February is typically the month we highlight heart disease, paying attention to all the issues involved with this killer of Canadians. And interestingly, we choose to devote the entire month, not just a day here and there, to focus on important messages, advocacy around care and education for the public.
While we may be afraid of breast cancer, passionate about brain health and motivated around osteoporosis, it is heart and stroke that will kill one out of three Canadians each year. That statistic demands our attention, our vigilance and our understanding in order to change that paradigm. We, as a population, are frightened of unknown viral diseases, and rightly so. But let’s not be complacent about our number one enemy, just because it is familiar. We must do better.
So what are the risks and how do we change them?
There are a number of risks we cannot alter. We cannot alter our family history, our genetic risk. We are born of one sex and risks are different for females and males. We cannot change aging as we all inevitably age.
But what can we change? The number one, most important, undeniable truth is that smoking kills. Even one to two cigarettes a day doubles your risk of a heart attack. There is no safe lower limit, no “small amount that won’t kill me,” no “just this once.” If you do nothing further, quitting smoking is the most important heart healthy behaviour I can recommend.
Let’s look at the other risk factors that are modifiable.
Hypertension or high blood pressure (BP) has been known as the silent killer as often patients have no symptoms, unless suddenly it’s very high or very low. Most doctors take blood pressure measurements on every visit for patients over 50. But don’t wait for your doctor. You can take your BP at most pharmacies or you can purchase a home cuff and an automated machine so that there are no surprises. While the number may vary, generally the goal is 140/90 or lower. It is different for different ages and situations but control of BP is essential. If you have high BP and are on medication, please follow instructions!The most perfect drug, well tested and well established will only work if you take it.
Hyperlipidemia or high cholesterol means too much fat in your blood. Partly that is from diet, eating foods that are fatty or from animal sources, about 30 per cent. There is also a genetic component where your liver produces too much cholesterol and even avoiding all animal fats will not have an impact. Yes, there are good components and bad components to cholesterol, the HDL, or high density lipoproteins and the LDL or low density lipoproteins. Bottom line, after much research, you need a low LDL to be healthy. Those with underlying risk, such as a previous heart attack or diabetes, need that LDL to be excessively low so there is less risk of another heart attack. So either through diet, exercise, weight loss or with the support of appropriate drugs, lowering cholesterol lowers risk.
Diet, weight and exercise are a trio of behaviours that seem to me to fit together. Those of us that are at an ideal weight, exercising regularly and eating a heart healthy diet in general are less likely to have a heart attack or stroke. And I absolutely believe that none of us are perfect! We all want to indulge occasionally and that is fine. What is not fine is when that indulgence becomes a regular habit.
We tend to have sedentary lifestyles in North America compared to other parts of the world. We drive rather than walk, we sit at a desk all day and then rush home, perhaps grabbing fast food on the way. Our overall life has become very hectic. But as I have said to patients and in my book, unfortunately, hectic does not equal aerobic. So let’s make some good choices, becoming more active on a daily basis, not just an occasional class at the gym. Let’s meet a friend for an exercise class or dance class or yoga or a hike, not for lunch, which typically starts with bread and butter!
February is heart month and we need to pay attention, as if our life depends on it. And it does.
For more information, this issue is discussed in my book A Woman’s Guide to Healthy Aging. There is also an excellent guide by Dr. Beth Abramson, a well-respected cardiologist at Toronto’s St Michael’s Hospital called Heart Health for Canadians. So no excuses, no accepting the phrase, “I just didn’t know.”
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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