Learning to listen to your heart

Blog: 4 May, 2021

In amongst the incessant small demands of modern life, it can be easy to forget the big things. Like having regular health checks. Particularly when we’re not feeling unwell; sometimes even when we are. Ask Jenny McAuliffe.

Living on a rural property in WA, Jenny, a former athlete, had been having unusual pains for weeks in her jaw and between her shoulder blades. Despite a family history of heart disease, she was convinced they were just signs of “getting older”. Even when her husband rang the GP who advised her to get to hospital, she insisted they do the 45-minute drive by car. When they arrived she was told she had a heart attack, and prescribed medication. Her story is far from unique.

New modelling by the Heart Foundation shows that if all Australians at high risk of heart disease were treated with guideline recommended blood pressure and cholesterol medications, the nation would avoid around 100,000 heart attacks, strokes and deaths from heart disease over the next five years.

Viewed another way, that’s an estimated 103,137 separate occasions on which Australians like Jenny will find their lives shockingly, perhaps catastrophically, altered by heart attack or stroke – or who will lose beloved friends or family members to a disease that is eminently avoidable – unless we can get to them first.

It’s also a huge opportunity to greatly improve Australians’ quality of life with straightforward, proven interventions that will also save the nation millions of dollars.

Another thing people forget: even if a heart attack or stroke isn’t fatal, it can still trigger profound, sometimes lasting changes. Not all those changes are bad. Some may even be good (I’m thinking of all the Heart Foundation walkers who each week reduce their risk of heart attack and improve their mood and wellbeing by walking in groups or with individual walking plans.) But for others, even the ‘lucky’ ones, heart disease can entail a long, slow recovery that may not always result in a return to the life you lived beforehand, and can include ongoing challenges for you and the people who care for you.

In this sense, each heart ‘event’ sends ripples out into the community of family, friends, colleagues and others whose lives intersect with yours.

An estimated 1.8 million Australians aged 45 and over are now missing out on medications that could prevent heart attack, stroke or other forms of heart disease, or help them manage existing heart conditions. That’s a lot of ripples.

It’s all the more concerning when you consider that many of us have no idea we are even at risk. Yet figures show that upwards of six million Australians have high blood pressure, and that 7.1 million have high cholesterol – both major risks for heart attack and stroke. And these conditions can develop and worsen over time without apparent symptoms. That’s why they’re known as silent killers. And that’s why too many Australians don’t see their doctors until it’s too late.

These concerns have only been amplified during the COVID-19 pandemic when many Australians with heart disease, or at high risk of developing it, have stayed away from hospitals and skipped or postponed medical appointments. This is despite more than two thirds of Australian adults having at least three risk factors for the nation’s biggest killer, heart disease, with one person having a stroke or heart attack every four minutes.

That is why, as part of Heart Week, we’re urging Australians – particularly those 45 and over, or from 30 if you are an Indigenous Australian; and whether or not you are feeling unwell or have a family history of heart disease – to see your GP for a Heart Health Check. It’s quick, painless and, thanks to a long Heart Foundation campaign, covered by Medicare. Apart from checking your blood pressure, doing a blood test for cholesterol and a diabetes check if needed, your GP will ask about your medical history and the heart health of your immediate family, as well as discussing lifestyle risks such as smoking. Your GP will then use this information to calculate your risk of heart attack or stroke over the next five years.

If warranted, your doctor will discuss simple, effective steps you can take to lower your risk, including, in some instances, medications. If Jenny McAuliffe had been on appropriate drugs, she may not have had that first heart attack. Or perhaps the two she has had since. Fortunately, she realised what was happening those next times, and as well as medication has embraced exercise, changed her diet and lost 14 kilos.

The Heart Foundation meanwhile is awaiting a government decision later this year on whether Heart Health Checks, introduced as a temporary MBS item in 2019, will be made permanent. The case seems clear. Our modelling shows that treating all high-risk patients with the medications recommended in the clinical guidelines would also bring huge economic benefits – almost $1.8 billion in gross healthcare savings over five years. Even accounting for the considerable costs of identifying and treating high-risk patients, we would still be $130 million ahead.

Not that this is likely to be of primary importance to the millions of Australians who simply want to get on with their lives: work, play, spend time with the people they care for, get some exercise, follow their passions, and all the other big and small moments of a well lived life.

Which makes it all the more important that if you are over 45, and don’t have heart disease, get yourself to a GP and ask for a Heart Health Check. Not just for yourself, but for all of us.

All up, our modellers predict, getting the necessary medications to the right people at the right time will not only improve our national quality of life dramatically, it will also endow us with an additional 45,000 years lived in good health. That’s a lot of memories.