart that a machine had to take over the gradually, starting with Cardiomyopathy A disease of the heart H heart attack is a ‘myocardial infarction’, UK are affected by AF but treatments are available. These becoming more global of containing soluble fi bre (also found in lowest rates of cardiovascular disease in Thai meals. transplant recipients Wendy treasures the fact that now she You should be invited to of the brain, that causes brain cells to die attention. Other symptoms can include breathlessness, The impact of AF can be far-reaching. “It becomes hearts. Remember to look at in this region eat more fruit and veg year to highlight the importance of organ heart’s pumping function. walking around your house, muscle in which the heart muscle becomes are tailored to the individual. naan bread, are rooted in India, Pakistan wholegrain foods such as oats) that can the world and this may be partly down Those living in Scotland, however, can be active with Joshua, 11, thanks to cardiac rehabilitation, which or ‘MI’ for short. This is when there is a or become damaged. This happens if an tiredness, dizziness and feeling faint. Some people more common with age, and with our ageing and Bangladesh and regularly top the other factors, such as not than elsewhere in Europe. Italy is a great donation. “It is about raising awareness and Five weeks later, she was given a new then short walks outside. Try weakened. The heart muscle may become 4 It’s a leading cause of stroke and help to lower cholesterol levels. to the Japanese diet. Traditionally, this are more likely to go for a sandwich; her transplant three years ago. “I can run teaches you how to exercise sudden loss of blood  ow to a part of the artery carrying blood to your brain becomes experience mild symptoms, and others may be population the number of people with AF in the UK charts of the nation’s favourite foods. smoking, being physically example where, along with the usual showing how lives can be saved through heart. “Suddenly you have a future again; to do some activity each day. thickened, enlarged and/or sti , depending heart muscle. Most heart attacks are caused increases the risk of having one by Traditional South Asian foods can be is low in saturated fat and includes a average consumption is one and around, go swimming with him, ride a bike, won safely. Regular physical activity blocked, or if an artery bleeds into your unaware of any. could double or triple in the next 20–30 years,” says active and sticking to ways fruits and vegetables are eaten, it’s the most amazing thing,” she says. Suzanne Swinson Remember to cool down at on the type of cardiomyopathy. It a ects about ve times. While these aren’t the most authentic or high in salt, which can contribute to range of foods that are linked to heart donating a loved one’s organs, and to or kick a football,” she says. “There are so can help with your recovery, by atherosclerosis, which is the gradual brain. A stroke is a medical emergency. Initially Mike’s AF came and went. “At rst it would recommended alcohol limits soff ritto – fi nely chopped onion, garlic, a half times higher than in Wales. After the transplant three years ago, three medals for skiing the end of your session. people of all ages and is usually inherited. Professor Kirchhof. “This is a real concern becauseD AF the healthiest choices, there are other health, including oily fi sh and soya found show honour and respect to our donors – build-up of atheroma (fatty material) within and 5 An irregular pulse is a possible high blood pressure, so focus instead on to reduce your risk of Watch out for the soft drinks that many things I can do now – it’s amazing.” Suzanne’s health gradually improved. and her team got gold help protect your heart and Cardiovascular disease (CVD) All disease of just happen now and again and wasn’t too much is the strongest individual risk factor for stroke traditional elements of the South Asian celery, carrot, rosemary and bay leaf in beans or tofu. Meals are an important without them, we wouldn’t still be here.” Avoid heavy lifting, sign of AF. If your pulse doesn’t follow using herbs and spices and other typical coronary heart disease. many wash their food down with – Suzanne, a civil servant and avid skier On the anniversary of her transplant, she for curling at the winter reduce your risk of having of a problem, but over the years it got worse until around every fourth stroke that happens is due to it.” diet we can learn from. cooked in olive oil – is used as a base of part of the day and culture in Japan. For Kyle Garlett, the games are “a great twisting, pushing or pulling if you want to know more a steady pattern, tell your GP. fl avours such as chilli, garlic and ginger, the Scots buy the most in the UK. from Glasgow, couldn’t ski for ve years decided to nd out if she could ski again. games in January further heart problems. eventually I was in AF all of the time,” he says. AF increases the risk of stroke because the irregular Having overcome AF, Vegetarianism is a way of life for many many traditional dishes. The traditional Japanese diet Photography Schneider Stockfood/Doug Zouev, Stockfood/Tanya Photography: way to celebrate donors, to meet other until your breastbone is Call the Heart Matters Helpline on 0300 330 3300 which liven up dishes in a healthy way. ≠ Go online to see a list of because she had advanced heart failure. She took a few wobbly turns at an indoor 49 This is not unusual, as Consultant Cardiologist activity in the atria allows blood to pool in the Mike Butler leads an in this region and, while a complete ban It adds an authentic fl avour and boosts balances taste, texture, colour and recipients and to be physically active in Watch out for ghee, too, as this seven world foods to avoid Her diagnosis came after she went to see ski centre and never looked back. At the

Professor Paulus Kirchhof from the University of the vegetable content of our meals. Hart Alice Laura Photography: heart. When blood pools, it tends to form clots which Funnell Greg Photography: active life as a farmer 19 on meat isn’t essential for heart health, is clarifi ed butter and adds a lot of 27 a way you wouldn’t have been able to her doctor with a cough. As a t and 43 Birmingham explains. “Initially, AF often comes bhf.org.uk/HMworldfood. winter games, held in the French Alps in bhf.org.uk can then be carried to the brain, causing a stroke. including some meat-free meals in our saturated fat to dishes, which can raise before”. Like Wendy, Kyle is taking part in active woman, she was deeply shocked. and goes without warning and long periods of Heart Matters diet can be a simple way to boost our bhf.org.uk the games for the second time this year. Heart Matters bhf.org.uk 18 26 42 10 Heart Matters bhf.org.uk 11 THE BIG INTERVIEW THE BIG INTERVIEW CARING TOGETHER Achieving care that is joined up and centred on Chris Ham: “It’s Integrated care model a marathon, the individual is one of the biggest challenges for not a sprint” healthcare services. Sarah Kidner speaks to Budgets Healthcare professionals Healthcare and social GPs, practice nurses and The King’s Fund Chief Executive, Chris Ham care pool resources specialists communicate to create a joined-up regularly about patients’ needs SK: How far away is an integrated care model? stablished 120 years ago, The King’s Fund is an care plan CH: There is a big divide between free healthcare and independent charitable foundation. The fund means-tested social care. We are really in the foothills Ecarries out research that helps to shape health at best. It is going to be a long journey to get from the policy and NHS services in the UK. We talk to the man fragmented to the much more joined-up integrated at its helm, Chief Executive Chris Ham. Community nurses system. It’s not easy to do, especially when money is tight. Perhaps the financial pressures will galvanise Manage the needs SK: What is integrated care? both politicians and leaders at a local level to move of patients and their CH: It means caring for the person, rather than just carers, using a care much more rapidly in the direction of integrated care, treating the condition. It’s the opposite of fragmented plan centred on the but we need to be realistic; it’s a marathon, not a sprint. care, which happens when people find themselves individual SK: What are the biggest challenges ahead? in contact with, for example, their GP, community CH: Moving beyond the historical division between nurse, specialist, and social care worker; each contact healthcare and social care, between GPs and hospital might be good, but it’s not joined up. Care can suffer doctors, getting them to collaborate. when different health and care professionals aren’t SK: How are we going to join up the services? communicating about the patient. Leaders CH: The big question is: “Is now the time to bring health SK: What would integrated care look like for patients? Align at national, and social care together, to have a single service and a CH: Whenever a person comes into contact with organisational and single budget?” We’ve set up the Barker Commission to a different doctor, nurse or a social worker, those team level look at this and it will give its full report in September professionals will have communicated with each other. 2014 (tinyurl.com/oede4f8). They will have shared information, they will all be SK: Is there an argument for integrated leadership? aware of the treatment being given and they will all CH: The NHS spends £110bn a year and employs play their part as members of a team. Volunteers Systems 1.4 million people, so it’s not easy to align everybody Carers, Would allow health around a few objectives. We need to hear people befrienders and social care saying: “These are the things that really matter: and hospital professionals to patient-centred care and high-quality outcomes.” Leading by example volunteers share and manage Organisations with engaged staff have lower We have developed an award work with the existing team to support patients the care plan mortality rates, better patient experience, reduced

programme to fund UK projects provide more integrated care for Fund King’s The by a diagram by inspired Illustration: Alberto Antoniazzi/Synergy, sickness absence and turnover, and better financial that focus on integrated care in people with heart conditions. performance. We also need good leadership at NHS the community for the long-term The nurses will work closely with board level, supported by ministers at a national level. treatment of patients with heart heart specialist doctors to identify increased understanding of why integrated care SK: Is there a leadership role for patients? and cardiovascular disease. patients earlier and ensure better Bringing people together matters, how it applies to cardiovascular services CH: Every patient is an expert in their own condition. More than £1m was awarded as care in hospitals. They also work A successful integrated care strategy depends on and how to make it a reality. We shared models of With that in mind, we have been talking a lot about part of the 2012 BHF Integrated with GPs to help prevent hospital people working together. In May 2014, the BHF integrated care and best practice from across the patients having the confidence and skills to manage Care Programme. This will help stays and support patients at and The King’s Fund jointly hosted a conference UK and invited patients to take part. their health and wellbeing. Part of that is around improve UK heart health services. home. The service will benefit more that brought together colleagues from a broad Speakers included King’s Fund Chief Executive collaborative care planning between patients and East Cheshire NHS Trust was than 2,000 patients and improve range of disciplines to debate integrated care. The Chris Ham, British Heart Foundation Chief healthcare professionals. awarded £154,847. This will provide care provided by around 200 conference had a specific focus on cardiovascular Executive Simon Gillespie and National Director for two new cardiology nurses to healthcare professionals. disease. Those who attended the day gained an Cardiac Care, NHS England Professor Huon Gray. ≠ To raise a concern or to find out about the quality of care in hospitals near you, visit cqc.org.uk/public.

12 Heart Matters bhf.org.uk 13 MY STORY MY STORY Cover story Knockout

Being active into your 90s isn’t 90sso unusual any more. Sarah Brealey talks to three people who are living proof of that

“I would recommend tai chi to anyone” Gladys Grimstead, 96, hero Gladys is the oldest in her tai chi class – in Tai chi can improve flexibility, balance, Friday, Gladys bakes cakes and gives them fact, some people in the class are younger strength and co-ordination. Older adults to friends and neighbours (she doesn’t eat than her grandchildren. at risk of falls are particularly encouraged any herself). “She has so many friends and Most people find it hard to believe that to do exercises to improve strength and is making more all the time,” says Gill. she’s 96. She has been doing tai chi for five balance (such as tai chi, yoga or dancing) Gladys lives alone and enjoys being years, but has been active all her life. at least two days a week. independent; she does her own cooking, “I don’t feel any older than I did when I was Three years ago, Gladys blacked out cleaning and shopping and walks as much 50,” Gladys, from Portsmouth, says. “The and had another fall, and went on to have as she can. Support from the BHF tai chi is lovely. I would recommend it to a pacemakerD fitted. She hasn’t had any A few months ago, she had a new We’ve got lots of free resources anyone, and afterwards you feel a lot better problems since then. “When it was first bathroom fitted and the workmen asked that can help you follow a healthy than you did when you started.” fitted it felt quite uncomfortable, and I felt her if she wanted a stair lift put in. Gladys lifestyle and support you with a Gladys took up tai chi after an like it stuck out of my chest, but it is fine was horrified and responded: “Over my heart condition, for example our unexplained fall led to her being referred now,” she says, and adds: “I am pleased to dead body!” free booklets Angina, Pacemakers, to a falls prevention course and, later, a have it. I think it is amazing what medical Gladys puts her long life and fitness Having heart surgery, Living with council-run exercise class which covered science can do these days.” down to the fact that she has never drunk Fighting fit: heart failure or Get active, stay strength and balance exercises. When it Gladys’s daughter, Gill, 71, who also or smoked. Her daughter agrees. “She is a Gladys Grimstead, active. There’s also our DVD, The finished, the instructor, Debbie Pentland, attends the tai chi class, says the pacemaker hero, so full of life,” Gill says with a smile. 96, doesn’t feel road ahead – your guide to heart asked Gladys if she would like to take her has given her mum “a new lease of life”. “She never does anything by halves and any older than tests and treatments. See page 50

tai chi class at a local community centre. She certainly has a lot of energy. Every never gives up. She is just a one-off.” Photography: Charlie Clift when she was 50 for details on how to order.

