Here on Joy 949, you're with Dee Mason on Brekkie. Now, pretty much the second I turned 50, I noticed that what used to be pretty fun dinner party conversations about real estate and movies and sport and all the things I loved turned pretty quickly to progesterone and cholesterol and all the things I didn't know enough about. I think as we get older, we face our mortality and we start to think more about ways to look after these bodies of ours and in particular, critical heart health. Cholesterol is linked, or the C word as we're calling it, is linked to a quarter of all deaths in Australia and it pretty much has no symptoms. I know a lot less about what causes it and how to fix it than my first guest, Dr. Warrick Bishop, who is a practicing cardiologist, a best-selling author, keynote speaker and the creator of the Healthy Heart Network. He has over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. You should see the waiting room. It's absolutely chockers. Dr. Bishop, thanks for joining me on Joy Breakfast. Dee, thanks for giving me the chance to share this morning as part of Cholesterol Awareness Week, which is in fact, I think, why we're having this opportunity to speak. It is indeed. And happy inaugural Cholesterol Awareness Week. Is the reason that we've decided to start an awareness week because people just weren't aware enough or has it just been one of those things that's on the rise? Dee, I think cholesterol has been a blind spot for such a long time. It is. As you say, it accounts or contributes to nearly one quarter of all deaths in our community. And yet we don't seem to give it the airplay it deserves. We have cricketers running around in pink for particular conditions. We have test kits turned up in the mail when we're 50 years of age to look for blood in the... in the stool, but cholesterol kills more than just about any other single condition. And yet it sort of flies under the radar. And as you alluded to, and you're quite right, we don't feel it. It's almost a silent killer. No one walks into my office saying, you know, doc, my cholesterol fills a bit elevated today. Can you help me? We don't feel it. And then these consequences occur. And what we wish we could have done is wind that clock back. have some information and do something about it to prevent the problem in the first place. Well, indeed, I was just saying in the intro there that, you know, I turned 50 and that's when I, you know, I don't know how old you are, but certainly when I turned 50, the conversation seemed to change directly for me and my friends, the menopause and blood-related things and heart stuff. And I just feel that 50 is too late to start the conversation. When's a good time for how do we start educating younger people about the importance of looking after things like a cholesterol? Yeah, look, some really good points there, Dee. First of all, I'm a little bit older than you, so when I get together, I do get the chance to speak with my mates about medical conditions, and that is the way of the world. It's really important to be aware of cholesterol early in your life. So 50 is a great starting point, but even earlier is even better. Hearts for Heart, who are a patient advocacy group, have really been trying to drive this. Cholesterol Awareness Week, they would be putting to people that as you're turning 20, 30, 35, 40, get along to the GP and get a heart risk check. And that would include getting a cholesterol level done. Now, obviously, if you're from a family where cholesterol problems are apparent, where cholesterol has been high, where people have been having heart attacks at a young age, then that would be a real flag to get along sooner rather than later. In my own practice, in my own sort of view of the world, I think a bit like we do a blood cancer screening test for colon cancer at 50 years of age, I think there should be a rite of passage for men and women with a heart scan. So one of the things that I'd be advocating... The vast majority of my patients to be considering is as men turn 45 to 50, they can get a heart scan. We call that a calcium score. As women turn about 55 to 60, they can get a heart scan, a calcium score. And that difference in age is not a sexist thing. It's just that women follow men by about a decade when it comes to heart disease. It's the other way around for osteoporosis. That heart scan... The GP can help you with that. So to interrupt Warrick, does that mean that I can go to my GP and say, I'm 55, I'm due my heart calcium scan? Can I go and order that? And is that a Medicare rebated service? At the moment, Dee, it's not Medicare rebated. They're about 300 bucks, something like that. They're literally in the order of a few hundred bucks, slightly different prices around the country. But for a few hundred bucks, it's cheaper than getting your car serviced. And it's the single most important engine in your entire life. In fact, one of the things that I've done as the Healthy Heart Network is create a web platform called virtualheartcheck.com.au, virtualheartcheck.com.au, to allow people who are about those age groups to jump online, put in their characteristics, and purchase a scan in any major centre in Australia without the need to even see a GP or a specialist so they can literally get the ball rolling. That's great. Firstly, let me just reintroduce you. I'm speaking with Dr. Warrick Bishop about Cholesterol Awareness Week, which is this week, and it will run until November 17. Warrick or Dr. Warrick, should we just back it up? Can I ask you the three basic questions? I'm sure you've answered it a million times. Cholesterol, what is it? What causes it? And what are the implications of