digest

heartuk.org.uk

2619 December digest .indd - Heart UK

December 2004

digest

For everyone seeking a healthy heart

In this issue...

News and research 3&4

Conference report: Soy and Health 6

Cardiovascular matters:

more on Heart Failure 10&11

Personal account 13 & 14

Spotlight on ...

Professor Durrington 15

Keep well,

keep

warm

this winter

– see page 4

Seasonal recipes from

around the world 16 & 17

Book review and

reader offer: ‘Adam’s Curse’ 20

No. 94 Volume 18

Hyperlipidaemia Education And

Research Trust UK

7 North Road, Maidenhead, Berkshire SL6 1PE

Telephone: 01628 628 638 Fax: 01628 628 698

e-mail: ask@heartuk.org.uk

website: www.heartuk.org.uk

© 2004 H . E . A . R . T UK ISSN 1741-7864

Charity Registration No: 1003904

Company limited by guarantee No: 2631049

ONLY MEMBERS

WIN PRIZES

See page 5


director’s cut

The Future’s Bright

I wrote back in August 2001 that we, the

Family Heart Association as it then was, had

not come very far in the broad sense. I was

roundly and rightly challenged on this by our

very good friend, Professor Jim Mann in New

Zealand, who, along with Katherine Broome,

was among the early founders of the Familial

Hypercholesterolaemia Association, as it was also

earlier known. In a sense, he was quite right.

The world of medicine, science and research in

our field had indeed come a long way; they had

jointly found the cause, the gremlin in the FH

engine, and had put the FH disorder on the map.

They also significantly marched forward with the

pharmaceutical industry to put well-researched

treatments of lipid disorders on the agenda and

shown their safety and efficacy. Indeed, by the

time I wrote the piece, a similar picture was

emerging globally, and scientists, epidemiologists,

researchers and clinicians were cross-fertilising

their ideas and communications, particularly in

Europe and the USA. But the health professional

cannot alone address the public arena in a

marketing way, and although great leaps had

been taken by a few for many, the potential for

great rewards was largely being neglected.

A little over a year later, Professor Chris Packard

addressed a group of Scottish MPs in Edinburgh

on the continuing disastrous situation regarding

heart disease and the lack of action, particularly

north of the border. “We”, I paraphrase, “all

seem to know there is a problem, and we,

the clinician, and they, the scientists and

researchers, have done all they can to paint

the clear picture; we have pressed the warning

button – ALERT STATE ONE – we have proven

the benefits of treatment and now YOU must

take up the challenge. The reward long term for

so doing is there for the taking.”

Today the future IS bright – not just at H·E·A·R·T

UK, but all concerned are surfing in partnership

the crest of a well-formed steady wave. We have

government funding for FH cascade testing in five

English centres and two other units have joined

the project with their own funding – Cardiff and

Harefield. The concepts of cascade screening

having been so well expounded by Professors

Durrington and Neil in Manchester and Oxford.

We now address early age prevention as one of

the great future potentials for success and we

fund two children’s lipid clinics – one in Cardiff

under the watchful eye of Dr Stephanie Matthews

and Julie Foxton, and shortly one in Birmingham.

We have just had the first informal meeting of

a new Family Support Centre in Birmingham

– linking in to the children’s clinic and one of

England’s cascade testing centres. Patients

gathered to hear that a permanent centre is being

set up and a formal launch will take place in April

2005. These centres will provide patients with a

forum and a place to regularly meet and listen to

presentations by doctors, nurses and dietitians.

We expect two, three or four more centres to be

opened in the UK over the next few years.

We politically address parliamentarians, on

the need to make the public more aware, and

raising the issue of high cholesterol further up

the agenda.

We are addressing the inequality of insurance and

assurance issues detrimentally affecting patients

with diagnosed FH, and following Professor

Neil’s ten year follow-up survey of UK insurance

companies, we expect to see beneficial results.

We are acutely aware of education across

the board; in the surgery, the workplace and

classroom. We ARE getting the message across

– in October there were over 5,000 unique visits

and more than a quarter of a million hits to and

on our website.

Membership of H·E·A·R·T UK is up 50% in the

last year.

Much is still to be done – but it must be done in

a relatively short time or else the weight of the

wave may disappear.

The future is indeed bright, Jim – definitely

bright.