14 Heart Matters bhf.org.uk 15 MY STORY MY STORY

“What will be will be. I don’t worry Research into older adults Professor Peter “The UK population is of 150 minutes of weekly about anything” Whincup leads ageing and the burden of physical activity, but when you Russel Weller, 91, survivor the British cardiovascular disease is much monitor their activity closely, Regional Heart greater in older age, partly only a small proportion do. Russel, from Chelmsford, Essex, has heart Study, an because key risk factors – We are trying to highlight ways failureD, kidney failure and diabetesD. investigation obesity, diabetes and low rates in which older people can He’s had two heart attacksD, a strokeD of the of physical activity – are much build up and maintain levels and a cardiac arrestD. But he’s kept going causes and prevention of greater in older age groups,” of physical activity which will and stayed positive despite his health cardiovascular diseaseD in says Professor Whincup. improve their heart health.” problems, and is a role model for his three older British men, based at “Yet, so far, most of the big children and four grandchildren. University College London. population studies looking Russel stays active by gardening and also He also works closely with at cardiovascular disease risk follows a healthy diet. “I just take things as Dr Juan-Pablo Casas, the have particularly looked at There are more than they come,” he says. “What will be will be. director of the British Women’s middle age. I don’t worry about anything. Heart and Health Study, “We are looking for simple “I can’t walk very far, but otherwise I feel looking at the causes of ways in which people can alter really well. I find it difficult to believe I am cardiovascular disease risk their habits to reduce their risk as old as I am.” in older British women. Both of heart disease, and we are 500,000 He’s also a living example of how studies are funded by the BHF focusing on physical activity. people aged 90 and healthcare has developed over the and most of the participants “Most people think they get decades. He still has scars all the way are aged between 70 and 95. their recommended minimum over living in the UK down both legs from his heart surgery in 1987. Nowadays, veins can usually be taken in a way that leaves less scarring. housework, washing, cooking and shopping. The Since then, he’s had two angioplastyD and only allowance she has made for her advancing stentD procedures to unblock his narrowed years is that her garden – which used to be her arteries – procedures that were not widely pride and joy – has been adapted so it is easier available in the 1980s. to maintain, and her son looks after it for her. “I Russel, who has been married to Mary for am quite well,” says Ada. “I have a bit of a problem 64 years, has been a keen musician all his with an irregular heartbeat and my breathing, so life and played the cornet and flugelhorn in I have to take it a bit slowly. But I just sit down for a Salvation Army band until he was nearly a minute if I need to. 90. “That was a big help to me,” he says. “I “I’ve always been an independent person. think it strengthened my lungs and I had I have no intention of stopping volunteering,

support from people there when I was ill.” AdvertiserPhotography: Swindon and I would recommend it to anyone.” Russel says he’s also had a lot of support from the BHF. “I read Heart Matters and “I have no intention ≠ Go online to learn more about our knockout have had several of the booklets, too. They of stopping volunteering” 90-somethings – listen to Ada talking about are very useful.” Ada Vincent, 91, volunteer her role in the Dutch resistance and read about To granddaughter Victoria Cornwell, 37, Gladys’s adventures by motorbike. Russel is a very special person. “He is such a Ada is a shining example of how helping others Visit bhf.org.uk/HM90. positive influence and he has taught me so can also be a good way of helping yourself. much about life and family values,” she says. She started volunteering in the BHF shop in Victoria and her granddad share a Swindon after her husband, Jim, died 11 years Want to become a volunteer? special bond, as around the same time that ago. “I felt a bit lost, and volunteering was an Call into your local BHF shop or Furniture & Electrical store and ask Russel had his heart bypass, Victoria had a escape, a way to meet people. You feel like you about volunteering opportunities or visit bhf.org.uk/volunteer. To narrowed heart valve corrected, aged 11. Victoria Cornwell feels are still somebody in the community,” she says. find your nearest shop, call 0800 915 3000. “It helped me not to be frightened, blessed to have had her “I enjoy it immensely.” Our shops always need volunteers, especially in September when because granddad had been through so grandfather, Russel, in Ada, who has one son and two adult we have our biggest stock campaign. We also need you to donate much more,” she says. “I feel blessed to have her life for so long grandsons, was married to Jim for nearly 45 your unwanted items to help raise money for our life-saving research.

Photography: Johanna Ward had my granddad in my life for so long.” years. She lives on her own and does all her own

16 Heart Matters bhf.org.uk 17 MEDICAL MEDICAL Focus on... atrial fibrillation

AF is an irregular and often fast heart rhythm. It is the most common heart rhythm disturbance and affects around one million people in the UK. Doireann Maddock explains

ike Butler, 67, a farmer from Evesham, time may pass in between episodes. Over time this Worcestershire, had his first warning often changes. We tend to categorise AF into three there might be a problem with his categories, which also relate to the progression of the heart when he was in his 30s. He was condition. In paroxysmal AF it resolves in less than scuba diving at night, 80ft under seven days without any treatment; persistent AF is water. “It came on as a very rapid and when it lasts for longer than seven days (or less when irregularM heartbeat but I put it down to being nervous treated) and longstanding persistent AF is when it has from the diving,” he says. “It went away by itself and continued for more than a year.” I put it out of my mind but a few weeks later it came back again. This time I was at home and it didn’t go Common causes of AF things you away by itself. The next thing I knew I was in the The exact cause of AF is not fully understood, although cardiac unit.” age is a factor. It also affects certain groups of people should know Normally the heart’s natural pacemaker sends more than others. Professor Kirchhof explains: “We out regular electrical impulses. Atrial fibrillation (AF) know that people with cardiovascular problems such about AF happens when impulses also fire off from different as high blood pressureD, coronary heart diseaseD, heart 51 AF is the most common heart places in the atria (the top chambers of the heart) in a failureD and heart valve disease are more likely to rhythm disturbance in the UK, disorganised way. These impulses override the heart’s develop AF, but we don’t really know the exact causes affecting around one million people, natural pacemaker, which can no longer control the of it in different patients.” but many more are undiagnosed and heart rhythm, causing your pulse to be irregular. Genetics may also play a part, especially if you don’t know they have it. A rapid and irregular heartbeat like Mike develop AF before the age of 60–65. This is an area that 2 It can occur at any age, but experienced is one of the more obvious indicators Professor Kirchhof is currently researching with the the risk of having AF increases of AF and it often prompts people to seek medical help of a £1,210,736 grant from the BHF (see box on substantially as you get older, with attention. Other symptoms can include breathlessness, page 21). it affecting about seven in every 100 tiredness, dizziness and feeling faint. Some people The impact of AF can be far-reaching. “It becomes people over the age of 65. experience mild symptoms, and others may be more common with age, and with our ageing 3 There is currently no cure for AF unaware of any. population the number of people with AF in the UK but treatments are available. These Initially Mike’s AF came and went. “At first it would could double or triple in the next 20–30 years,” says are tailored to the individual. just happen now and again and wasn’t too much Professor Kirchhof. “This is a real concern because AF 4 It’s a leading cause of stroke and of a problem, but over the years it got worse until is the strongest individual risk factor for strokeD and increases the risk of having one by eventually I was in AF all of the time,” he says. around every fourth stroke that happens is due to it.” about five times. This is not unusual, as Consultant Cardiologist AF increases the risk of stroke because the irregular 5 An irregular pulse is a possible Professor Paulus Kirchhof from the University of activity in the atria allows blood to pool in the Having overcome AF, sign of AF. If your pulse doesn’t follow Birmingham explains. “Initially, AF often comes heart. When blood pools, it tends to form clots which Mike Butler leads an a steady pattern, tell your GP.

and goes without warning and long periods of can then be carried to the brain, causing a stroke. Funnell Photography: Greg active life as a farmer 18 Heart Matters 19 MEDICAL MEDICAL

How to check your pulse Professor Paulus You can check to see if you might have AF by feeling Kirchhof, Consultant your pulse at your wrist. A normal pulse should follow a steady beat. If you have AF, your pulse Cardiologist, will feel irregular, erratic and possibly fast, and the University of strength will vary. If your pulse feels like this, or if Birmingham, on you’re concerned, see your GP. his BHF-funded research

The BHF has recently awarded Professor Kirchhof a Senior Clinical Research Fellowship worth £1,210,736 to bring his AF research and clinical work together and establish a world-leading research programme in Birmingham. The research is focused on unravelling how a faulty gene may lead to AF. “We know that 1 Put one of your 2 Use the index finger 3 Press lightly and feel 4 Once you’ve found alterations to DNA near a gene called PITX2, hands out so you’re and middle finger of your the pulse. If you can’t feel your pulse, continue which is required for development of many looking at your palm. other hand and place the anything, press slightly to feel it for about structures in the embryo, are linked with early pads of these fingers on harder or move your 20–30 seconds. Note development of AF and we’ve found that usually the inside of your wrist. fingers around until you the rhythm of the the left atrium has high levels of PITX2,” says You should place them at find your pulse. pulse and whether it is Professor Kirchhof, who will now study why this the base of your thumb regular or irregular. is important, and whether alterations in the near where the strap of a PITX2 gene can lead to AF. watch would sit. Professor Kirchhof hopes that when we learn more about the different causes of AF, we may discover alternative treatments. “We have Mike still enjoys learned a lot in the last 20 years and we have snorkelling and the the heart is given a controlled electric shock with I had my second ablation almost a year later and I’ve occasional scuba dive the aim of restoring a normal rhythm) and catheter remained in sinus rhythm ever since,” he says. ablation (this works by scarring or destroying tissue Requiring more than one ablation in order to achieve in the heart that triggers the AF). Having a pacemaker sinus rhythm is common, Professor Kirchhof says. “In £1,210,736 Since the second ablation I feel great; fitted to help the heart beat regularly may also be an people without other structural disease of the heart option for some people. who may not have had AF for a long time the success to explore possible genetic the lethargic feeling is completely gone” Mike has experienced a wide range of treatments rate after catheter ablation at one year is about causes of AF over the years. He received cardioversion on five 80 per cent, with patients having up to three ablations. separate occasions, has taken different combinations If you look at those patients five or six years later the tools in hand such as medication and catheter “Clots that form in the left atrium can potentially of medication and most recently had two catheter recurrence rate is about 50 per cent. So, although ablation to treat these electrical changes, be quite big and if pumped out can lodge in a large ablations. “In the early days I tried several different we have to accept that at some point many patients but we need to go one step beforehand to vessel in the brain causing significant and permanent types of medication to help my heart rhythm will have a recurrence of their AF, the period of time understand why someone with a certain genetic damage,” says Professor Kirchhof. and eventually we settled on the combination of without it can be very valuable, especially if there were predisposition develops AF. So we still have a lot It’s also a concern that, over time, persistent AF can amiodarone and sotalol. I also took warfarin to help bad symptoms because of the AF.” of missing links and this is where research like lead to a weakening of the heart muscle, causing it to protect me from having a stroke,” he says. Although Mike often felt tired during the years he this comes in.” pump less effectively. With the right treatment, these The amiodarone and sotalol worked well for Mike had AF, as a keen cyclist he tried to keep as active as The impact of the research could be far risks can be significantly reduced. until about four years ago, when the AF became possible. It wasn’t always easy. “I often felt very drained, reaching. “I’m very grateful to anyone who has longstanding and persistent. At this point his just really lethargic, and cycling was an effort,” he says. donated to the BHF for their support in this Common treatments for AF cardiologist suggested an ablation. “But since the second ablation I feel great; the lethargic important piece of research. I think and hope There is currently no cure for AF and the way it is Catheter ablation is often used when medication has feeling is completely gone and I get out on my bike as that we may be able to develop completely treated is individualised to the patient’s needs. It may not been effective. Mike needed two ablations about much as possible.” new ways to treat patients with this genetic involve medication (both to prevent a stroke and to 12 months apart. “After the first one, I spent around six Mike’s love of cycling has also led him to support the predisposition once we have our insights.” D control the heart rate or rhythm), cardioversion (when months in sinus rhythm but then went back into AF. of Alan Woodgate/Son illustration: Lee Funnell; Photography: Greg BHF in the London to Brighton bike ride five times.

