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Changing perceptions: how heart disease conversations with all ages could save lives

Heart disease does not discriminate against age – despite what a lot of patients think. Senior cardiac nurse Philippa Hobson, speaking at the recent RCNi chronic disease study day, discusses the benefits of a cardiac rehabilitation programme

Heart disease does not discriminate against age – despite what a lot of patients think. Senior cardiac nurse Philippa Hobson, speaking at the recent RCNi chronic disease study day, discusses the benefits of a cardiac rehabilitation programme

We know that heart disease results in angina and heart attacks, which can lead to heart failure. It is one of the UK’s biggest killers and remains the leading cause of death worldwide.

If I had a pound for every patient who said to me, ‘My mum smoked for 40 years and she didn’t have a heart attack, so it won’t happen to me,’ I wouldn’t be writing this.


Picture: iStock

People firmly perceive themselves as fit and healthy and, as they don’t feel unwell, they don’t take steps to protect their health for the future. Why would they worry about there not being a bed in emergency care or the critical care unit otherwise – until it’s their turn?

The creeping factor

We desperately need to raise awareness that heart disease creeps up on us and leaves devastation in its wake. We would have the UK population at our fingertips if only they would listen to us and truly consider the devastating impact that heard disease can cause.

Having dedicated my 30-year career to nursing cardiac patients across many disciplines (predominantly coronary care, cardiothoracic surgery and cardiac rehabilitation), I have seen it from all perspectives. I have been fortunate enough to have been part of the amazing developments that have made such a difference to peoples’ lives.

We urgently need to get the message across if we are going to keep people out of hospital and protect their heart health, to avoid life changing events like heart attack and stroke.

Now I work for the British Heart Foundation, I recognise that everything I took for granted in my practice arose from the persistence of scientists in finding causes, treatments and working towards cures. Because heart disease is not currently a curable condition. If you have had a stent/bypass after your heart attack, you haven’t been cured. Regardless of what your surgeon tells you, keep taking your tablets and stop smoking. It might be difficult news to deliver, but it’s the only way people can minimise their risk and reduce their chances of having another major event.

'Invite people between the ages of 40 and 74 for their NHS health check to determine their risk of developing cardiovascular disease'

Silent risk factors

We are in a prime position to act as patient advocates, enabling people to make healthy lifestyle choices. High blood pressure and cholesterol are major culprits as they creep up unawares and are essentially silent risk factors which are directly linked to heart disease. Add onto this that most people know that when they light up their cigarette, eat a huge pizza or slump on the sofa, it’s not keeping them healthy despite their misconception that it helps them relax. We can’t help our age or ethnicity, but discussing a background of a family history will reduce the risk in further generations as medical advances develop even further.

Inviting people between the ages of 40 and 74 for their NHS health check to determine their risk of developing cardiovascular disease – with maybe a text reminder a day before the appointment or a phone call from a GP practice receptionist – will ensure people know they are on the radar and that you, as nurses, actually do have their interests at heart.

Once they have the appointment and know their risk it is time to take on the supportive, motivating role. If they are at low risk we want them to stay that way.

Benefits of a cardiac rehabilitation programme

For those living with an incurable heart condition, encourage them to join a cardiac rehabilitation programme.

You may think I’m biased given my background, but the evidence base strongly supports that the programme significantly reduces levels of mortality, morbidity and hospital admission/readmission from acute cardiac events.

Cardiac rehabilitation is a structured individualised programme, which generally delivers an education and exercise component as well as providing crucial psychological support. This is delivered by a team of experienced cardiac nurses, physiotherapists and clinical psychologists. Far from the misconception that it is always full of older men huffing and puffing their way around an exercise class, this simply isn’t the case. Heart disease doesn’t age discriminate.

RCNi Study Days 2018: Chronic Disease Management


About the author

Philippa Hobson is a senior cardiac nurse for the British Heart Foundation based in Greater London

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