Welcome to my miniseries on understanding and preventing heart attack, but before we get started, I'd like to start with a story.

That story was way back in 2005, was on a weekend day, I was heading to work, and they happened to be a fun run in progress as I was driving. I noticed there was a commotion. In fact, an ambulance and people gathered. I thought they must have been a problem. So, I stopped to offer assistance. I am a doctor after all. It turned out that a man in his early fifties, one of the participants of the fun run, had literally had a heart attack and dropped dead by the side of the road. Obviously, there were two ambulance officers in attendance. There was a front runner who was a doctor, and one who is a nurse who also stopped to offer assistance, and myself. We worked on this man and we were able to get his heart beating again. We got him in the back of the ambulance, he got to the local hospital and received a lifesaving stent.

Now, his story was so notable that he made the front page of the local newspaper just a couple of days later. And, of course, not wanting to be too proud I took that newspaper into work to show the staff what I had been involved with over the weekend.

After all, it was a really good outcome.

My secretary, however, was quick to point out that I'd seen the very same man some 18 months earlier. I was shocked. I went back and looked at the notes and I had reassured this man after a treadmill test that everything was okay, literally to be standing over his dead body some 18 months later.

Well, my name is Dr. Warrick Bishop. I have a serious interest in preventing heart attacks. I'm an author of several books, and I'm on a mission to try and allow you to live as well as possible for as long as possible by preventing heart attack, because I believe that heart attacks are preventable.

I was devastated when I found out what had happened to this man and that I had reassuring literally a couple of years earlier. I'd felt like I'd failed him. I went back and looked at his notes, but really I'd done everything right within the guidelines at the time. It was all we could do- is put people through a treadmill test, but it really challenged me, as you might imagine. I just felt that it wasn't good enough. And I became incredibly aware of how our evaluations at that time in 2003 were potentially costing lives.

That meant that I was open to better ways, new technology, and I started to become more focused on prevention being better than cure. And now I'm convinced that we can do better.

We all know the statistics. They’re enormous. Coronary artery disease is one of the biggest killers in Australia. It takes 50 or more people per day. And every 30 odd minutes we lose another life to this condition. I don't have to go through those statistics with you. There's a good chance you've already been touched either through family or friends with the sadness and the consequences of heart attack. We see the headlines in newspapers all the time. And to be honest, sometimes it's a little bit confusing. We hear about the number of people dying. We hear the statistics, but we also hear these little snippets like eggs are good for you or eggs are bad for you, or blueberries are good for you or blueberries are bad few, or women have a worse cause with heart attack than men. All sorts of information come through. What do we hold on to?

Well, heart attack is confusing and challenging. The question is, could it affect you? Could it affect a family or friend? We see from the media that stars, famous people, get affected, often without warning. We know that heart attack can lead to death but can also lead to being incapacitated. And the biggest question is, could it happen to you or a loved one? We know that over 90 percent of all Australians have at least one risk factor for heart attack. How do we deal with that information? Because heart attack is too common. What does heart attack actually mean? What are the significance of an elevated cholesterol or a raised blood pressure or smoking history or even a family history, for that matter. And why do heart attacks appear to occur out of the blue?

The fun runner, whose story I told you, that man put on his sandshoes that morning feeling well. He was looking to run 10 kilometers. He didn't feel like someone who was going to drop dead by the side of the road during his run. The question I think we need to keep asking is, can we prevent heart attack? And I believe we can. So my goal is to help you to live as well as possible, for as long as possible, by avoiding unexpected heart attack. Because what I've realized after doing this for years is that people can look fit and well on the outside, but still have a heart attack. You've heard those stories. Man walks out of the gym, obviously looking feeling well, has a heart attack and dies. The fun runner who looked fit and well until the moment. I realized that the way we currently deal with evaluating risk is a bit like rolling a die. And I think our lives are more important than to gamble. And I also realize there's a lot of confusion about what the right thing to do is, and what cholesterol means. Should we be on cholesterol lowering tablets?

These are things that are really important and hold us back. I'd go so far as to say there are three secrets to unwrapping and dealing with those issues. One is that technology has changed the way we undertake traditional risk assessment. But not everyone knows about that technology. We know that there are doctors who are just not familiar with using this technology. And that makes sense. When a new tool becomes available, it takes a little while to get used to it.
And the last secret is for you to get the best results, you need the best support, and that includes information and education. Because our current paradigm is what we call a risk calculator, and that takes characteristics or details around an individual and puts into a risk calculating calculator. I've got a picture of one here on the screen. We're here looking at a man who's fifty-three years of age. This is very much like the fun runner, in fact. That blood pressure that's just slightly elevated a non-smoker, a very average cholesterol and an average good cholesterol. No diabetes and a normal ACG. Well, the risk calculator tells us that the risk of heart attack for this man is six per cent over the next five years. And in fact, if you're looking at the picture I’ve got, you'll see that's a green thermometer, which would give us nothing but reassurance.

But if this was the risk calculator I'd used for my fun runner in 2003, and it was wrong. So, what I want to do is talk about how we can do better. And what I want to do is share with you who gets the best advice. I want to discuss with you the sort of test, testing and thinking, that is currently used routinely by NASA astronauts and presidents of the United States in America, and why would you be interested to find out if that was appropriate for you. Because what I want to do is show you a path to your best health. Come and join me in part two of the miniseries to learn how we evaluate risk of heart attack and how we can do better. Let me walk you through the next steps because I believe heart attack is preventable.
Thank you for your attention. Take care and bye for now.

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Hi, my name is Warrick Bishop and I'd just like to make something clear - that the information I'm sharing with you at this stage is to my knowledge as accurate and complete as possible. It is also a representation of my own approach to the clinical situations I deal with with my own patients. It's really important you don't rely on this information in isolation, but that you use this information in conjunction with your own medical practitioner, who really is in the best place to provide you with your specific medical requirements and needs. The intent of this information that I've been providing is really to allow you to be informed and be educated around heart health so that you can get the most meaningful conversation with your medical provider, for your best outcome. I wish you the best of health.

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