20 Heart Matters bhf.org.uk 21 MEDICAL MEDICAL

MEDICAL DICTIONARY MEDICAL TERMS Acute coronary syndromes (ACS) A term A used to describe a range of problems the heart and circulation – for example a ecting the heart, including unstable coronary heart disease (angina and heart NEXT ISSUE angina and heart attack. ‘Syndrome’ means a attack) and stroke. Has your doctor got the set of symptoms that happen together, and Coronary Artery Bypass Graft An operation to ‘coronary’ means to do with the heart. Acute right bedside manner? We treat coronary heart disease. The arteries investigate the right approach. coronary syndrome is a medical emergency. from your chest wall, or veins from your leg, Plus: Focus on cardiomyopathy, Angina An uncomfortable feeling, tightness are used to bypass the blocked or narrowed and inspiring stories of or pain in your chest, which can also be felt coronary arteries. This helps to improve the fundraisers and their global in your arms, neck, jaw, back or stomach. The  ow of blood to your heart muscle. symptoms are usually caused by coronary Coronary heart disease When the walls of adventures heart disease. The build-up of fatty deposits the coronary arteries (the arteries that can narrow the arteries, restricting blood supply blood to the heart muscle) become  ow to the heart muscle. It is often brought narrowed due to a gradual build-up of fatty the artery walls. If the atheroma becomes on by physical activity, an emotional upset, Medical dictionary deposits called atheroma. This can lead to unstable, a piece may break o and lead cold weather or after a meal. angina. If a piece of atheroma breaks away to a blood clot forming. This can block a X-ray pictures that show whether Angiogram from the artery wall, it can cause a blood coronary artery, causing a heart attack and the arteries are narrowed and, if so, how clot to form, which could block the coronary irreversible damage to the heart muscle. A narrowed they have become. A coronary artery and starve your heart of blood and heart attack is a medical emergency and can angiogram examines the coronary arteries oxygen. This is a heart attack. lead to a cardiac arrest. – the arteries that supply the heart muscle Medical words, identified by a small with blood. Heart failure A condition where the Diabetes A condition in which glucose Angioplasty A treatment to widen a D heart becomes less e cient at (sugar) levels in the blood are too high. pumping blood around the body. narrowed artery. There are two main types of diabetes: type See p22 High blood pressure (hypertension) A trial fi brillation (AF) A common 1 where your body stops producing insulin High blood pressure is when your blood Drug cabinet: arrhythmia (abnormal heart and type 2 where your body is unable to D pressure is consistently higher than the See p18 rhythm) in which the atria (the use the insulin that is produced e ectively, recommended level. The higher pressure upper two chambers of the heart) usually because excess fat in organs leads puts extra strain on your heart and blood symbol , are explained in plain beat in an irregular pattern. Fibrillation to resistance to normal e ects of insulin. vessels, and over time can increase your risk means ‘quivering’ or ‘twitching’. People Having diabetes increases your risk of of having a heart attack or stroke. with atrial  brillation have an irregular and developing cardiovascular disease. sometimes fast pulse. P Pacemaker A small device that is E Echocardiogram A test to examine implanted just under the skin on B Bypass surgery See Coronary Artery the structures within the heart, for the chest and is connected to your heart Bypass Graft. example the heart valves, and to see how by one or more wires. It monitors the English in our dictionary on page 49 well the heart is pumping. electrical signals within your heart and can C Cardiac arrest The ultimate medical Electrocardiogram (ECG) An ECG is a simple stimulate the heart to contract and produce emergency. This is when a person’s and painless test to record the electrical a heartbeat. heart stops pumping blood round their activity of the heart. Small sticky patches body and they stop breathing called electrodes are put onto your arms, Sinus rhythm The normal electrical normally. Many cardiac arrests legs and chest. These are connected to S pattern of your heart. in adults happen because the a machine that picks up and records the See p16 Stent A short tube of expandable person is having a heart attack. electrical signals that make your heart beat. stainless-steel mesh, which is inserted Cardiomyopathy A disease of the heart into an artery to hold it open after an muscle in which the heart muscle becomes Heart attack The medical term for a angioplasty. This improves the  ow of blood weakened. The heart muscle may become H heart attack is a ‘myocardial infarction’, through the artery. thickened, enlarged and/or sti , depending or ‘MI’ for short. This is when there is a Stroke An interruption of blood  ow to part on the type of cardiomyopathy. It a ects sudden loss of blood  ow to a part of the of the brain, that causes brain cells to die people of all ages and is usually inherited. heart muscle. Most heart attacks are caused or become damaged. This happens if an Cardiovascular disease (CVD) All disease of by atherosclerosis, which is the gradual artery carrying blood to your brain becomes build-up of atheroma (fatty material) within blocked, or if an artery bleeds into your Call the Heart Matters Helpline on 0300 330 3300 brain. A stroke is a medical emergency. BETA bhf.org.uk if you want to know more 49

BLOCKERS that may include an ACE inhibitor (for example, cause cold hands and feet, particularly in ramipril) and/or a calcium channel blocker (for older people, and may also be associated Doireann Maddock example, amlodipine). with unusually vivid dreams. Some patients Q is a senior cardiac nurse with more experience fatigue, perhaps related to than 10 years’ experience. She has Q How do they work? excessive slowing of the heart rate. Erectile worked internationally in areas such A Beta blockers, also called beta adrenergic dysfunction is occasionally a problem for some as heart and lung transplant and blocking agents, block the release of the stress men who take beta blockers. cardiothoracic surgery. hormones adrenaline and noradrenaline in If you think you are experiencing side certain parts of the body. This results in a effects, speak to your GP as soon as possible. slowing of the heart rate and reduces the force Do not stop taking a beta blocker suddenly at which blood is pumped around your body. without consulting your doctor. This is Adam Timmis Beta blockers can also block your kidneys important because when you take a beta A is Professor of Clinical Cardiology from producing a hormone called angiotensin blocker regularly, your body becomes used to in the National Institute for Health II. This results in lowering your blood pressure. it. Stopping it suddenly could cause problems Research Biomedical Research such as palpitations, a recurrence of angina Beta blockers save Unit and the Farr Institute at Barts Q Are there different types? pain or a rise in blood pressure. lives by lowering blood Health, Queen Mary, University A Beta blockers are classified as being D pressure, protecting London. His interests are angina non-selective and selective. Non-selective Q If I experience severe side effects, and acute coronary syndromesD. against heart attacks and treating heart failure beta blockers, such as propranolol, are active is there something else I can take? in blocking adrenaline and noradrenaline in A Side effects can often be managed other areas of the body, as well as the heart. by reducing the dose or switching to Beta blockers are among the Q What exactly are beta blockers? failure caused by impaired contraction of the This can cause some unwanted side effects, a selective beta blocker. However, if you most important drugs used A They are inexpensive, well tolerated left ventricle (the main pump chamber of the Fast facts including cold hands and a predisposition to have problems with beta blockers, there are drugs and save many lives by lowering blood heart). Guidelines recommend that all patients ● Beta blockers block the release of asthma attacks. alternative drugs available. If you have angina by cardiologists. Professor pressure, protecting against recurrent heart with left ventricular impairment should take the stress hormones adrenaline and Selective beta blockers, such as atenolol or AF, for example, other drugs that slow the Adam Timmis answers some attacksD and helping people with heart a beta blocker – regardless of symptom noradrenaline and bisoprolol, are used more commonly by heart rate, such as diltiazem or verapamil, D common questions failure to live longer. severity – as part of a treatment plan that also ● cardiologists because their activity mostly may be substituted. The recently available They are used to treat conditions including includes angiotensin converting enzyme (ACE) They are widely prescribed for affects the heart and has less pronounced ivabradine also slows the heart rate and can angina, heart failure and some heart rhythm inhibitors, for example ramipril, and, in many angina, heart failure and some heart effects in other parts of the body. be used to treat angina (but not AF) if beta disorders, and after a heart attack. cases, an aldosterone inhibitor. rhythm disorders, and to control blockers aren’t advised. They are also sometimes prescribed for ● Treatment of some heart rhythm disorders blood pressure Q Is there anybody who shouldn’t be glaucoma, anxiety and migraines. Common – beta blockers are used to control the ● prescribed a beta blocker? types include propranolol, atenolol, bisoprolol irregular heart rhythm in people with atrial They are usually tolerated well A There are some conditions in which beta and nadolol. fibrillationD (AF) . By slowing the heart rate, without significant side effects blockers are not recommended. This includes the symptoms caused by AF, particularly uncontrolled heart failure, hypotension (low Medicines for your heart Q Why would I be prescribed this? palpitations and fatigue, are often improved. blood pressure), certain problems with the Find out more A Beta blockers are widely prescribed for ● Protection against recurrent heart attacks rhythm of your heart, or bradycardia (a very For more people with heart disease in these ways: – in people who have had a heart attack, beta slow heart beat). If you have been diagnosed information, ● D Treatment of angina – by slowing the blockers help reduce the risk of further ones. with asthma or another lung disease, beta download or heart rate, beta blockers reduce the oxygen Guidelines recommend that all patients who blockers are not normally prescribed because order our free demand of the heart and reduce the frequency have had a heart attack should be prescribed they can occasionally provoke severe asthma booklets Angina, of angina attacks. Guidelines recommend beta a beta blocker before hospital discharge as attacks. Your doctor will consider the balance Blood pressure and blockers as first-line treatment in patients with part of a package of risk reduction measures. of benefits versus risks. Medicines for your heart. Visit angina either on their own or in combination Treatment should usually continue for life. bhf.org.uk/HMpublications or call with a calcium channel blocker. ● Control of blood pressure – beta blockers Q What are the potential side effects? 0870 600 6566. Turn to page 50 for ● Treatment of heart failure – beta blockers are commonly used to help lower blood A Beta blockers are usually tolerated well more guides and order codes.

improve life expectancy in people with heart pressure, usually as a part of a treatment plan LibraryPhotography: Science Photo without significant side effects. They may

22 Heart Matters bhf.org.uk 23 RESEARCH RESEARCH

Policy explained: Air Breath of pollution levels in the UK are illegal In February this year the In April, a thick smog European Commission launched FRESH AIR legal proceedings against the swept over London, We’re leading the way in proving links between highlighting the UK Government for failing to normally invisible threat. meet the deadline for reducing air pollution and heart disease. BHF Professor Below: Professor David Newby nitrogen dioxide emission after David Newby talks to Sarah Kidner the European Supreme Court ruled that the UK was in breach of EU emission legislation. Therefore we are calling e can’t afford to be complacent,” says BHF The question of risk varies worldwide, he explains. on the UK Government and Professor David Newby. He’s talking about the “If you compare London with Beijing, there’s a huge administrations around the Wstate of the air that we breathe every time we difference in air quality. In Beijing, there are masses of UK to do all that they can, as step outside. It’s not as fresh as you might think. particles in the air that are many times more prevalent quickly as they can, to reduce This is because diesel and petrol fumes pollute the than in most European cities. But even where air air pollution and protect the air with ultra-fine nanoparticles. These stop blood quality is relatively good, as in the UK, there is still a population, especially those with vessels relaxing and contracting, which increases the link with heart attacks and heart failure.” cardiovascular disease. risk of clots and heart attacksD. Research released by the World Health Organization We are also calling on the We know this thanks to more than a decade of in March this year claims that one in eight of total Government to retain the legal research by Professor Newby and BHF Intermediate global deaths is a result of air pollution exposure. This duty on local authorities to Research Fellow Nick Mills, both now based at our more than doubles previous estimates and confirms monitor air quality in their area Edinburgh Centre of Research Excellence. Professor that air pollution is now the world’s largest single so the true extent of air pollution Newby explains: “In the 1950s, when there was a lot environmental health risk. “Your risk if you are a healthy levels are recorded across the UK. of smog, the problem used to be that particles were person is very, very small. It might be a one in a million big and they stuck in the upper airways. Now these chance of having a heart attack per day. However, on a nanoparticles go straight past, deep into the lungs, population level, the risks are high,” he says.

even into the bloodstream. We have a clear link Professor Newby and the team have been working Photography: Getty between air pollution levels and heart attacks, and we with specialists in the Netherlands, Sweden and Beijing believe the particles in the air are the cause of this.” to see if reducing exposure to air pollution could clarifies. “It might have a role if it’s a really bad benefit the heart and circulation. pollution day and you have to go outdoors, but I Understanding the risks am not encouraging the whole population to go Air pollution reports Pollution is a particular problem for the Global co-operation out wearing a mask.” The Department for Environment, Food and Rural 750,000 people in the UK living with In Beijing, they organised local people with However, he does recommend that those living with Affairs provides air-quality information on its Air heart failureD, shows a study by Professor coronary heart disease (CHD)D to walk around heart failure and CHD take caution (see box, right). Information Resource website, UK-AIR Newby’s Edinburgh-based research team. the city hooked up to portable blood pressure “People with coronary heart disease, and particularly (uk-air.defra.gov.uk). You can also find forecasts The team analysed data from 12 countries and heart rate monitors. those with heart failure, should avoid spending long of air pollution over the next 24 hours for 16 covering more than four million Backpacks contained specialist equipment periods outdoors in areas where traffic pollution is regions of the UK, and 16 urban areas within people living with heart failure and that measured their heart function and likely to be high. Local air quality reports could help them. Visit uk-air.defra.gov.uk/forecasting. found they had an increased risk of exposure to air pollutants. The team people understand when they might be most at risk.” You can find information on Scotland’s hospitalisation and death where discovered that if volunteers wore a However, for most people, the benefits of exercising air quality at scottishairquality.co.uk. For pollution levels were high. “People facemask to filter out the pollution outdoors outweigh the risks associated with pollution. Wales, check the Welsh Air Quality Forum with heart failure are a vulnerable particles, their blood pressure was lower We’ll continue to fund research exploring the welshairquality.co.uk. The Department of the group and, when the air quality and their heart activity was healthier. links between pollution and heart disease and we’ll Environment in Northern Ireland also has a falls, more of them are admitted to That isn’t to say we should all rush lobby the Government to do the same. As Professor website on air-quality issues: airqualityni.co.uk. hospital,” says Professor Newby. out and buy facemasks, Professor Newby Newby says, “We can’t afford to be complacent.”

