OUT AND ABOUT, FEELING GREAT AND SUDDENLY YOU DROP DEAD: THE SUGAR FACTOR
Are you going to drop dead from a sudden heart attack?
Heart disease is the biggest killer of Australian men, and 25 per cent of those who die from it do so unexpectedly. These men, most of whom are middle-aged, have never had any cause to worry about their hearts. Many believe they are fit and healthy. They exercise and eat well, and while they may have other problems, they have always depended on having a strong heart.
Then out of the blue, they are felled by SUCD – shorthand for sudden unexpected cardiac death. They start experiencing chest pain and within an hour they are dead. As this condition is, by definition, untreatable, the important thing for men to do is to try to avoid it.
But what exactly is it they should try to avoid?
In an attempt to answer this question and determine if there are any special risk factors, a group of researchers conducted a detailed study of all men who suffered a premature death in Tasmania from the beginning of 1987 to the end of 1989. They confined themselves to men between the ages of 25 and 74 and found 178 had experienced SUCD.
Most of these men were in their late 50s and early 60s and none had been treated for heart problems, nor complained of chest pain. The researchers collected information about the men from death certificates, hospital records, necropsy reports, the records of their local doctors and interviews with existing spouses or partners.
From the results men can draw a new warning. Watch out for diabetes! The most significant finding was that diabetes is a risk factor for SUCD.
Figures showed that a middle-aged man who had diabetes was four times more likely to have a SUCD than a man of the same age who did not have the disease.
In fact, the risk is probably even greater than this study implies, because the team’s calculations were based on known cases of diabetes, and there are many men walking around with diabetes who don’t even know they have it.
Diabetes can exist ‘underground’ for 5 or more years before it becomes noticeable, and it is estimated that for every Australian case diagnosed, there is at least one other undiagnosed.
As both diabetes type I and type II (see the section ‘The Silent Killer’ on p. 261 for more information) are risk factors, all middle-aged men should ensure they are regularly checked for signs of diabetes. All it takes is a simple blood-sugar test.
The study also found two other independent risk factors for SUCD: being a current smoker and having a family history of heart disease.
Being a current smoker increases a man’s risk threefold. And risk factors for heart disease don’t just add up, they multiply. If, for example, a man is diabetic and smokes, he does not have a sevenfold risk (four plus three); rather, he has a 12-fold risk.
The usual other risk factors for heart disease, such as hypertension, high cholesterol, high alcohol intake and bad exercise habits, are also risk factors for a SUCD.
To reduce the chance of a SUCD, men should cut out smoking, treat their diabetes and keep their blood pressure controlled. They shouldn’t assume their blood pressure is fine because, like diabetes, hypertension can exist for years without symptoms.
Cardiac disease can be silent too. About 25 per cent of men who have heart disease don’t know they have it. It only becomes obvious when they suddenly go into heart failure or die.
Three times more men than women under the age of 70 have heart attacks. Out of every 10 men who have a heart attack, four will have a cardiac arrest. This means their heart will stop sending blood to their brain. They will stop breathing, lose consciousness and collapse.
The researchers in the earlier study travelled around Tasmania interviewing wives, family and friends about the lives of the men who had suffered a SUCD. This usually took place within 3 months of the death.
The researchers were constantly reminded of how the death of one relatively young man can affect large numbers of people. Many of the deaths occurred at work, and the impact on workmates was profound. One thing workmates tended to recall was the sound of the man falling.
One man died on the toilet, another died as he came through the front door after work. One distraught woman told how her husband got up in the night to go to the toilet and she heard the fall. They lived in the bush and the ambulance took 30 minutes to arrive. He had no chance.
The experience was shattering for the surviving spouses. One woman in her mid-50s was racked with grief and had not left the house for 6 months. No-one could understand why she was not pulling herself together. Her husband, obviously a good man to her and the family, had worked his entire life and they had diligently saved for retirement. They had spent years planning activities for this time and were both looking forward to it tremendously. Then, a month into his retirement, he dropped dead. All their hopes and aspirations were dashed in that instant.
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