The Observer - 04.08.2019

28

The Observer

04.08.19 Health

we have the best evidence for is

probably the Mediterranean diet,

so I use a lot more olive oil, nuts

and healthy fats. That’s something

that I changed based on my

reading of the evidence.

But one important factor as far

as my risk is concerned is that

I’m a  south Asian male, and south

Asians are at an incredibly high

risk for heart disease. That really

hasn’t been recognised much until

recently.

the food we eat is highly

processed, the salt we consume

is so much more than we need,

and there’s so much stress we

experience. It seems like every

fact of life has been designed to

add fuel to this fi re.

What action do you take in your own

life to maintain a healthy heart?

One thing I try to do is run maybe

once or twice a week, although I

could probably do more. The diet

Haider

Warraich

The cardiologist talks to

Kelly Oakes about why

we need to take heart

disease more seriously,

cutting-edge treatments

and how you really can

die from a broken heart

Haider Warr aich is a cardiologist

at Duke University Medical Center

in Durham, North Carolina. His

medical training began in his

native Pakistan, and this autumn

he will join the faculty of Brigham

and Women’s hospital at Harvard

Medical School and the VA Boston

(Department of Veterans Affairs

medical facilities). In his book

State of the Heart, he looks at the

history, science  and future of cardiac

disease, and argues that it has

become an overlooked condition.

People are more likely to survive

a heart attack today, but heart

disease is still the biggest killer

worldwide. Why is that?

In the last few decades we’ve

changed a heart attack from an

almost certainly fatal diagnosis to

one the vast majority of patients

can recover from. However, those

advances mean people live long

enough that they develop other

conditions, including heart failure,

which is a chronic condition in

which the heart is unable to get

blood to the entire body.

What kills people today is

chronic disease. Unless we change

our health system to focus on

chronic diseases, and have contact

with patients throughout their

lives rather than just waiting for

them to get sicker, we’re going to

keep having this disconnect.

What’s the biggest advance in heart

health you think has gone unnoticed?

Until recently, open heart surgery

was the only way that you would

treat a condition called aortic

stenosis. The aortic valve is the

last valve in the heart that blood

has to fl ow through to be able

to get to the rest of the body. As

we get older, it starts to thicken

and harden. That increases the

amount of pressure the heart has

to beat against to force blood into

the body, and can cause a lot of

strain on the heart.

But the last decade has seen the

development of a new procedure

called transcatheter aortic valve

replacement (TAVR ). Cardiologists

are able to replace the valve through

a minimally invasive procedure.

They insert this valve through the

veins in your leg and snake it up

all the way to your heart. Recently

Mick Jagger got this procedure

done and just days after he was

back touring, he was dancing – you

would have no idea that he’d had

this performed.

You suggest that one reason

people don’t take heart disease

seriously is because they think

that when someone gets heart

disease it’s their own fault. How

much does diet feed into our

heart health?

For many patients it’s not

something they have any control

over. For example, if a woman who

gave birth develops postpartum

cardiomyopathy, there’s nothing

she could have done to avoid it.

At the same time, there’s a lot

of heart disease for which you

can reduce the risk by instituting

lifestyle changes. We do everything

in our modern lifestyle to hurt the

heart: there’s very little aerobic

exercise in our daily routines,

Main picture:

Haider

Warraich. Inset:

Mick Jagger on

stage last month,

following heart

surgery in April.

Shawn Rocco/

Duke Health;

Rex/Shutterstock

the food we

processed,

is so much

and there’s s

experience. It

fact of life has

add fueltothi

What action do

life to maintain

One thing I try

once or twice

could probabl

n picture:

der

raich. Inset:

k Jagger on

e last month,

wing heart

ery in April.

wn Rocco/

e Health;

Shutterstock

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