24 Heart Matters bhf.org.uk 25 NUTRITION NUTRITION

Soffritto – finely The Spanish are nuts chopped vegetables about nuts, which – forms the basis of may have heart- many Italian dishes health benefits World FOOD As British cuisine becomes increasingly global, can we get the best of all worlds, asks senior dietitian Victoria Taylor

n the UK, we’re lucky to have embraced a broad diversity of cultural cuisine. The ‘traditional’ British diet is a fusion of ingredients and tastes from around the globe, thanks to a history of From global to local exploration, immigration and travel. Even within the UK, the way we eat Variety may well be the spice of life, but Vegetarian dishes, The Japanese eat varies. The Family Food 2012 survey I a variety of oily as we incorporate other nations’ cuisine such as this chickpea looks at food purchases across the into our own, it’s important to choose stew, are found in fish, here salmon UK and identifies some interesting healthier elements where we can. We know South Asian cuisine on a plate of sushi findings. Although there is little from research that the Mediterranean diet difference in the energy and is healthy, but what can we learn from nutrient intakes between the four diets across the globe? intake of fruit and vegetables and cut cholesterol levels. Substituting ghee with Because the vegetables are chopped so nations, there are differences in back on saturated fat. Managing unsaturated oils works just as well and finely, soffritto blends into the dish and our food choices. South Asia The South Asian diet makes good use makes recipes more heart healthy. may even go undetected by reluctant When it comes to food at home, The dishes we enjoy in the UK, such as of lentils and other pulses as a source of risk factors vegetable eaters. households in England buy the chicken tikka masala, onion bhajis and protein. These have the added benefit Improving our diet is only Italy most fruit, while the Welsh buy the naan bread, are rooted in India, Pakistan of containing soluble fibre (also found in one way to protect our The Mediterranean diet is rich in fruit Japan most vegetables. Looking at meals and Bangladesh and regularly top the wholegrain foods such as oats) that can hearts. Remember to look at and vegetables and the people living When last surveyed, Japan had one of the out, households in Northern Ireland charts of the nation’s favourite foods. help to lower cholesterol levels. other factors, such as not in this region eat more fruit and veg lowest rates of cardiovascular disease in eat the most Indian, Chinese and While these aren’t the most authentic or Traditional South Asian foods can be smoking, being physically than elsewhere in Europe. Italy is a great the world and this may be partly down Thai meals. the healthiest choices, there are other high in salt, which can contribute to active and sticking to example where, along with the usual to the Japanese diet. Traditionally, this Those living in Scotland, however, traditional elements of the South Asian high blood pressure, so focus instead on recommended alcohol limits ways fruits and vegetables are eaten, is low in saturated fat and includes a are more likely to go for a sandwich; diet we can learn from. using herbs and spices and other typical to reduce your risk of soffritto – finely chopped onion, garlic, range of foods that are linked to heart average consumption is one and Vegetarianism is a way of life for many flavours such as chilli, garlic and ginger, coronary heart disease. celery, carrot, rosemary and bay leaf health, including oily fish and soya found a half times higher than in Wales. in this region and, while a complete ban which liven up dishes in a healthy way. cooked in olive oil – is used as a base of in beans or tofu. Meals are an important Watch out for the soft drinks that on meat isn’t essential for heart health, Watch out for ghee, too, as this ≠ Go online to see a list of many traditional dishes. part of the day and culture in Japan. many wash their food down with – including some meat-free meals in our is clarified butter and adds a lot of seven world foods to avoid It adds an authentic flavour and boosts The traditional Japanese diet the Scots buy the most in the UK.

diet can be a simple way to boost our saturated fat to dishes, which can raise bhf.org.uk/HMworldfood. the vegetable content of our meals. balances taste, texture, colour and Schneider Photography Stockfood/Doug Zouev, Photography: Stockfood/Tanya

26 bhf.org.uk 27 NUTRITION NUTRITION Focus on… SALT Eating patterns in Europe Our senior dietitian Victoria Taylor answers common It’s not only people ICELAND questions about salt and how it affects our health living in Finland who have changed DENMARK e all need some have some way to go before food tastes bland. However, better for you. Whether it’s their dietary habits. salt in our diet but, we achieve the target as, on flavour doesn’t only come from rock, crystal or flakes, they still FRANCE Other Europeans Won average, we’re average, people consume salt. Fresh and dried herbs, have the same effect on your have, too, as this SERBIA/MONTENEGRO consuming too much. Regularly about 8.1g a day. spices, black pepper, chilli and blood pressure as standard graph of saturated eating too much salt is lemon are all great ways to add table salt. It’s the sodium that fat intake over a SWITZERLAND associated with raised blood Why are we going over flavour. So while you reduce we really need to watch out decade shows. pressure, a risk factor this limit? the amount of salt you eat, for; we should also monitor FINLAND for coronary heart diseaseD One of the reasons it can be substitute it with these other ingredients such as fish and and strokeD. tricky to reduce our salt intake flavour enhancers and you soy sauce and raising agents BELGIUM is that it is often already in the won’t notice the loss as much. such as baking powder and HUNGARY What is salt? foods we buy – about 75 per bicarbonate of soda. By salt, we mean table salt, cent of the salt we eat comes Are alternative sources of Percentage change in AUSTRIA which is otherwise known from processed foods. It’s not salt better for me? ≠ Go online to see our list of saturated fat intake as sodium chloride. It is the just in ready meals, soups and Don’t be fooled into thinking seven surprisingly salty foods. from 1996/97 to 2006/07 UK biggest source of sodium in sauces, though – keep an eye that fancier types of salt are Visit bhf.org.uk/HMsalt. Source: calculated from our diets and it’s this sodium on everyday foods such as FAOSTAT food supply data that’s the problem in relation breads and cereals, as well as (faostat.fao.org) -10% -5% 0% +5% +10% to blood pressure. While we sweet foods harbouring a salty do need some sodium in our surprise. Read food labels to Say no to salt diet to help regulate fluid in make sure that you are making Our Heart Matters recipe finder (bhf.org.uk/recipefinder) minerals and fibre, but it’s important we However, it’s now common around the body, it’s unusual for us low-salt choices. is constantly being updated with recipes that Cut down eat them in their natural state, rather than the developed world to get saturated not to get enough – and only are full of flavour rather than salt. For more tips on salt It’s important for you salted, sugared or dry roasted. fat from multiple sources. So that means, as too common for us to have How can I cut back? and tricks to help you reduce your salt intake, and your family Snacking on fresh fruit and vegetables well as butter, milk, cheese and meat, we all too much. We acquire a taste for salt and, download or order our free booklet Cut down and small amounts of unsalted nuts and need to watch out for a raft of temptation over time, get used to a certain on salt. Visit bhf.org.uk/HMpublications or dried fruit helps to increase nutrients in the form of pastries, cakes, biscuits, ice What’s the daily limit? amount in our diets. If you cut call 0870 600 6566. and reduce saturated fat, salt and added cream and the like. The Government recommends back drastically and suddenly, A public sugars in our diet. This can help us to The approach taken in Finland is a useful that we eat no more than 6g you may at first find that your Beating heart disease together health programme manage our weight, cholesterol levels reminder that we need to be mindful of of salt a day. That’s about a cut saturated fat and blood pressure. how our environment influences our food Photography: Johanna Ward teaspoon. However, we still intake in Finland choices. We might not be able to change Finland our wider environment, but we can be in In the late 1960s, men in Finland had control of our micro-environment – inside flavour. While deep-fried tempura often the highest death rates from coronary our homes, around the office or in the car. features, it is only in small amounts. heart disease in the world. A long-term For example, keep chopped vegetable It’s not necessary to eliminate all foods national public health programme was sticks at eye level in the fridge, a fruit bowl containing fat and sugar, but remember set up to tackle the problem by changing on your desk at work and small bags of that eating too much of them will behaviours and reducing cardiovascular dried fruit in the glove compartment of mean more calories, which could lead risk factors. your car to help you resist the temptation to weight gain. Finland was a country with a lot of dairy of unhealthy snacks. farming – butter and milk production Spain were subsidised, while all vegetable Nuts are prevalent in the Mediterranean oils were imported. Developing oil Try our recipes diet, particularly in parts of Spain, and production in the country, alongside an Pull out and keep our recipe cards for studies have suggested that eating them education programme, helped to reduce healthy meal inspiration from around the regularly may benefit our heart health. the amount of saturated fat eaten and globe or visit bhf.org.uk/recipefinder.

Nuts are also a source of protein, vitamins, lower cardiovascular death rates. Photography: Stockfood

28 Heart Matters bhf.org.uk 29 RESEARCH RESEARCH

Aorta The mitral valve Supplies body with explained blood he mitral valve makes sure Tblood doesn’t leak between the two chambers in the left side Pulmonary of the heart. It has to withstand valve high pressure because the Pulmonary left side of the heart pumps artery blood to the rest of the body. Takes blood Common problems include Superior to lungs mitral regurgitation (a back flow vena cava of blood), mitral valve prolapse Main vein; Pulmonary (when the valve collapses, often blood flows veins leading to regurgitation) and in from head Blood flows mitral valve stenosis (when the and neck into heart valve narrows). from lungs Right Problems like this can Left atrium cause symptoms such as atrium breathlessness, especially during Mitral valve activity, although mild problems Tricuspid Aortic valve valve Dr Gaetano Burriesci (left) and his with the mitral valve may not colleagues are designing an artificial bring on any symptoms and may valve that is small enough to pass not need any specific treatment. Inferior through blood vessels Left untreated, moderate to vena cava

Photography: UCL Medical Illustrations Services severe mitral regurgitation can lead to heart failure. Although there are less invasive ways that Right Left ventricle the mitral valve can be repaired, ventricle currently, the only option for a mitral valve replacement is to Oxygenated blood MITRAL MIRACLE have open heart surgery. Non-oxygenated blood

eople who need a mitral valve because of what Dr Burriesci describes as of Alan Woodgate/Son Illustration: Lee BHF-funded research hopes replacement in the future may benefit “unique technical challenges”. to develop a new type of Pfrom an innovative valve design, Specifically, the anatomy of the mitral they need to apply for the next stage of lead to heart failureD unless the valve is artificial valve for the heart which would mean they no longer need valve is complex and needs to withstand research, which would mean testing the repaired or replaced. “Mitral valve problems that could benefit many open heart surgery. high pressure. prototype artificial valve in animals. are a worry for many people in the UK, Dr Gaetano Burriesci and his team of especially as problems increase as we get £182,714 patients. Doireann Maddock researchers at University College London Finding a solution World-class development older,” says Dr Burriesci. “This type of valve Amount of funding finds out more from are designing an artificial valve that will To overcome these challenges, Dr Burriesci’s If successful, the technique could prove replacement could happen in parts of the enable surgeons to replace the mitral valve team is designing an artificial valve that suitable for patients currently excluded world where it is currently limited or not provided by the BHF Dr Gaetano Burriesci using a transcatheter technique, a less is small enough to be delivered through from surgery. “About 50 per cent of people available, due to the costs and resources invasive method than open heart surgery. narrow blood vessels. He explains: “It needs who would benefit from a new mitral valve required to perform conventional mitral They have the backing of a £182,714 grant to collapse to a small enough size to fit in are unable to have it due to the high risk valve replacement surgery. It’s exciting to from the BHF. the catheter, and when it’s passed through of surgery, so the impact on this patient work in a field where you can potentially The transcatheter technique is already the catheter into place, it then needs to group could be huge,” says Dr Burriesci. reach such a huge number of people and in use with high-risk patients for aortic expand in size and function effectively as “Replacing the valve would also be improve their lives.” or pulmonary valve replacements. This a mitral valve.” quicker and the stay in hospital would be is where the valve is delivered via a Once they have a prototype of the valve, shorter, resulting in a reduction in costs, peripheral blood vessel (in the leg, for the team will test it using instruments that and a shorter recovery time,” he adds. Donate now example) using a catheter (a thin plastic simulate the body’s circulatory system. The Mitral valve problems can make the Without your donations we can’t continue to fund our life-saving research. tube). To date, it hasn’t been possible to findings from these laboratory-based tests heart less efficient at pumping blood To give what you can, go to bhf.org.uk/donate. replace the mitral valve via this method will give Dr Burriesci and his team the data around the body; severe problems can