Michael Livingston

Director H.E.A.R.T UK

out and about

Nutrition and

Health Show

On Sunday, 26 September 2004, two of my

friends, our mums and I went to the Nutrition

and Health Show at Olympia in London. It was

a great day out with lots of exhibitors giving

free advice about being healthy, and also free

gifts! My favourite part was a stand that had

a Playstation Two and a Simpsons’ game that

you played by using a bicycle, so you would

get fit and have fun at the same time! My other

favourite part was the African dancing and

exercise. It was so much fun that I’d like to

have them for my next birthday party, although

my mum is worried about what our neighbours

might think about the loud music.

It was a great experience and we didn’t want to

go home. I hope we can go again next year.

Antonia Wightman, age 12

World Heart Day

For the third consecutive year, Sid Barker

of T.H.R.O.B. (The Heart Rehabilitation

Organisation Berkshire) organised a successful

Healthy Heart Display in Maidenhead town

centre to mark World Heart Day on 25

September 2004.

Visitors were able to have their cholesterol,

blood pressure and body mass index measured

and to receive follow-up information and

advice from H·E·A·R·T UK and the local

Asian Women’s Health Support Group. There

were also resuscitation demonstrations

throughout the morning (thankfully only on the

‘Resuscianne’ model!)

Page 2 digest

December 2004


news and research

Childrens food bill campaign

Call for AAA screening

In the Public Health White Paper, it is said that

the Government will set out its preferred option

for voluntary controls on junk food advertising

to children. But Sustain’s Children’s Food Bill

campaign argues that each year that legislation

is delayed, an estimated 40,000 children will

become obese.

It is now more than ten years since Sustain

first called upon the industry to show social

responsibility in its food promotion to children,

a call which has recently been repeated by

the Food Standards Agency (FSA) , the House

of Commons Health Committee and the Chief

Medical Officer. However, in spite of the

overwhelming support from parents and health

and obesity charities, industry has probably

increased rather than restricted their unhealthy

marketing to children.

The Children’s Food Bill was introduced to

Parliament by Debra Shipley MP in May this

year and is already supported by 241 crossparty

MPs and 122 national organisations. The

Bill will introduce a range of statutory measures

- rather than ineffective voluntary rules - which

will improve children’s food, children’s diets and

their current and future health. These include:

• protecting children from the marketing of

unhealthy food and drink products

• improving standards to ensure that all school

meals are healthy

• banning the sale of unhealthy food and drinks

from school vending machines

• teaching food education and practical food

skills, such as cooking and growing, to all

children

• ensuring the government promotes healthy

foods, like fruit and vegetables, to children

Charlie Powell, Campaign Co-ordinator at

Sustain explained, “Junk food advertising to

children is intense, relentless and exploitative

and the Government should legislate now. The

Children’s Food Bill would not only protect

children, but also provide a level playing field

for all food companies.”

www.sustainweb.org

MPs have backed a proposal submitted

by the The Men’s Health Forum (MHF) for

the introduction of ultrasound screening for

abdominal aortic aneurysms (AAA) for all men

over 60 years of age.

An aortic aneurysm, a potentially life-threatening

condition, is an abnormal ballooning of the

major artery from the heart, the aorta, and

this weakens the wall of the artery, making

it more liable to rupture. The condition is ten

times more common in men than women and

accounts for some 6000 deaths in men in the

UK each year. Smoking and high blood pressure

are contributory factors.

Research recently reported in The Lancet

showed that screening men over 65 years

reduced mortality from aneurysms by 42%

after four years of follow-up. The condition

can be detected by a simple, non-invasive

ultrasound scan, and if discovered and treated

early, the death rate falls to 3% compared with

more than 50% mortality in those treated for a

burst aneurysm.

Dr Ian Banks, MHF president said:

“Aneurysms kill more men than colon cancer.

Early diagnosis is crucial, as is wider action

to tackle the underlying causes of aneurysms,

especially smoking, obesity and hypertension.

Early treatment is as near a cure as is possible

in medicine.”

For more information:

www.aaasurvivors.org

www.MensHealthForum.org.uk

Ikorel (nicorandil)

Ikorel (nicorandil), an anti-anginal drug, has a

new indication. It has proven to significantly

reduce the frequency of coronary events in

individuals with chronic stable angina. The new

indication was granted following the largest

all-British study of medical outcomes in angina

to date, the ‘Impact Of Nicorandil in Angina’

(IONA) study.*

The study, which assessed 5,126 patients,

demonstrated the ability of Ikorel to significantly

reduce the combined risk of death and major

coronary events in patients with chronic stable

angina by 20%.* Ikorel also provides effective

symptomatic control.

