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Sorry gentlemen, size does matter. Let’s talk cardiovascular health

Dr Alex Dimitrijevich

When doctors talk about cardiovascular disease (CVD), we’re referring to any disease affecting the heart and blood vessels. In Australia, the main types of CVD are coronary heart disease, stroke and heart failure. CVD remains a leading cause of death in Australia, is the most common cause of hospitalisation, and places an enormous burden on our health system. On average, one Australian dies every 12 minutes from CVD.

CVD events are the result of many factors, a perfect storm of poor diet, lack of exercise, high blood glucose, cholesterol, alcohol, genetics… the list goes on. A simple routine check-up with your GP is all it takes to get a grasp of your risk profile. From there we have high quality, evidence based, risk factor modification strategies that can actually prevent CVD, and for those with established CVD, can substantially reduce the rate of future events.

In terms of CVD risk reduction, it’s not just about diet and exercise (well, it sort of is), the best results come from tailoring the approach to the individual – not everyone’s risk factors are the same. We also advocate a multi-disciplinary approach, using other health specialists who can focus on a person’s particular area of need – a teamwork strategy. This allows us, as GPs, to take a more holistic view, and “steer the ship”.

There’s always going to be some people who seem low risk (by traditional assessment) but, through nothing else but bad luck, will still go on to develop CVD. This is a frightening reality of CVD and for people worried about this we have some excellent, innovative, non-invasive testing available for people who wish to take a deeper look into their heart heath. Examples are coronary artery calcium scoring, and coronary CT angiography. Coronary artery calcium scoring can be organised by your GP, although new in Australia, has been used for 25 years in the USA, and can catch those with impending CVD, who otherwise might have fallen through the cracks of conventional risk factor models. CT coronary angiography is a bit different – used by cardiologists for investigation of chest pain, and can assist in deciding whether to progress to more aggressive intervention.

As exciting as these innovative technologies are, a surprisingly low-tech assessment tool is one of the most robust indicators of CVD. It involves no blood test, no fancy CT scanner, and it doesn’t even need to be performed by a doctor – it’s your waist circumference. All you need is a tape measure. Central obesity (belly fat) is one of the most ominous factors when considering CVD risk. For men, waist circumference of over 94cm (37 inches) means your cardiovascular health is at risk.

As a community, it’s time to get serious about our cardiovascular health. So gentlemen, if it’s been a while since your last check-up, you could be at risk. Take the initiative, go ahead and measure your waist – because size really does matter when it comes to your cardiovascular health.

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