30 Heart Matters bhf.org.uk 31 WELLBEING WELLBEING

Dealing with angina and erectile dysfunction Tom Riley, 86, and his wife Suzy, 73, sought advice from their GP about erectile dysfunction. Tom, a retired electronics engineer from West Sussex, developed anginaD in his early 60s. He says: “Day to day the angina was fairly easy to cope with, including the intimacies of marriage, although a little tweak of angina could be felt at the Tom’s advice: “Try to moment of orgasm.” talk openly with your Tom had a quadruple bypass in 1993 partner. We have no and felt very weak afterwards. When he left bother discussing hospital he could only walk a few yards, it at all. Having a good but was determined to keep active. He laugh about it helps.” LET’S gradually increased his walking and after a few weeks was able to walk six miles, at which point he and Suzy resumed sex. At 80, 16 years after the bypass, Tom started to suffer from erectile dysfunction coronary artery, problems with the aortic (ED). He put this down to the effects of valve and an abdominal aortic aneurysm. TALK blood pressure medication, although His angina was increasingly troublesome, ageing can contribute. “My GP prescribed so the couple put their sex life on hold Viagra, which helped, although it affected until after Tom’s operation last October. my vision in bright light,” he says. “We tried “Six weeks later we thought we’d try to ABOUT Cialis, which caused the same issue plus resume our sex life without Levitra, as we spots, but at last we changed to Levitra, weren’t sure about using it with my new which was satisfactory in every way.” medications,” says Tom. “The works hadn’t It may be hard to tell whether problems quite recovered, although a good snuggle such as ED or loss of libido are caused by is always nice. We resolved to wait until the medication, the heart disease, or its after my appointment with our GP.” psychological effects. The couple got the go-ahead to use SEX Last year Tom was told he had a blocked Levitra and, says Tom, “It was lovely.” If your heart condition is affecting your sex life, you’re not alone. Sarah Brealey talks to two couples AN EXPERT’S VIEW who have overcome their issues and Graham Jackson is which are less likely to if you can walk a mile on honorary consultant cause a problem, so the flat in about rekindled their desire cardiologist at Guy’s and speak to your GP about a 20 minutes, or two flights St Thomas’ Hospitals and change in medication. of stairs in 20 seconds. chairman of the Sexual “There are some heart “It may not be helpful ex is a thorny issue for many heart patients Advice Association. drugs which can even be to wait too long to have – whether it’s due to the physical effects “For most people, helpful and give you a sex again. The longer you of heart disease, the medications, or the sexual issues are caused firmer erection. leave it, the bigger an emotional impact of surgery. As our survey by the underlying heart “Generally you can issue it may seem. in our last issue found, the majority of disease, not the drugs, resume having sex when “Don’t suffer in people with a heart condition – three out but there are some you feel comfortable silence. It’s really of four – said it affected their sex life. But a diagnosis drugs which can cause to do so, usually two to important to have good S Tom and Suzy Riley of heart disease needn’t put an end to your intimacy. problems. Often, there four weeks after a heart communication with your enjoy an active sex life Seeking medical help, and talking honestly with your are similar medications attack. You should be fine partner and GP.”

partner, are the first steps in overcoming the issue. Photography: Johanna Ward

32 Heart Matters bhf.org.uk 33 WELLBEING

Sudden heart attack For Martin and Louise Tailford, a heart Martin’s advice to others: “Begin earlier. If you attack when Martin was just 33 has want to have sex at midnight, start at 3pm with affected every area of their lives. Two a text message – you need to build the mood. years on, things are much better. Don’t be disappointed if things don’t go well Martin Tailford felt fit and healthy until he initially. It’s not the other person’s fault, and had a heart attack on Christmas morning it’s not your fault if you can’t perform. It’s not 2011. Martin, now 36, a driving instructor because they don’t find you sexually attractive from Norwich, was in hospital for 11 days. any more.” Louise, 32, a scientist, says: “Being apart Louise’s advice: “Worrying about your partner’s was stressful, and we weren’t able to be Martin and Louise health can put you off, but it can make you intimate during Martin’s time in hospital.” Tailford value their realise the importance of the ‘here and now’, Having sex after a heart event can cause quality time so make the most of it.” together anxieties, but there’s no need to worry. Sex is highly unlikely to trigger a heart attack, and can be good for your general health and wellbeing. HEART Martin and Louise tried to have sex the day he came out of hospital but found it difficult. Martin says: “Louise had MATTERS been alone for 10 days – we didn’t feel contraception – Martin has been advised emotionally connected, and I felt like I not to have a vasectomy because of the looked terrible. strain the anaesthetic might place on his HELPLINE “I was underneath and I didn’t really heart, so Louise has had a coil fitted. When it comes to anything heart tolerate having her weight on me. Louise The couple have found that good related, we’re here to help. Call was quite upset.” communication helps a lot. As Martin says: or email our Helpline for support Martin says their sex life remained “Our relationship is not based exclusively and information on: difficult for at least a month. “Sex was less on sex, but sex is the glue that holds frequent and required a lot more planning.” everything else together.” The heart attack left Martin with heart Louise adds: “Martin’s heart attack has Heart conditions failureD. Last year he was fitted with a affected our whole life, sex life included. pacemakerD and defibrillator, which But it does make us appreciate each other Healthy eating helped, and he may be considered for a and everything that we have.” heart transplant in future. Heart medications * He’s been diagnosed with Marfan syndrome, a genetic condition that led to Heart Support Groups 0300 330 3300 a coronary artery dissection which caused Where to get help the heart attack. The experience has affected not just If you are having sexual difficulties, see your GP. ≠ To watch a short film Keeping your Martin but also Louise. “Martin takes Don’t be afraid to go back if the first solution doesn’t about sex and heart heart healthy warfarin, so bruises more easily, and the work. If your doctor seems unable or unwilling to disease, go online at bruises can be upsetting, as is the sight and discuss it, ask to be referred, or consider changing bhf.org.uk/HMsex. feel of the pacemaker and scar,” she says. your GP. Cardiac rehabilitation should also cover this You can also find the Lowering your risk “Stress and worry reduces my libido. It area and provide support. results of our sex survey factors such as high was hard to go from a ‘nurse’ role to lover.” For questions about sex and your heart condition, from our last issue, and Contraception is also a concern, as the call our Heart Helpline on 0300 330 3300 or email our article about erectile blood pressure couple do not want more children. (Their [email protected]. dysfunction – or order the five-year-old son has been diagnosed with For information on sexual problems, contact the May/June issue on Marfan syndrome, but is healthy so far.) Sexual Advice Association on 020 7486 7262 or 0870 600 6566. The couple have found ways to deal with email [email protected]. To read about Tom’s some of their issues, such as wearing a For information on Marfan syndrome, contact the experience of heart t-shirt to cover scars and bruising. They use Marfan Association at marfan-association.org.uk or disease, visit FIGHT Call the Heart Matters Helpline or sexual positions which are less tiring for on 01252 810 472. bhf.org.uk/HMtomriley. FOR EVERY email [email protected] Martin and have tried different methods of HEARTBEAT 34 Heart Matters bhf.org.uk *Call rates are similar to 01 and 02 numbers. Lines are open 9am–5pm, Monday to Friday WELLBEING WELLBEING Thenext t last, a lifetime of hard graft and pension Psychology of Retirement. “Many will be faced with contributions has paid off – it’s time to some difficult transitions, such as having to build up hang up your hat/suit jacket/work boots a new support network and dealing with work-related (delete as appropriate) and have some fun. loss, such as identity and structure. chapter But while you may have been dreaming of “People can make the transition smoother by this moment since your first day at work, continuing to use their skills and relationships in a way Tony Cooley has used his retirement have A you got a plan for how you’re going to spend that maintains what went before, whether that’s in the to make healthy lifestyle changes. your time? And, just as importantly, a plan B if things voluntary sector or by joining a club.” don’t turn out quite as you’d imagined? Tony is feeling fit again following successful heart Ruth Ganthony finds out how When Tony Cooley was 60, he was offered early bypass surgery in January 2012, a couple of months retirement from his job in the council tax department into his retirement. He attended cardiac rehabilitation of his local council. Having worked there for 43 years, sessions at a local charity, Heart Care, which he he grabbed the opportunity with open arms. Tony, continues to go to each week. Here, he found support from Walsall in the West Midlands, was looking forward from other heart patients, and he was eased into to plenty of activities and days out with his wife Linda, physical activity. He found that exercising gave him but everything changed during his last month at work. something to focus on. “At first, not having to go to “News of my heart condition came as a devastating work was strange and I struggled to stop thinking blow,” says Tony, now 63, who had gone to the doctor about it,” says Tony. “But then, after the operation, with suspected indigestion, only to be told he’d had because I was so concerned about getting myself fit a heart attackD and needed to have bypass surgeryD. again, I was able to move on.” “I immediately thought, ‘That’s my retirement up the spout’. All my ideas about how I might enjoy myself Rising to the challenge were put on hold. I had visions of being armchair- Retirement can bring testing times such as loneliness bound, wrapped up in a shawl, not daring to move.” and changes to relationships, self-esteem and health, but how you deal with these can make all the Plan ahead difference. “If you’ve had heart surgery and you have While you may not be able to plan for a heart event, pain or physical limitations, acknowledge this and you can and should prepare mentally for retirement. reframe any negative thoughts,” says Dr Milne. “Solve “Retirement is like emigrating,” says Dr Derek Milne, problems and reassure yourself that this is not the end

Photography: Tom Jackson, Getty Tom Photography: Newcastle University psychologist and author of The – you just need to find a way of working around it.”

TOP 1 Get your finances in order 2 Wind down gently 3 Prepare for ups and downs 4 Eat well 5 Develop a routine 6 Exercise your mind 7 Keep physically active Organise your money so you Ensure a smoother transition There may be times when Make sure you eat regular You may find it feels more Government studies have We should all aim to do can work out what you’ll have by retiring in stages. By you feel lonely or a bit lost, meals, especially if your normal to continue getting shown that learning in later at least 150 minutes of to live on. Gradually reducing easing off your workload which is normal. If ill health or previous pattern, while at up, eating and going to bed at years can help people moderate-intensity physical your spending in the lead up to over several years, you’ll be changes in your relationships work, was to snack. Take roughly the same time every stay independent, so use activity a week, so build up retirement will make it easier able to get used to the idea temporarily scupper your plans, advantage of the extra time day. Plan in regular activities your free time to continue to to this if you haven’t made to adjust. Track down any old of not working and fill your accept that this has happened on your hands and explore such as voluntary work, challenge yourself mentally, exercise a normal part of your 10 pensions, claim your state time in other ways. Ask your and get your back-up plan in healthy cooking options. exercise and hobbies. This will whether it’s learning an life previously. Why not sign up RETIREMENT pension and check what other employer if you can cut back action. Think positively and See our recipe cards (page keep things interesting and instrument or a language or for a charity event to give you a TIPS benefits you can claim. your working hours. share any concerns with others. 26) for inspiration. give you a purpose. getting a qualification. goal to work towards?

36 Heart Matters bhf.org.uk 37 WELLBEING AN EASY-TO-USE MOBILE PHONE WIN! WORTH £120 becoming more active. “The most successful transitions are people who see it as a growth opportunity, where e’ve teamed up with things you’ve always wanted to do become possible,” Doro to give Heart says Dr Milne. “Tackle it like a new job, use all your skills WMatters readers the and treat it like a new beginning.” chance to win one of 10 Doro Thanks to Tony’s positive outlook and the support of PhoneEasy 621 mobile phones. others, he and Linda are now enjoying the retirement Doro specialises in making Tony attended they always wanted. “We’re discovering lots of nooks easy-to-use mobile phones cardiac rehab and and crannies around the UK to go and visit. We recently that are ideal for anyone with still goes to the went to the Lake District and enjoyed some of the easy reduced hearing, vision or gym every week walks,” he says. “Retirement is actually better than I dexterity, or just for people who expected – we’ve been given a new lease of life.” are looking for a simple phone. The Doro PhoneEasy 621 is Dr Milne gives an example of an allotment group ≠ Go online for an additional 10 tips on how to fill your a modern handset for people who haven’t let health problems get in the way of retirement and to read Tony’s extended story who want an attractive, high- their passion. “Among the ‘allotmenteers’ are people of dealing with a heart condition: quality mobile with a camera. who have had strokesD, heart attacksD, hip and knee bhf.org.uk/HMretirement. This model also has a built-in replacements. They share wisdom and provide each video camera, so you can easily other with practical support,” he says. “For example, send video messages – the one guy who’d had a stroke was helped to build raised Where to go for help perfect way to share special beds that he could then work on from a wheelchair.” moments with loved ones. He stresses the importance of social support to ● Citizens Advice Bureau: adviceguide.org.uk; The phone features a large, enable you to turn any negative thoughts around. “To 0844 411 1444 (England) or 0844 477 2020 (Wales). bright and exceptionally have someone who knows what you’re talking about ● Pension Tracing Service: clear colour screen, as well as validates your feelings. People are often staggered by gov.uk/find-lost-pension; 0845 6002 537. extra loud, clear sounds with how similar their experiences are and it makes them ● Department for Work and Pensions: hearing-aid compatibility. Find out more realise they’re not alone.” gov.uk/dwp; 0845 606 0265. The clamshell-style handset If you’re not lucky enough to ● Age UK: ageuk.org.uk/money-matters/pensions; is available in two colour The handset is not tied to any win a phone, you can learn more New beginnings 0800 169 6565. combinations – burgundy/ mobile network and you’ll need about Doro online at doro.co.uk. Whatever your situation, retirement can also offer ● Heart Matters Helpline: 0300 330 3300. white or black/graphite. a SIM card to use the phone. The Doro PhoneEasy 621 has an the potential for positive change – whether that’s ● Online community: community.bhf.org.uk. Bluetooth connectivity SIM cards are available for little RRP of £120 and is available from volunteering for a charity, resolving to eat healthily or means you can use a headset or no cost from mobile phone 02 stores and online. Doro has an or earpiece with it and it also shops and online, or you may extensive range of easy-to-use has space for a memory card, be able to transfer the SIM phones and recently launched its so you can manually transfer card from your existing mobile first easy smartphone, the Doro content such as photos onto phone. If in doubt, ask your Liberto 810. computers or other phones. mobile phone provider. 8 Make a list 9 Seek social support 10 Make peace Writing down your aims may For many people, work can and move on How to enter help you focus on what you form a big part of their social Don’t spend your The winner of the Mullion really want to achieve – like a life and it’s common to feel at retirement dwelling To be in with a chance of winning, send your name, address and telephone Cove Hotel break (Mar/Apr ‘to do’ list. Work out what you a bit of a loose end once you on your working days. number to Heart Matters/Doro prize draw, Freepost RTCH-BXUB-XCTV, 2A 2014) was Lorraine Adam can afford to do and schedule retire. Fill the gaps by joining Accept that you’ve done Halifax Road, Melksham SN12 6YY or [email protected] from Darlington. time to make it happen, so clubs and groups. Turn to all you can in that job by 31 August 2014. you experience a sense of page 46 to read about the and focus on your next accomplishment, as you would social and physical benefits challenge. You’ve still Terms and conditions All entries must be received by midnight on 31 August 2014. There are 10 prizes, as described above. The promoter is Doro. Entrants must be aged 18 or over and UK residents. Only have done at work. of walking groups. got lots to achieve. one entry per person. All BHF and Doro employees, associates and direct suppliers are ineligible to enter. Only the winners will be notified. The prize includes a handset but not a SIM card and does not cover the cost of any telephone calls. The prize is non-transferable and non-refundable and there is no cash alternative. The promoter reserves the right to change the prize or cancel the draw at any time.