Stable angina is a potentially debilitating

condition and can also be a marker for underlying

serious coronary heart disease (CHD). 25% of all

patients presenting with a first heart attack* have

a history of stable angina.

The cardiovascular benefits of Ikorel were

demonstrated in a range of angina patients at

increased risk, including those with diabetes,

hypertension, peripheral vascular disease,

cerebrovascular disease and a history of

myocardial infarction (heart attack).*

Ikorel is well-tolerated with the most frequent

side effect reported being headache, which is

usually temporary, occurring when treatment

is first started. The drug can be used as a

monotherapy, or combined with other antianginal

therapies such as beta-blockers or

calcium antagonists.

Dr Terry McCormack, principal in general

practice in Whitby, North Yorkshire, and deputy

chairman of the Primary Care Cardiovascular

Society, commented: “Nicorandil has been

effective in reducing angina symptoms for

some time. The IONA trial showed a reduction

in cardiac events compared to placebo,

which provided the evidence for this new

cardioprotective indication.”

*The Lancet 2002; 359: 1269-75

December 2004

digest

Page 3


more news

“If you knew about flu, you’d get the jab”

A bout of flu can leave you bedridden and could

ruin your Christmas; the flu jab cannot give

you flu but can keep you well this winter. If you

suffer from a chronic illness like asthma, heart

condition, kidney disease or diabetes; have

lowered immunity due to HIV, steroid medication

or cancer; or are over 65 years old, you are

particularly at risk. So if you haven’t already

had your free flu jab, contact your surgery, ring

NHS Direct on 0845 4647 or go to website:

www.immunisation.nhs.uk to find out about

vaccinations now!

You know you’ve got the flu if:

• Your head is telling you that you spent the

night on the town, when you know the furthest

you travelled was to the bathroom and back

• Your neck feels like you might just have

swallowed a couple of golf balls

• Your body aches as if you had spent the

previous day as Amir Khan’s practice

punch bag

• You have to put on your jumper, coat, hat and

scarf just to get into bed, never mind getting

out of it again

• Your head feels like there’s an elephant

trampling around in there

• You’re all wrapped up with the central heating

up high, but you can’t stop shivering

“300,000 people in the UK have heart attacks

each year, and coronary heart disease claims the

lives of over 140,000 people every year, 20,000

of whom will die before they reach the age of 65.

Vitamin E

The recommendation from some doctors

at November’s American Heart Association

Scientific Meeting is to throw out those bottles

of vitamin E. Professor Edgar Miller, from Johns

Hopkins University, presented his research

showing that those taking 400 international

units or more per day of vitamin E had about

5% higher overall mortality rates than those

who didn’t take the supplements. The research

is based on an analysis of 19 previous studies

involving 136,000 patients, although they

included many patients over 60 years old who

had pre-existing conditions.

Most multi-vitamins contain 35 – 40 units of

vitamin E, which, said Professor Miller, the study

suggests might be slightly beneficial for health.

H·E·A·R·T UK recommends that anyone with

CHD visit their GP to discuss having their free flu

jab. Flu is a great cause for concern as it could

lead to more serious complications for those

people with CHD.

This year the pneumo jab (against pneumococcal

infection) is also being offered to everyone

aged 75 and over. The vaccine protects against

pneumonia, meningitis and blood poisoning and

can be given at any time of the year.

The Department of Health has also launched a

campaign to help older people “Keep Warm Keep

Niaspan

Preliminary results from a study presented at

the American Heart Association (AHA) scientific

sessions show that by combining Niaspan

(prolonged-release nicotinic acid)* with statin

therapy, progression of atherosclerosis can

be halted. After just 12 months of treatment,

cardiovascular patients in the Arterial Biology

for the Investigation of the Treatment Effects of

Reducing cholesterol (ARBITER 2) study who

received Niaspan and statin combination therapy

had little or no progression of atherosclerosis.

There was also a significant increase in their

levels of HDL cholesterol (HDL-C).

In addition to the results of ARBITER 2, a

second study presented at the AHA offers more

evidence that raising blood levels of HDL-C may

play a larger role in heart disease prevention

Well” over the winter. The campaign aims to reduce

the number of cold-related illnesses and deaths this

winter. Older people, their carers, health and social

care professionals and other vulnerable people

can call a special Winter Warmth Advice Line:

Freephone 0800 085 7000 for practical help on

keeping warm and staying healthy. There is also

a free Winter Guide available from the advice line

with a range of practical tips.

than currently appreciated. A pooled analysis of

17 landmark clinical trials of monotherapy and

combination therapy lipid interventions showed

a direct link between an increase in HDL-C

levels and a lowering of the risk of heart attack.

