The heart is one of the most cherished organs in the body.
It is the source of love and life, but it is also one of the most commonly neglected and mistreated body parts.
The 20th Annual R.W. Gunton Symposium on Cardiovascular Therapeutics held Sept. 16 at University Hospital explored prevention strategies, risk factors and management strategies for cardiovascular events, such as heart attacks and stroke.
Going Mediterranean is more than just a travel choice, it is the key to good heart health, says David Spence, a neurologist and scientist at the Stroke Prevention & Atherosclerosis Research Centre at Robarts Research Institute.
Spence says eating a Mediterranean diet significantly reduces the risk of heart attack, stroke and other cardiovascular events.
This means, start chomping down on whole grains, fruits, vegetables and beans, legumes and nuts, use olive oil, cheese and yogurt for daily meals. What is missing from this list and what should be eaten in moderation (weekly or monthly) are fish, poultry, eggs, meats and sweet items.
“The low-fat diet is not the answer,” says Spence. “The best diet … is the Mediterranean diet. Human beings are not meant to eat meat every day.”
Instead of turning to medication for the prevention of cardiovascular events, Spence encourages everyone to look to Mother Nature for treatment.
“Mother Nature has a bigger pharmacy than all the drug companies,” he says.
“Nutrition is really important. It’s not just about weight … it’s about the kinds of foods we eat. By following a Mediterranean diet and starting to learn how to make it enjoyable, what patients can do about their diet is more than what their doctors can do.”
The other side of the coin is to examine how much physical activity a patient receives, adds Robert Petrella, a professor and Ivey Research Chair, Program Leader of Aging, Rehabilitation and Geriatric Care at Western and Lawson Health Research.
Just like prescribing medication, doctors treating a patient at risk for cardiovascular disease should write a prescription for exercise, says Petrella.
“Exercise does just as well as most pharmacological interventions in trying to reduce the risks after the (cardiovascular) event,” he says.
When he surveyed family physicians, Petrella found most did not give a written prescription for exercise. Family physicians should prescribe at-risk patients to participate in 30 minutes or more of moderate intensity exercise, seven days a week.
Patients are more likely to comply with an exercise program if it is prescribed by the doctor, he adds.
Another piece of the puzzle and one of the areas that would have the most significant impact on reducing a patient’s risk for a cardiovascular event is smoking cessation.
Andrew Pipe, Medical Director of Minto Prevention and Rehabilitation Centre at the University of Ottawa Heart Institute, says although attitudes towards smoking have changed, clinical approaches are still in the past.
It is not enough to treat a patient for cardiovascular diseases and then refer them to a family physician to discuss a smoking cessation program, he says. Every time a patient is hospitalized should be seen as an opportunity for doctors to begin a smoking cessation program.
Hospitals have also fallen short of helping patients deal with a tobacco addiction because in spite of legislation prohibiting smoking in public places, a designated area has been set up outside most hospitals to allow patients and staff to continue their habit.
Pipe says hospitals “should be scandalized” to see a crowd of people, many of them patients, standing outside in the cold and lighting up cigarettes. Instead they should consider taking a zero-tolerance approach to smoking, he suggests.
Improvements should also be made to the approach of dealing with nicotine withdrawal and nicotine replacement therapy can be a good option, he adds.
He recommends physicians give clear, strong, personalized, unambiguous and non-judgmental advice, offer assistance and match this with an institutional system of best practices.
“If we can help a person deal with a tobacco addiction, we eliminate a risk factor,” says Pipe.
Other speakers discussed risk factors and risk factor management, and secondary prevention for patients who have suffered from heart attacks.
The symposium is named after Ramsay Gunton, a Western medical school graduate who specialized in cardiology and served as professor and Chair of the Department of Medicine until 1975. He was actively involved in the planning of University Hospital and Robarts Research Institute, and he was a former President of the Royal College of Physicians & Surgeons.
Gunton attended the symposium and provided a lecture on “Advances in the acute management of myocardial infarction: perspectives over a half century.”