Photography: Tom Jackson, Getty Tom Photography: The colours of winners’ phones will be allocated at random. Entry denotes acceptance of these terms and conditions. 38 Heart Matters bhf.org.uk 39 ONLINE ONLINE

Previous top sellers on our Ebay shop £978 £1,999 £700 State-of-the-art Vintage 1898 Limited edition 60in LG television, silver-plated cornet, ‘I made this,’ white Xbox One six months old, in damaged console, originally offered to Collectibles good condition Microsoft employees, unused This is enough to WITH A CONSCIENCE This is enough to buy a new fund 10 days’ work This is enough to pay for three electrophoresis gel tank kit, an essential from a post-doctoral weeks’ worth of the proteins item for our lab scientists that allows scientist, helping and amino acid ‘building blocks’ them to separate out molecules in order promising talents our Cambridge-based scientists We’re using Ebay to make the most out of to analyse them and find new ways of pursue cutting-edge will use to build new working the unusual goods donated via our shops. tackling heart disease. medical research. heart tissue. Sarah Brealey finds out more

n a warehouse in Leeds is a collectors’ how many people are registered shoppers Staff numbers have grown from six to 25, spotting hidden gems. “The quirky, unusual Military memorabilia, paradise – a treasure trove of everything on the site worldwide.” and this, plus the extra space, has helped stuff makes the most money, although vintage toys, such regular designer stuff still does well,” she fromI sewing machines and CD players to Shop volunteers play an important role it to go from strength to strength. as the 1950s’ camera lenses and ice skates. in deciding what to list on Ebay. Many of Many of the warehouse staff have says. “When we list something and it’s Barbie (left), The clothing rails are as likely to contain them have a special interest in collectibles specialist knowledge in a particular area, successful, the shops see that and send us and practical items a Second World War military overcoat as an and books, so they can help advise on such as crockery or fashion. This means similar things, which is great.” like sewing unworn Donna Karan wrap dress. Whether anything rare or valuable that might get that they can advertise items well and set Ashley finds the job fun as well as machines are your childhood toys were Action Man a better price on the auction site. a suitable starting price for the bid. rewarding. “For people like me with a among the or Sindy, Hornby train sets or Scalextric, Ashley says they are always happy to Sally Parsons is a vintage and 30-year career in retail, this is as exciting as best-sellers on Teletubbies or even Steiff teddies, there’s have a chat if there is any doubt about a contemporary clothing expert who used to it gets,” he says. “As a collector, it is a bit like our auction site something to evoke happy memories. certain donation. “If you are a collector, you work for a shoe retailer. Her role includes being Willy Wonka in a chocolate factory, By the door, boxes are piled high with enjoy it when someone rings up from a weeding out the fake designer goods, and, of course, we are raising money for a the latest arrivals, all of which have been shop and says ‘We have got this, how much which come along regularly, as well as great cause.” donated to our shops and Furniture & money do you think it would fetch?’” ≠ Go online for a tour of our Ebay As a collector, it is a bit like being warehouse and 10 pieces of ‘junk’ that are Willy Wonka in a chocolate factory” worth a fortune. Visit bhf.org.uk/HMebay.

Electrical stores. The warehouse isn’t open Once items arrive at the warehouse, to members of the public, but you can members of the team photograph them browse and buy its treasures by logging and list them on Ebay, doing extra research How can you help? on to our Ebay shop, which is part of the if necessary to help describe them. Items We rely on your donations to help fund our world’s largest online auction site. must be carefully filed so they can be found life-saving work. Anything you donate to a BHF again when the auction is over. Then the shop will either be sold in that particular store or, Millions of potential customers item will be packed and dispatched to the if appropriate, in another one, or on our Ebay shop. Your donations fund our life-saving winning bidder. If it’s a large item, such as If you’re a taxpayer, filling in a Gift Aid form will help research, so we try to make sure they raise furniture, it will often stay in the shop and us get even more from your donation. as much money as possible. “It’s great be advertised on Ebay for collection from Our shops always need volunteers, especially when a shop sends us something that we that particular store. in September as that is when we run one of our can then get £300 for – when it would biggest stock-generating campaigns. Pop into your have fetched only £30 in store,” says Ashley From warehouse to winner local store or visit bhf.org.uk/volunteer. Skaife, our Ebay manager. “When we put The BHF Ebay operation was set up in 2006 Visit our online Ebay shop at something on Ebay, we have access to in two rooms above a shop in Halifax. A stores.ebay.co.uk/British-Heart-Foundation-Shop.

233 million potential customers – that’s year ago, it moved to a warehouse in Leeds. iStock Getty, Photography: Alamy,

40 Heart Matters 41 ACTIVITY ACTIVITY “What we all have in common is we cherish Kyle Garlett has competed in the every second of every day” Transplant Games as well as two Ironman triathlons This summer’s Transplant Games celebrate the gift of life. Sarah Brealey meets three inspiring people who show how heart transplants transform – and save – lives

undreds of transplant Suzanne Swinson, 61, competed in recipients will take part in this the Winter Transplant Games and says they summer’s Transplant Games, gave her something to aim for after her proving that their life-saving transplant. “I was absolutely made up when surgery allows them to live life I heard about the games,” she says. “I just to the full. saw it advertised by chance and it caught H The games, taking place from 7 to 10 my imagination.” August in Bolton, have been held since 1978 and are open to anyone who has had Celebrating the future an organ or bone marrow transplant, or All three feel that their heart transplant has is a living donor. The first year there were given them a second chance in life. 99 competitors on one day; there are now Wendy was seriously ill for nearly more than 600 across four days, competing nine years after being diagnosed with Wendy Lingham took in a wide range of sports. cardiomyopathyD shortly after giving birth part in a volleyball One of them is heart transplant recipient to her son, Joshua. She came so close to tournament organised Wendy Lingham, 35, from York. “What we death that she made plans for her own by Transplant Games all have in common is that we cherish every funeral and how her son would be looked second of every day,” she says. after without her. “It was hard on Joshua,” “I thought, ‘Somebody has made a mistake.’” Wendy decided to take part in the she says. “He’d always known me being ill. Two years passed before she was Transplant Games last year and again this I couldn’t take him out like other mums.” admitted to hospital with such a weak year to highlight the importance of organ Wendy treasures the fact that now she heart that a machine had to take over the Exercising after a heart transplant or surgery donation. “It is about raising awareness and can be active with Joshua, 11, thanks to heart’s pumping function. Increase your level of activity healed, which will take three showing how lives can be saved through her transplant three years ago. “I can run Five weeks later, she was given a new gradually, starting with to four months. donating a loved one’s organs, and to around, go swimming with him, ride a bike, heart. “Suddenly you have a future again; walking around your house, You should be invited to show honour and respect to our donors – or kick a football,” she says. “There are so it’s the most amazing thing,” she says. then short walks outside. Try cardiac rehabilitation, which without them, we wouldn’t still be here.” many things I can do now – it’s amazing.” After the transplant three years ago, Suzanne Swinson won to do some activity each day. teaches you how to exercise For Kyle Garlett, the games are “a great Suzanne, a civil servant and avid skier Suzanne’s health gradually improved. three medals for skiing Remember to cool down at safely. Regular physical activity way to celebrate donors, to meet other from Glasgow, couldn’t ski for five years On the anniversary of her transplant, she and her team got gold the end of your session. can help with your recovery, recipients and to be physically active in because she had advanced heart failure. decided to find out if she could ski again. for curling at the winter Avoid heavy lifting, help protect your heart and a way you wouldn’t have been able to Her diagnosis came after she went to see She took a few wobbly turns at an indoor games in January twisting, pushing or pulling reduce your risk of having before”. Like Wendy, Kyle is taking part in her doctor with a cough. As a fit and ski centre and never looked back. At the until your breastbone is further heart problems.

the games for the second time this year. active woman, she was deeply shocked. winter games, held in the French Alps in Photography: Laura Alice Hart

42 Heart Matters bhf.org.uk 43 ACTIVITY ACTIVITY

BHF ambassador is going for gold lympic heptathlete Oand Commonwealth heptathlon gold medallist Louise Hazel, 28, has come out of retirement to compete in this year’s Commonwealth Games in Glasgow (23 July to 3 August). She will also Aiming high: Louise Hazel act as a Commonwealth is determined to get ambassador for a Commonwealth medal Team England. Multitasking She is back after taking time out place on getting a gold medal, you to set up her own business. would be on a winning streak. “I generally get up at 7–7.30am to “We find time to sit down and train and am home by 9am to start watch our favourite television work on the business, or I train programme or procrastinate all January, she won three medals for skiing to show what transplant patients can do. of York bike ride twice since her transplant. after work,” she says. day long on social media, but what Organ donation and her team won gold for curling. “I can’t describe how exciting that is, to Life now, says Suzanne, is “wonderful, “I’ll do three running sessions a we are sometimes reluctant to do On average, every day, three “I met the most incredible people,” she realise that from tomorrow I am going to amazing”. She adds: “I can do almost week; I’ll do a high jump session; a is invest in our health and fitness.” people die in the UK waiting for an says. “Everyone had had a transplant, be getting healthier – how wonderful that everything I could before. I can’t walk up long jump session; a javelin session; organ. For those with end-stage everyone was doing the best they could.” feels,” he says. big hills, but I can get to the top if I drive and probably two shot put sessions. Achieving her ambitions heart failure, a heart transplant is Kyle, who previously lived in Los to a high car park and walk from there. You It’s like spinning plates.” One of Louise’s personal goals their only hope of treatment. Angeles, spent more than five years on the can’t always do things in the same way, but Work takes priority, she says, has been to become a running By signing the Organ Donor Getting active Register and becoming a donor, transplant list after chemotherapy (he’s Kyle, 42, who now lives in London and you can adapt.” but that doesn’t mean Louise isn’t ambassador for the BHF. It’s a role you could save the lives of up to had cancer four times) left him with heart is a writer and motivational speaker, has she’s passionate about after losing nine people. failure. He couldn’t even carry a bag of even taken part in two extreme Ironman ≠ You may be interested in some of our her father to heart disease in 2008. National Transplant Week is 7 to shopping and used to black out when he triathlons since his transplant. free booklets, including Living with heart I hang my gold “I took a team to the 10km run at 13 July, so there’s no better time to stood up. He says he’d encourage others to get failure, Heart transplantation, Physical medal alongside Blenheim Palace in September last sign up: bhf.org.uk/transplant or Like Wendy and Suzanne, a heart active after recovery from heart surgery, activity and your heart, and Get active, year. I got to 3km and I had to stop pop into your local BHF shop during transplant transformed Kyle’s life. “I didn’t although, he admits, “Doing an Ironman stay active. Turn to page 50 for details of my BHF medal” because I had a stitch, but the fact July to collect a transplant donor realise the effect it had on me until I got the is on the crazy side. Competing in the how to order. If you have questions about that you are doing it in memory of form. Don’t forget to tell your loved phone call [saying a heart was available]. Transplant Games or running a 5km are exercise or your heart condition, call our setting her sights high. “The aim someone is a strong force and it can ones about your wishes. It is like wearing ankle weights all the time much more sane and just as rewarding.” Heart Matters Helpline on 0300 330 3300. is to come away with a medal,” power you to the finish line. and when they are taken off, you can jump Suzanne and Wendy agree that gentler she explains. “I hang my gold medal alongside 10 feet in the air.” activities, such as walking, have helped Louise is harnessing this my BHF medal because they Week after week, he could feel himself their recovery. They also pay tribute to Go online competitive spirit in her business, have the same importance on getting stronger. “There is still a part of me the role the BHF plays in research and Go online for our exclusive video of training tips a 60-day fitness and nutritional my mantelpiece.” that almost feels like a child – like I can run support. Wendy, who won a silver medal from Kyle Garlett and Louise Hazel (right), plus plan that she has designed. “If you and jump and play forever.” for cycling at last year’s Transplant Games more detail of all three transplant recipients’ place as much importance on your ≠ For more information about After Kyle’s transplant, he was feeling and has also taken part in a volleyball inspirational stories. bhf.org.uk/HMgames health as, say, an athlete would Louise, visit louisehazel.com.