*Nicotinic acid is a well-established treatment

for raising HDL-C and has been shown

previously to slow progression of atherosclerosis.

Page 4 digest

December 2004


fundraising

Raise funds via the web!

As a charity, H·E·A·R·T UK relies on the

generosity and kindness of you, our valued

members, to ensure that we can continue our

work. We appreciate immensely the donations

you have made over the year, but hope you

won’t mind me sharing a quick and easy

method which you could adopt to support

H·E·A·R·T UK that little bit more.

With Christmas fast approaching, I am sure

many of you will be busier than ever, buying

gifts for the festive season and filling your

shopping trolleys with more groceries than

usual! If, like me, you make use of the internet

to buy goods and services, you may not be

aware of a fantastic site which will donate a

percentage of the money you spend online to

your favourite charity. The great news is that

you are not charged a penny more for the

goods and services you buy but H·E·A·R·T UK

benefits directly.

Intrigued...? This is how it works: by

registering on the website: www.mycashback.

com and entering the referral code: heartuk,

when you are prompted to do so, you can gain

access to over 700 widely-used retail sites

including Tesco, Debenhams, John Lewis,

Argos, Dell, WH Smith, CD Wow, Lastminute

and Dixons. Whenever you make a purchase

online at one of these sites, via mycashback.

com, a percentage of the money you spend

will be given back to you, for you to do what

you will with! You have control of your cash

back account and can, if you wish, periodically

donate some ... or all - if you’re feeling

especially full of seasonal goodwill - of the

money you have ‘earned’ to H·E·A·R·T UK!

Happy shopping!

Emma Buitendag

Membership Manager

Prize winners

The draw for this issue of the Digest took place

last week and the lucky winners are:

Mrs Joan Atherton

2 tickets for a visit to Kensington Palace

Mrs Jill Webb

2 tickets for Chepstow races

Mr David Bayfield

2 tickets for Ludlow races

Miss Suzy Humphries

2 tickets for tapas and champagne at the

Sherlock Holmes Hotel in London

Mrs E M Brown

The star prize of a night for two at the Oxford

Spires Hotel plus English breakfast

Mrs Isobel Powell

A nurse in Halkirk, near John O’Groats, Isobel

won the medical professional’s prize, a copy

of ‘Heart Health at your fingertips’ by

Dr Graham Jackson

Harpenden tyre dealership ‘has big heart’

Local First Stop tyre

dealership, Pan Autos,

has raised almost

£3,500 for H·E·A·R·T UK – in support of one of

its regular customers who had a heart bypass

operation.

Approximately fifty golfers took part in an annual

tournament held at Harpenden Golf Club with

a further thirty people joining them at a special

fund-raising dinner at the club in the evening.

John Tarbox, owner of Pan Autos on Grove

Road, Harpenden, said: “We’ve held a golf day

every year for the past 10 years as a means of

thanking our loyal customers for their support

and to raise money for a good cause.”

“We always ask our customers to nominate

a worthwhile charity. This year one of our

regulars, Tony Herbert, who had a heart bypass

operation eighteen years ago and is now a

member of the charity, asked us to consider

H·E·A·R·T UK. We were only too happy to

oblige as it’s a very worthwhile cause.”

The money was raised through sponsorship,

nearest-the-pin and longest drive competitions,

and a raffle and auction that included many

pieces of motor sport memorabilia, donated by

Bridgestone.

Pan Autos is part of the Bridgestone UK network

of independent tyre dealers.

H·E·A·R·T UK fundraiser Stephen Adams writes:

“The charity is extremely grateful to Tony

Herbert for suggesting us as the beneficiary of

Pan Autos’ charity golf day and we thank them

most warmly for their generous contribution

of £3480 to our funds. We know from past

experience just how much time and effort is

required to run a successful golf day.

Maybe some of our other members can follow

Tony Herbert’s initiative by suggesting to local

organisations they might consider running a

charitable event with H·E·A·R·T UK being the

beneficiary!”.

We would like to record our gratitude to the

management of these establishments for their

generosity in providing these prizes and to Class

Publishing for donating the book, Heart Health.

“ Thank you, H·E·A·R·T UK and the staff at

Goodwood ... for enabling my partner and I to

have such a wonderful day on 12 September.

We even managed to pick a winner!”