having it? Really briefly. So cholesterol is what we would call an organic molecule. We call it a form of lipid, which means it's got characteristics, essentially meaning it would float in water. So the organic chemists listening would be able to give a better definition than that. But basically, it's a fat. It's an organic molecule. We all have it, Dee. We all make it. It's part of every cell in our body, and every cell in our body can actually produce it. It's essential for cell integrity. It's really important for moving vitamins around the body. It's really important for hormone formation. It's important for bile acid formation, for digestion. So it's a compound or a chemical that we use broadly in our body. What we tend to think of it in terms of when problems arise is, and you've got to wind back, not just in this interview, but wind back in an evolutionary sense. If you think about it, you and I, and quite possibly a good number of the people listening, when you stop to think about it, are probably past our biological blueprint used by date because our evolutionary DNA was all created approximately three to four million years ago for hominids that were running around two million years ago. where their average life expectancy was about 20-odd years. So we've got a situation where we're living way past that, which means things that were occurring in our body up until 20 years of age 2 million years ago weren't causing a problem, but now they sort of are. And cholesterol falls into that category. And the way I often try and explain it to people is if we think of cholesterol ending up with rust in your... coronary arteries as pipes rusting your pipes think of parking your car by the ocean and that environment of salt air driving rust in your car the longer that car is in that salt air environment the greater the risk of rust forming the further you move that car away from that salt air environment the greater the reduction in risk of rust forming in the pipes Cholesterol is a bit the same. The longer you're in an environment where that cholesterol is elevated, the greater the chances you have plaque forming in the arteries. And conversely, the longer you can run a low cholesterol environment or atmosphere, then the better your arteries are likely to be. So I'm able to move this 55-year-old car away from the sea. By doing what? What are the key things I can do to lower my cholesterol? That's a good thing I'm taking from that is that it is reversible or it is controllable even though you might have a high cholesterol. Absolutely, Dee. If I could scream that out and shout it and shake the world and tell them that the reason why I'm deeply passionate about this and I've really been in this space of preventative cardiology for a decade is because if we can identify high-risk people, before they have an event, we can put in place strategies to reduce that risk. So things like cholesterol tablets will make a marked difference on individuals' risk of heart attack and their likely progression of development of plaque. Things like adding aspirin, being more attentive to blood pressure, being more careful with weight, exercise, stress, diabetes. All these things, once we start to identify people, and this is where getting a heart check becomes really valuable, once we identify these risks, then we can really start to pull that risk profile down and make it more acceptable rather than completely unacceptable and managing or trying to manage emergencies when they occur. Think about your car. You don't drive it around. telling yourself it seems to be going fine. There's no reason for me to worry about it. I'll wait till it breaks down till I get it checked. No, you go and get it checked on a regular basis for the very reason you don't want it to break down. I really, really want people to start to think of their hearts in that way. I mean, I am out of washer fluid and I keep ignoring that signal when it comes up. Yeah, washer fluid won't kill you, dude. But if you could tell our listeners, here's one thing I want you to do for your heart health. What's the one thing to help you look after your heart? What's the best thing to do? Well, if it was one thing, then we'd probably all do it, to be honest, Dee. And I mean, I think if I've got... one frustration with the world, and I'm not having a chip at you at all, but people are always looking for a soundbite to save their lives. Honestly, it's way more complicated than that. But I think it's super important to be aware that you've got to be proactive. So that's number one. Don't be stupid and don't wait to respond to heart health. Approximately 20% to 25% of people, their first exposure to a problem with their heart is a heart attack. Yeah. Now, that's way too late, way, way too late. And of those people that have a heart attack, D, one in six die there and then. Think of Shane Warne. His first experience with coronary artery disease, and this is a tragedy, his first experience with coronary artery disease was dying from a heart attack at 53 years of age. Now, if he'd had a heart scan, a calcium score, as I was talking about before, if he'd had a heart scan at 50 years of age, 45 to 50 years of age, we would have identified rust in his pipes that would have allowed us to put in strategies that would have quite likely altered his future. Well, that's the other thing, Dr. Warrick, is that you can't assume just because somebody's been an athlete or a sportsman all their life or, you know, we've all got stories of somebody who's a wiry, fit-looking person and then you find out they've got crazy high cholesterol. So because it's asymptomatic, you can't assume that you know what's happening inside your pipes unless you go and get your calcium score. Gee, that is so true. And again, if we could really highlight that for your listeners. You can look fit and well on the outside. You can, and we see this, but you can have terrible arteries on the inside. 