If you have a heart attack today, you’ve a better chance of walking out of hospital than ever before. And new stents and new drugs – and a better understanding of how to use them – have combined to increase your chances of still being alive 5 years after your first attack to better than four in five (depending on where you live).*
New results presented at the recent American College of Cardiology meeting in San Diego paint a potentially even rosier future.
All this does presuppose you actually make it to hospital. The first few minutes of a heart attack are pretty dicey, and still the best way to have a long and healthy life is to avoid a heart attack in the first place. For example, following a heart problem, we know that stopping smoking, regular exercise and improving diet quality are associated with better survival and fewer recurrent events.
But people are notoriously reluctant to change their behaviour to decrease their chances of a first, or subsequent, heart attack. Fewer than 5% of patients who have had a heart attack or stroke adopt three healthy lifestyle changes:
- 48% of smokers continue to smoke;
- 65% do not exercise;
- ~60% do not change their diet for the better;
and
- 14% don’t make a single lifestyle change.
These are global numbers; in poorer regions, the adoption of lifestyle changes is even worse.
But hiding in these stats is something that bugs me.
As I walked to work the other morning, a little girl was stepping through the daffodil beds in Goldington Crescent Gardens. Her mother screamed at her to get out, and then went back to her mobile. Passersby turned to stare, and to tut at the girl.
And you know, I thought, if you can’t walk through daffodils occasionally without someone yelling at you then what’s the point?
Because all these healthy lifestyle modifications presuppose that the most important thing is length of life, or length of time before you have to go back into hospital. And the messages we receive from these studies and from health authorities and on Twitter and the like is that living a long time is the most important thing that should ever matter to us, in some kind of frenetic orgy of longevity.
Which ultimately is doomed to failure anyway.
It strikes me that if one were to follow all the recommendations of all the self-appointed keepers of health then our lives might well be longer, but they’d seem a whole lot thinner.
No. Shouldn’t we rather regain our understanding of what it means to be human, of what quality of life means?
Many smokers enjoy smoking and don’t want to quit. Many of us like a tipple occasionally – or even more than occasionally. Some of us are so knackered after a day’s work we just want to collapse on the sofa and cuddle our spouse/children/dog, and perhaps eat a bacon butty. For some, and I suspect most, of us there’d be no actual point in living to 107 if we couldn’t eat meat or smoke or dance or drink or screw. Especially if we lived in those naughty, poorer regions mentioned above.
Now, that wasn’t simply a chance to link gratuitously to a Pulp video. The thing is, some lifestyle modifications are quite enjoyable. But there is as a significant association between myocardial infarction and erectile dysfunction – erectile dysfunction affects at least a third of men who suffer a heart attack, and in some populations it might be as high as 80%.
I don’t think that anybody would disagree that erectile dysfunction has a severe, negative effect on quality of life. So maybe that’s the key to getting people (men, at least) to change unhealthy behaviour. But as I’ve hinted, it’s hard. People find it difficult to change, even with some pretty serious driving motivations. And if you are already finding it difficult to stop smoking, or to give up the bacon and cheese roll habit (and maybe you don’t want to), and then you also find that your sex life is non-existent, you might wonder what is the point at all.
On the other hand, if there was something simple and enjoyable you could do, that would not only reduce your chances of a (repeat) heart attack but also improve your love life, you’d have to be pretty far gone indeed not to have a go at it.
Well, a recent, small study reports that perhaps there is something. We already knew that the faster you walk, the more chance you have of avoiding Death. Now we read that a “progressive outdoor walking” programme in low risk heart attack patients resulted in a rather striking reduction in the reported incidence of erectile dysfunction.
It’s not too difficult to see why this might be so. Purposeful walking is a low-risk activity that slowly but steadily improves cardiac function. From my own experience I know it leads to weight-loss and feeling fitter – since moving house just before Christmas and having a longer trip to the station I’ve lost half a stone.
Walking is great. And it’s something that most men can do relatively cheaply and easily. You need some good shoes, sure, and perhaps a decent hat if it’s raining, but you don’t need lycra or expensive equipment. It’s less dangerous (and sweaty) than running.
It doesn’t have to be an arduous, oh-God-I can’t-be-arsed sort of task. Maybe it’s that excuse to justify getting the dog you always wanted as a kid. And you don’t have to live in the countryside: you could simply decide to walk the long way home. Our towns are full of parks – is there one near where you work? Perhaps you can get off the Tube a stop earlier.
You could even go go for a walk right now. Get up, say “I’m just going for a walk, love” (or “boss”), and do it.
Walk to the pub.
A simple “lifestyle intervention” – sustained, purposeful walking – not only cuts your chance of a (recurrent) heart attack, but potentially makes bedtime a lot more fun.
And you get to see more daffodils. What’s not to like?
*Maths corrected. Thanks to DoctorChris in the comments.
Richard P Grant is a London-based sci/med writer who doesn’t smoke or have a sofa. But he does walk a hell of a lot.