healthier than he had for years and wanted tournament, has completed our Heart Photography: Laura Alice Hart, Getty

44 Heart Matters bhf.org.uk 45 ACTIVITY ACTIVITY

Walking groups Who: Walking for Health ropes. There are age-specific Cost: £13 a year for What: Free short walks to groups and non-age-specific individuals or £19.50 a year encourage people to get groups (mostly retired for families. You don’t have to active at their own pace. people). be an LDWA member to take Walks range from 30 minutes Where: England, Scotland part in a ‘challenge event’, WALK this way to 90 minutes. and Wales. although it usually offers an Where: England. Cost: £3 a month or £32 a entry discount. You can try Cost: No charge. year for individuals. Joint a few ‘social walks’ for free It’s free and it’s available to everyone – whatever your age. For some, Contact: 020 7339 8541; membership, concessions before joining. a group is the easiest way to get started, says Ruth Ganthony walkingforhealth.org.uk and discounts are also Contact: 01937 586 364; available, and the first three ldwa.org.uk Who: Ramblers walks are free. walking group can give you the Brighton Trek in 26 hours, raising £4,500 A 100km trek won’t be for everyone, What: Ramblers works to Contact: 020 7339 8500; Who: Walk NI kick-start you need to get active. for the BHF. “Elation and exhaustion finally and Gary stresses the importance of little safeguard the places where ramblers.org.uk What: A range of clubs AGary Glazerman, 60, is living proof of overtook us both as we crossed the finish and often. “Never underestimate the short people go walking and offering short (up to five that. Joining a walking group helped him line, hand in hand and close to tears,” he walks,” he says. “When you add them all up, encourages more people Who: The Long Distance miles), medium (five to go from being clinically obese to taking says. “When you throw in the non-stop including walking to and from the groups, to do so. It offers a range of Walkers Association 20 miles) and long walks part in a 100km walk to raise money for us. nature of the walk, which went on through Liz and I walk a marathon a week!” walks, from ‘easy access’ (LDWA) (longer than 20 miles), plus In 2005, Gary took early retirement from the night, it was certainly one of the Gary has now lost three and a half stone. walks suitable for What: Long-distance group an accessible walk scheme a high-pressure job in IT. He weighed 18st most mentally and physically challenging people with mobility walks and ‘challenge events’ for people with mobility 7lb. “I’d let myself go,” he admits. “I was at fundraising events I have ever been Meet new people issues and those (usually at least 20 miles) issues. a bit of a loose end, desperately unfit and involved in. But the one thing that drove Walking for Health provides health walk pushing wheelchairs in rural, mountainous and Where: Northern Ireland very overweight.” us both on was the sponsorship money schemes around England, with the aim and pushchairs, to moorland areas. Cost: Ask individual clubs Gary’s wife Liz persuaded him to try riding on our efforts.” of getting people physically active and ‘technical’, which may Where: England, Wales and Contact: 028 9030 3930; walking and, after about eight weeks, he Gary was born with a defective enjoying the health benefits of walking. require scrambling and Southern Scotland walkni.com realised he was enjoying it. “I noticed that pulmonary valve and several holes in The groups often attract people who have I was able to walk without getting puffed his heart. He has had open heart surgery retired, although everyone is welcome. out and I was starting to lose weight, which three times – twice when he was a child, “We encourage all ages and abilities,” “We might get 50 people at a time, so shoes and you’re prepared for the weather, was a great incentive,” he says. and the third time in March 2012. “The says Gary. “Our oldest walker is about 85, you can always find someone to chat to.” anyone can take part.” strides that technology and surgery our youngest is a three-month-old baby Walking will help you achieve the Walking for Health group walks are free Leading by example have taken over the years have just been brought along in his mother’s arms.” recommended minimum 150 minutes of and you can simply turn up on the day. When he saw a poster asking for Walking for amazing,” he says. There’s a social element, too. “We always moderate-intensity physical activity we “Don’t just think about it; get out there and Health group leaders, Gary was the first to He now feels fitter than ever, which he try to start or finish near a café so we can should all do each week in order to look try a walking group,” says Gary. “Persevere sign up. Six years on, he still leads two walks says helped him make a swift recovery from have a chinwag at the end.” after our heart health. Whether you’re and it soon becomes part of your life. You’ll a week, and typically joins four other group his pulmonary valve replacement two years Gary lives in Harrow, Middlesex, where looking to improve your fitness, meet never look back.” walks. He also does his own walks and likes ago: “I surprised my surgeon with a much there are about 12 organised Walking for new people or just fancy some fresh air, to challenge himself with longer distances. faster recovery than he’d predicted,” he Health groups. Around 200–300 people why not give it a go? “You don’t have to ≠ Walking groups are a great way to train Last year, Gary and his daughter says. “I’m sure all the walking I have been walk every week. “Some of the walks be super fit,” says Gary. “As long as you for BHF treks. Read Carolyn Isaaks’ story at Jacqueline walked the 100km London to doing has played a part in that.” are hugely popular,” he says. can walk, you have a reasonable pair of bhf.org.uk/HMcarolyn.

Gary Glazerman walks a marathon Walk with the BHF a week when you You can get fit while raising funds for our vital research add up all the by taking part in one of our UK hikes and treks. Set £4,500 short group in some of Britain’s most beautiful countryside, these walks he does include a popular nine-mile hike along Hadrian’s Wall for the BHF and the non-stop 100km trek from London to Brighton. Read more on why Gary (left) was determined to The amount Gary complete the 100km London to Brighton Trek for the raised in the London BHF at bhf.org.uk/garysfight. Visit bhf.org.uk/ukhikes to find the right challenge for you. to Brighton Trek Photography: Tim Cochrane

46 Heart Matters bhf.org.uk 47 MEDICAL TERMS JOIN Celebrating an MEDICAL DICTIONARY NEXT ISSUE inspiring mum A Acute coronary syndromes (ACS) A term the heart and circulation – for example THE used to describe a range of problems coronary heart disease (angina and heart Has your doctor got the affecting the heart, including unstable attack) and stroke. right bedside manner? We and granny angina and heart attack. ‘Syndrome’ means a Coronary Artery Bypass Graft An operation to investigate the right approach. set of symptoms that happen together, and treat coronary heart disease. The arteries Plus: Focus on cardiomyopathy, FIGHT ‘coronary’ means to do with the heart. Acute from your chest wall, or veins from your leg, and inspiring stories of ● After the BHF helped Sheila Set yourself a coronary syndrome is a medical emergency. are used to bypass the blocked or narrowed fundraisers and their global fundraising challenge Bavington recover from a heart attack, her family organised a bike Angina An uncomfortable feeling, tightness coronary arteries. This helps to improve the adventures ● Get friends and ride to say thank you or pain in your chest, which can also be felt flow of blood to your heart muscle. family involved in your arms, neck, jaw, back or stomach. The Coronary heart disease When the walls of aving a heart attackD came as a symptoms are usually caused by coronary the coronary arteries (the arteries that ● Raise funds for our “dreadful shock” to Sheila Bavington heart disease. The build-up of fatty deposits supply blood to the heart muscle) become the artery walls. If the atheroma becomes life-saving work and her whole family. Sheila Bavington can narrow the arteries, restricting blood narrowed due to a gradual build-up of fatty unstable, a piece may break off and lead H has had the support She explains: “I’m not overweight, I’ve flow to the heart muscle. It is often brought deposits called atheroma. This can lead to to a blood clot forming. This can block a never smoked or drunk alcohol and I’m a of her family in her recovery on by physical activity, an emotional upset, angina. If a piece of atheroma breaks away coronary artery, causing a heart attack and vegetarian – so I thought I wasn’t really a cold weather or after a meal. from the artery wall, it can cause a blood irreversible damage to the heart muscle. A candidate for a heart attack.” regularly works out at her local gym. Now 69, Angiogram X-ray pictures that show whether clot to form, which could block the coronary heart attack is a medical emergency and can It was a frightening experience for Sheila. she says that in the three years since her heart the arteries are narrowed and, if so, how artery and starve your heart of blood and lead to a cardiac arrest. “At the time I thought I wouldn’t survive,” she attack she’s felt better than ever. narrowed they have become. A coronary oxygen. This is a heart attack. Heart failure A condition where the says. “My mother died of a heart attack at the Earlier this year, Sheila’s children and angiogram examines the coronary arteries heart becomes less efficient at age of 49, so I thought a heart attack meant grandchildren organised a sponsored – the arteries that supply the heart muscle Diabetes A condition in which glucose pumping blood around the body. See p22 you would die straight away.” bike ride in their local country park in with blood. D (sugar) levels in the blood are too high. High blood pressure (hypertension) But within minutes of arriving at University Warwickshire, raising more than £1,000. Angioplasty A treatment to widen a There are two main types of diabetes: type High blood pressure is when your blood Hospital Coventry, Sheila was being treated Her daughter, Julie Kelly, says: “This is our narrowed artery. 1 where your body stops producing insulin pressure is consistently higher than the with an angioplastyD and stentD procedure to way of giving something back for all the good Atrial fibrillation (AF) A common and type 2 where your body is unable to recommended level. The higher pressure unblock her coronary artery. work that the BHF does.” arrhythmia (abnormal heart use the insulin that is produced effectively, puts extra strain on your heart and blood She says: “I would like to thank all the “My mum’s heart attack came like a bolt out rhythm) in which the atria (the usually because excess fat in organs leads vessels, and over time can increase your risk See p18 doctors and nurses who helped save my of the blue. It was such a shock but Mum is upper two chambers of the heart) to resistance to normal effects of insulin. of having a heart attack or stroke. life. And the BHF for all the progress it has a fighter against all odds and a fantastic role beat in an irregular pattern. Fibrillation Having diabetes increases your risk of contributed to over the years. My generation model to other heart attack survivors. means ‘quivering’ or ‘twitching’. People developing cardiovascular disease. Pacemaker A small device that is is surely blessed.” “The BHF has been such a support and she is with atrial fibrillation have an irregular and P implanted just under the skin on The experience has inspired Sheila to overjoyed and very proud that we’ve raised so sometimes fast pulse. Echocardiogram A test to examine the chest and is connected to your heart make sure she follows a healthy diet, and she much money for this very worthy charity.” E the structures within the heart, for by one or more wires. It monitors the Bypass surgery See Coronary Artery example the heart valves, and to see how electrical signals within your heart and can B Bypass Graft. well the heart is pumping. stimulate the heart to contract and produce Electrocardiogram (ECG) An ECG is a simple a heartbeat. Walking to remember friends Cardiac arrest The ultimate medical and painless test to record the electrical Walking the Great Glen Way up of Gordon’s son David, Neil great finishing the walk. We C emergency. This is when a person’s activity of the heart. Small sticky patches Sinus rhythm The normal electrical (79 miles from Inverness to Baxter, Jim Duncan, Jonathan wanted to walk for the BHF as heart stops pumping blood round their called electrodes are put onto your arms, S pattern of your heart. Fort William) was the mission Sheldrick, co-owner of Port so much money is still needed body and they stop breathing legs and chest. These are connected to Stent A short tube of expandable for five tenants and staff Ban, and his wife Nelleke. They for research into heart disease. normally. Many cardiac arrests a machine that picks up and records the stainless-steel mesh, which is inserted at Port Ban Holiday Park in were thrilled to raise £2,500. Raising the money for BHF in adults happen because the electrical signals that make your heart beat. into an artery to hold it open after an Kilberry, Argyll. Nelleke says: “It felt really was fun; it’s an organisation See p16 person is having a heart attack. angioplasty. This improves the flow of blood Inspired to They were walking in everybody has heard of and Cardiomyopathy A disease of the heart Heart attack The medical term for a through the artery. memory of best friends most people have had a muscle in which the heart muscle becomes H heart attack is a ‘myocardial infarction’, Stroke An interruption of blood flow to part raise funds? Archie Neil, 62, and friend or relative affected by weakened. The heart muscle may become or ‘MI’ for short. This is when there is a of the brain, that causes brain cells to die To help us fund more Gordon Austin, 51, heart disease, so they were all thickened, enlarged and/or stiff, depending sudden loss of blood flow to a part of the or become damaged. This happens if an crucial research, tenants of the holiday willing to sponsor us. on the type of cardiomyopathy. It affects heart muscle. Most heart attacks are caused artery carrying blood to your brain becomes call 0300 330 3322 park who died within six “Thanks to all our sponsors; people of all ages and is usually inherited. by atherosclerosis, which is the gradual blocked, or if an artery bleeds into your months of each other, tenants at Port Ban Holiday Cardiovascular disease (CVD) All disease of build-up of atheroma (fatty material) within brain. A stroke is a medical emergency. or go online at both of heart attacks. Park, our local community bhf.org.uk/fundraise. The group was made and friends and family.” Call the Heart Matters Helpline on 0300 330 3300 if you want to know more