20% of people who die from coronary artery disease are less than 65 years of age. That's you and me. So it's not an old person's disease. So looking well on the outside is really good, and I'm always encouraging people to exercise. But even in Australia here, we had a high-level Ironman. Dean Mercer, if you remember, he was an Ironman triathlete, very, very fit guy, one of the fittest in Australia, dropped dead at approximately 50 years of age from a heart attack out of the blue. And that's more to do with levels of cholesterol in the blood. And because you don't feel it, you don't know that that rust is occurring. Yeah, I mean, that's, so in terms of who's most at risk, I'm just thinking about, you know, because we're an LGBTQIA plus radio station, and I happen to know that our community bats above its average in terms of smoking, alcohol consumption, recreational drugs, but also fabulousness. So, you know, maybe it evens out. But I think that that must put our community at a greater risk. Look, I think... One of the things I'm doing at the moment, you mentioned I've written a couple of books. I'm actually in the process of writing a book on cholesterol right at the moment, Dee. And one of the things I'm thinking of putting in there to reframe the conversation is altering the way we think about risk. And I think we have to accept if one in four people are being impacted by coronary artery disease, then we have to accept. that everyone is potentially at risk of a heart attack. And then we should be thinking who's at greater risk and then maybe screening those people earlier, checking their cholesterols, as I said, getting calcium scores, getting their GP to follow blood pressure, diabetes risk and so forth. I think we've got to be careful not to assume people are at low risk. I think we have to assume everyone's at risk. and then accept that there'll be risk enhancers. Now, LGBTQI may be a risk enhancer, and being fabulous may be a risk depleter. But I don't care, and neither should the people listening. They should go, wow, one in four, why don't I just get checked? I mean, the numbers for colonic cancer are a fraction of that, and yet everyone gets sent a test kit. Well, should we be lobbying? the powers that be to have this included on the register of free and broad testing? That's in process. I think it will come. There is rebates for certain sort of scans in a similar relation, but there's time required to work that into what we do. In the meantime, because there's a gap, and look, there'll always be a gap between what's available and what's delivered. It's an opportunity for educated individuals. particularly when it comes to scanning, to seek that out themselves. As I said, I've put together a website, virtualheartcheck.com, so that people can actually be proactive independently and do that without the need for a GP or specialist. But equally, they can speak to their GP who may either do that or send them to a specialist for more guidance around that. But that gap will exist for a while. And I think at one stage down the line, we will see calcium scoring become Medicare rebatable. But my strong advocacy is don't wait till that happens because you might have a heart attack waiting for it. That's right. Don't get your car serviced is the message I'm getting. Go and get your body serviced instead. Dr. Warrick, thanks so much for joining us on Joy Breakfast. That website again is virtualheartcheck.com. And also Hearts for Hearts, I think, is a great resource. Hearts for Hearts is fantastic. Brilliant patient advocacy group. They've got resources. At Dr. Warrick Bishop, I've got books, virtual heart check. People can check out whether they want to get a scan. So pleasure sharing with you, Dee. Thank you. And I've got a little track lined up especially for you. This is Young Hearts Run and Free. Dr. Warrick, thanks so much for joining us on Joy Breakfast. It's a pleasure. Thank you. We've had some great messages in, and I'd like to take the time just to share them with you. Paul texts in to say, some intersex people have a predisposition to high cholesterol because of their biology. Now, that's something I did not know, Paul, and I will fact check, of course, with Dr. Warrick, but it might be worth getting on Dr. Warrick again, just to have a chat about issues that might pertain particularly to people in our community. If that is indeed true, then we'd better look into it. This from Little Jase. Why are such important tests so expensive? We're talking about the calcium test that Dr. Warrick was talking about. People on low incomes can't always afford 300 bucks. And why aren't the governments coming forward to include testing? Well, that's exactly what Dr. Warrick was saying. Why are we... I mean, it's important that we get our bowel screening over the age of 50, but he would like this test done for all Australians over 50 as well. As it is, high cholesterol does in fact... contribute to the deaths of one quarter of us. And this also from Daryl with one. Good morning, fabulousness. I've been dealing with cholesterol for many years. I've been taking... Joy! I can't say the brand name. That supplement that tastes a bit orangey that has husks and wheat in it, I think. He's been taking that twice a day and it certainly helped a lot with cholesterol. I did not know that as well. I also take that product and, well, if it's reducing my cholesterol, that is a great thing.