Dr Ellie Cannon’s Heart Health Q&A
Our resident GP columnist answers the questions she’s asked most in her clinic
QI TAKE daily aspirin to reduce my heart attack risk. But is it worth risking damage to my stomach?
AONCEaspirin was recommended to prevent heart attacks as it thins the blood and makes arteries less likely to fur up. But we know now there is little benefit in taking it daily unless your heart disease risk is particularly high. And, yes, it is known to cause bleeding of the stomach. Q A I’M told I’m at risk of heart failure – does this mean it can stop any time? NO, because the term does not refer to a sudden failure of the heart (that’s a cardiac arrest) but rather a decline in its pumping ability, often due to high blood pressure or faulty valves. It is a serious condition, though, and if you have high blood pressure, you’ll need drugs to lower it. Symptoms include breathlessness, fatigue, and heart palpitations and swollen ankles due to fluid retention.
QCANI take an online tests to find out my heart attack risk?
ANOTexactly. There is a five-minute online heart age test launched by Public Health England in 2018. It takes account of age, lifestyle and medical and family history. Then it tells you ways to improve your health. It can’t tell you your heart attack risk, though, as this has to be done by your GP, after an assessment. The online test is free at nhs.uk. QMY
parents died from heart attacks in their early 60s. I am 50, go to the gym three times a week, eat healthily and am slim. Will my genes curse me? AYOUR
parents’ deaths could have been due to their poor diet, lack of exercise or smoking. You are less likely to be affected if you live healthily. If they died due to raised cholesterol, high blood pressure or type 2 diabetes, there may be a genetic element. But these can still be well controlled with medication.
QA FRIEND has an abnormal heart rhythm and is being treated to prevent a stroke. I also get palpitations: do I need treatment?
AATRIAL fibrillation is the most common rhythm problem and causes the heart to race (130 beats per
minute or rather more than 70bpm) and beat irregularly. Turbulent blood flow means clots can form in the heart which travel to the brain, blocking tiny blood vessels and causing a stroke.
Treatment involves drugs to slow the heart and thin the blood. Many people have no symptoms but if you are suffering palpitations, ask your GP for a 24-hour ECG test.
QAFTER ten years on statins for ‘borderline’ high cholesterol, I’ve now been told I don’t need them. Does this sound right?
AFOR years, statins were offered to anyone with high cholesterol to reduce the risk of heart disease. Thanks to many large studies this has been finetuned and we now look more closely at individual risk factors, not just cholesterol, using a risk assessment tool called QRISK, which also takes into account many other things.
If you’ve already had a heart attack, have a QRISK score of more than ten per cent and type 2 diabetes or kidney disease, you need a statin. For everyone else, they are no longer routinely prescribed. Patients are instead urged to make lifestyle and dietary changes. Q A WHAT is a heart murmur? How do I know if I have one? WHEN a doctor listens to a heart it should have a very consistent and rhythmic 1-2 1-2 1-2 sound – triggered by the heart valves as they open and close.
A murmur is unexpected noises in addition to this, or instead of it. A heart murmur may be innocent, but can indicate a leaky or narrowed valve which puts extra strain on the heart.
Heart valve disease would be diagnosed on an echocardiogram which visualises the structure and function of the valves.
QEVEN though I am a healthy weight, I’ve been told I am still at increased risk of a heart attack. Why would this be?
AWEIGHT is an important risk factor for heart disease but it is not the full picture. Even in someone who is a healthy weight, a higher waist circumference or lack of exercise could contribute to risk, as can smoking, family history, age and other diseases, such as rheumatoid arthritis.
Don’t forget, high cholesterol and high blood pressure also occur in those of a healthy weight, so when it comes to heart disease, the scales can be falsely reassuring.