48 Heart Matters bhf.org.uk 49 BHF SUPPORT

Use our booklets, DVDs and information sheets to help you improve your heart health and get support on living with a heart condition. To see the whole range of guides, order the Take heart (G5) catalogue Interested in eating healthily on a budget? Find our four new films at ORDER YOUR FREE GUIDES bhf.org.uk/budget Healthy eating and lifestyle Be active for life (physical activity information for over-65s) G364 Lifelines: heart surgery and after (DVD) DVD10 Coping with stress G187 Living with heart failure HIS8 Cut down on salt G160 NEW Medicines for your heart HIS17 Eating well G186/0214 My progress record (a manual to keep important information Get active, stay active G12 about your medication, test dates and results) M92M Guide to food labelling G54 One step at a time – living with heart failure (DVD) DVD5 Healthy living, healthy heart Pacemakers HIS15 (information for African Caribbean communities) G532 Peripheral arterial disease HIS16 Healthy meals, healthy heart (South Asian recipes) G6 Physical activity and your heart HIS1 Keep your heart healthy HIS25 Primary angioplasty for a heart attack HIS26 Looking after your heart Reducing your blood cholesterol HIS3 (information for South Asian communities) G223 Returning to work with a heart condition HIS21 Put your heart into walking G26 Statins (information sheet) IS66 NEW Risking it – short films designed Test for heart conditions HIS9 to help you tackle risk factors DVD21 or bhf.org.uk/riskingit NEW The road ahead – your guide So you want to lose weight… for good M2 to heart tests and treatments DVD30 or bhf.org.uk/videos Stop smoking G118 Warfarin (information sheet) IS67 Traditional foods – healthy dishes (African Caribbean recipes) G503 Your heart, our help G598 Get your free booklets Women and heart disease M37 ● Take the 10 minute challenge Small changes to your daily life can make a Living with a heart condition big difference to your heart health An everyday guide to living with heart failure G275U These quick guides to healthy eating, being active, quitting smoking, reducing Angina HIS6 stress and managing your blood pressure all Atrial fibrillation HIS24 include a challenge chart to help you make, Blood pressure HIS4 and track small, sustainable changes. Cardiac rehabilitation HIS23 ● Artie’s safari adventure Caring for someone with a heart condition HIS20 Get the grandkids moving with the help Coronary angioplasty HIS10 of Artie Beat. He and his friends travel to

FIGHT Africa to teach the animals all about the FOR EVERY Diabetes and your heart HIS22 HEARTBEAT 1 importance of 60 mins of activity a day to bhf.org.uk Having heart surgery HIS12 help them be fit and healthy. G383 ARTIE’S Heart attack HIS7/0314 MUSEUM ● Artie’s museum adventure ADVENTURE Heart rhythms HIS14 Artie and his friends help save the museum NEW Heart to heart: heart disease and from closure by searching for a priceless your emotional wellbeing G954 ruby, they learn all about how the heart and

FIGHT body work as they go through the museum FOR EVERY Heart transplantation HIS13 HEARTBEAT bhf.org.uk Heart valve disease HIS11 looking for clues. G385 1 Implantable cardioverter defibrillators (ICDs) HIS19 Order now at bhf.org.uk/ten or ring 0870 600 6566

Order your free guides by calling 0870 600 6566 or visiting bhf.org.uk/HMpublications 50 Heart Matters Stir-fried tofu 100g (3½oz) dried rice noodles or dried medium egg noodles with pak choi (standard or wholewheat) Oriental flavours sing out in this simple dish 1 tsp cornflour Preparation time: 20 minutes 6 tbsp water (or homemade or reduced-salt vegetable stock) Cooking time: 15 minutes 2 tsp reduced-salt soy sauce Serves: 2 2 tsp smooth hot chilli (dipping) sauce or sweet chilli sauce 2 tsp rapeseed oil

Each portion contains: 4 spring onions, thinly sliced Energy Sugars Fat Saturates Salt 1 fresh red chilli, deseeded and finely chopped 1515kJ23% 10.2g 8.1g 0.8g 0.5g 359kcal Low Low Low Low 1cm (½in) piece of fresh root ginger, finely chopped 18% 11% 12% 4% 8% 1 clove garlic, finely chopped (optional) % = an adult’s reference intake 1 red or orange pepper, deseeded and sliced 175g (6oz) firm (original) tofu (drained weight), drained and diced 140g (5oz) pak choi, shredded 85g (3oz) mangetout 1–2 tbsp chopped fresh coriander (optional) 1 Cook (or soak) noodles according to packet instructions. Drain well (rinse, if necessary). Keep warm.

2 Meanwhile, in a small bowl, mix cornflour with water until smooth. Stir in soy sauce and chilli sauce; set aside.

3 Heat rapeseed oil in a non-stick wok. Add spring onions, red chilli, ginger and garlic (if using); stir-fry over a medium-high heat for 1 minute. Add red or orange pepper; stir-fry for 2–3 minutes. Add tofu; stir-fry for 4–5 minutes or until tofu is beginning to brown in places (stir-fry gently at this stage, being careful not to break up tofu). COOK'S TIPS 4 Add pak choi and mangetout; stir-fry for about 2 minutes or • Swap the mangetout or pak choi for beansprouts or until vegetables are lightly cooked. Add cornflour mixture to wok; lightly cooked small broccoli florets. stir-fry over a medium heat for 1–2 minutes or until mixture is • Sprinkle the stir-fry with toasted sesame seeds, just before thickened and bubbling. you serve. 5 Add cooked noodles to stir-fry; toss to mix. Stir-fry for about Pak choi is simple to grow if you have a garden or veg plot. • 2 minutes or until noodles are hot. Remove from heat; stir in coriander (if using). Serve immediately. Quick tomato salsa Herb-breaded fish 2 spring onions, finely chopped 2 or 3 ripe tomatoes (about 225g/8oz total weight), skinned, with sweet potato deseeded and finely chopped 1 tsp olive oil 1 tbsp finely shredded fresh basil wedges Freshly ground black pepper, to taste Sweet potato wedges and tomato salsa bring a fresh twist to this healthy and sustainable version of fish and chips Sweet potato wedges Preparation time: 25 minutes 1 large sweet potato (about 450g/1lb), scrubbed or peeled Cooking time: 30 minutes 2 tsp olive oil Serves: 2 A good pinch or two of dried thyme

Each portion contains: Herb-breaded fish Energy Sugars Fat Saturates Salt 55g (2oz) fresh wholemeal or white breadcrumbs 2050kJ23% 16.5g 12g 2.3g 1g 487kcal Low Low Low Low 1½ tsp finely grated lemon zest 24% 18% 17% 12% 17% 2 tbsp chopped fresh flat-leaf parsley % = an adult’s reference intake ½ tsp dried crushed chilli flakes (optional) 2 thick-cut sustainable skinless white fish fillets, such as pollock (about 140g/5oz each) 1 egg, beaten 1½ tsp olive oil 1 Preheat oven to 200ºC/180ºC fan/gas mark 6. Combine all salsa ingredients in a bowl. Cover; set aside until ready to serve.

2 Cut sweet potato in half widthways, and each half into 8 wedges. Place in a small, shallow, non-stick roasting tin. Add olive oil, thyme and black pepper; toss to coat wedges all over. Spread out in a single layer. Bake for about 30 minutes, turning twice, until wedges are tender and tinged brown along edges.

3 Meanwhile, for fish, combine breadcrumbs, lemon zest, parsley, chilli flakes (if using) and black pepper in a shallow dish. Dip fish fillets into beaten egg and then in breadcrumb mixture, COOK'S TIPS turning fish to coat all over. Put coated fish on a lightly greased, non-stick baking sheet; drizzle over olive oil. • Add 1 small crushed clove of garlic to the salsa, if you like. • For the breadcrumb coating, try using orange or lime zest 4 Bake fish in oven for final 20 minutes of potato wedges’ in place of the lemon zest. cooking time or until cooked. Serve breaded fish with potato wedges, tomato salsa and cooked peas or green beans. Heart Matters July/August 2014 If you're not already a member, join for free by calling 0300 330 3300 Piri-piri chicken 4 skinless, boneless chicken thigh fillets Portuguese-style chicken is a great summer sizzler but is also (about 400–475g/14–17oz total weight) delicious all year round 1 small fresh red chilli, deseeded and finely chopped Preparation time: 15 minutes, plus 30 minutes' marinating time 1 clove garlic, crushed (optional) Cooking time: 30–40 minutes ½ tsp dried oregano Serves: 2 1 tsp smoked paprika 3 tsp olive oil 1 tbsp freshly squeezed lemon juice Each portion contains: Freshly ground black pepper, to taste Energy Sugars Fat Saturates Salt 1655kJ23% 9.3g 15.3g 4.1g 0.5g 1 red pepper, deseeded and cut into small chunks 394kcal Low Med Low Low 20% 10% 22% 21% 8% 1 red onion, sliced or cut into thin wedges % = an adult’s reference intake 1 Score a couple or so of deep slashes in each chicken thigh using a sharp knife. Combine red chilli, garlic (if using), oregano, smoked paprika, 2 teaspoons of the olive oil, the lemon juice

and black pepper in a bowl. Add chicken thighs; turn to coat all food Sara Lewis; styling: prop styling: Anne Sheasby; Recipes: Tony Hutchinson; photography: William Shaw over. Cover; leave to marinate in a cool place for 30 minutes.

2 Preheat oven to 200ºC/180ºC fan/gas mark 6. Put red pepper and red onion into a small, non-stick roasting tin; add remaining olive oil and toss to coat. Add chicken thighs to roasting tin, nestling them among vegetables.

3 Roast in oven for 30–40 minutes or until chicken is thoroughly cooked and piping hot, stirring vegetables and turning chicken thighs over about halfway through cooking.

4 Serve immediately with crusty bread or flatbreads and a mixed-leaf salad.

COOK'S TIPS • Swap the red pepper and red onion for a yellow pepper and standard onion (or 4 shallots). • Try grilling the marinated chicken thighs over a barbecue. Cook over medium-hot coals until thoroughly cooked through, turning occasionally. You may need to brush the chicken with a little olive oil during cooking to prevent them from becoming too dry. Serve with salad instead of roasted veg. See our May/June recipes for inspiration. Beef and bean burritos This popular Mexican-style dish creates an ideal supper for sharing 2½ tsp rapeseed oil Preparation time: 25 minutes 140g (5oz) lean beef steak (such as sirloin), cut into thin strips Cooking time: 15 minutes 1 tsp hot chilli powder Serves: 2 1 tsp ground cumin 1 small red onion, finely chopped 1 red pepper, deseeded and chopped 227g (8oz) can chopped tomatoes in rich natural juice 220g (8oz) can red kidney beans in water, rinsed and drained 4 soft flour tortillas (each about 20cm/8in in diameter) 6–8 tsp 5% fat Greek-style natural yoghurt (optional) 1 Heat 2 teaspoons of the rapeseed oil in a non-stick saucepan over a medium-high heat. Add beef; cook for 2–3 minutes or until sealed all over, stirring frequently. Add chilli powder and cumin; cook for 1 minute, stirring. Remove beef from pan to a plate using slotted spoon.

2 Add red onion, red pepper and remaining oil to pan; stir-fry over a medium-high heat for 3–4 minutes. Add tomatoes, beans and sealed beef to pan; bubble over a medium heat for 4–5 minutes or until vegetables and beef are cooked and piping hot, stirring regularly.

3 Meanwhile, warm tortillas according to packet instructions.

4 To serve, divide beef mixture evenly between warm tortillas; top each with a little yoghurt, if using. Fold or roll up; serve immediately with rocket or mixed salad leaves.

COOK'S TIPS

Each portion contains: • Skinless, boneless chicken or turkey thigh meat or lean Energy Sugars Fat Saturates Salt pork can be substituted for the beef. 2950kJ23% 15.9g 13.7g 4.4g 1.5g 700cal Low Low Low Low • Swap the red pepper for a yellow or orange pepper. 35% 18% 20% 22% 25% •  Try using Quorn (mycoprotein) or tofu instead of beef. % = an adult’s reference intake Heart Matters July/August 2014 If you're not already a member, join for free by calling 0300 330 3300