Georgina Bell

Christmas Prize Draw

In addition to our regular prize draw for each

issue of the Digest, there is a special one for

Christmas. The prizes will be provided by

our sponsors and will comprise both gifts and

vouchers for redemption at various retail outlets.

Prize winners will learn of their good fortune

before Christmas and details will be published

in the February edition.

As we have said before, if you want to be

eligible for this continuing bonanza of prizes,

you really must become a member. The

benefits are genuinely substantial and the cost

is minimal at £12 per year. Such a balance is

rare nowadays!

Only members win prizes

Stephen Adams

December 2004

digest

Page 5


conference report

Soy and Health 2004

The enchanting city of Bruges hosted an

interesting conference in September on

the benefits of soy in a range of conditions

including cardiovascular disease, osteoporosis

and cancer, cognitive function, menopause

and obesity. This report focusses primarily on

the protective role of soy protein in the diet

against cardiovascular disease.

The ‘modern applications for an ancient

bean’ began with the effects of soy protein on

cholesterol and triglycerides by Dr Maria Lovati

from Milan University, who claimed that the

soy bean diet is the most potent dietary tool for

hypercholesterolaemia. The cholesterol-reducing

effect of soy protein, however, is seen mostly

when cholesterol levels are above 7mmol/L, with

minimal effects, said Dr Lovati, on levels below

6mmol/L. It works by activating the low-density

lipoprotein (LDL) receptor pathway, increasing

the uptake and degradation of LDL-cholesterol.

The soy protein involved in this action (a sub-unit

of 7S globulin) has also been shown, in animal

studies, to reduce triglyceride absorption.

Dr Kurt Widhalm, from the Medical University

of Vienna, went on to discuss the use of soy

in the dietary management of young patients

with familial hypercholesterolaemia (FH). Dr

Widhalm’s research involved comparing a

modified-fat diet (saturated fat reduced by 50%)

with a diet incorporating 15-20mg soy protein

as a meat replacement in eleven children with

FH. There are several hundred genetic mutations

in this condition, and the study found that the

individual’s response to dietary treatment varies

depending upon the particular molecular defect.

In this study the modified-fat diet reduced

cholesterol levels by 5% and in the soy diet a

17% reduction in Lp(a) levels were seen. (Lp(a)

is similar in structure to LDL but also contains

a potential clotting factor.) Dietary intervention

for children with FH usually starts between six

and eight years of age and the diet should not

contain more than 30% fat, said Dr Widhalm.

Dr Stephen Atkin, from the Dept of Diabetes

and Endocrinology, University of Hull, (Hull is

the UK’s ‘obesity capital’) reminded us that

type 2 diabetes increases the risk of death from

cardiovascular disease (CVD) by two to fourfold,

and women with diabetes are four times

more likely to die from cardiovascular disease

than men. Post-menopausal oestrogen depletion

and raised insulin resistance may contribute to

this acceleration of CVD. Type 2 diabetes affects

one in ten older people in the UK and costs a

staggering £1.83bn per year (4.2% of total UK

health expenditure). Of those with the condition,

Page 6 digest

December 2004

7% has cerebrovascular disease, 18%,

abnormal ECG and 35% high blood pressure.

Soy contains complex carbohydrates, vegetable

protein, soluble fibre, oligosaccharides,

phytoestrogens, isoflavones (particularly

genistein and daidzin) and minerals that may

all be beneficial in the treatment of diabetes. Dr

Atkin and his team carried out a study of dietary

supplementation with phytoestrogens (soy

protein 30g/day, isoflavones 132mg/day) versus

placebo, to determine if a dietary supplement

with soy protein and isoflavones affected insulin

resistance, blood sugar (glycaemic) control and

cardiovascular risk markers in post-menopausal

women with type 2 diabetes. Results have

shown that dietary supplementation with soy

phytoestrogens favourably may alter insulin

resistance, glycaemic control and serum

lipoproteins in this group, thereby improving

their cardiovascular risk profile. However,

whether it is the isoflavones, protein or the

necessary combination of both that is active, is

unclear and warrants further study.

Ways of introducing soya into the diet are many

and varied and Angie Jefferson, Consultant

Dietitian from Berkshire, demonstrated some of

them. The popularity of soya foods is growing

in Europe and the USA, encouraged by the

newly introduced health claims on both sides

of the Atlantic for soya protein and cholesterol

reduction. The humble soya bean is a nutrition

powerhouse, said Ms Jefferson, rich in protein,

equal in iron content to red meat, with a

modest fat content and useful amounts of

dietary fibre and calcium. In order to achieve

a health benefit, an intake of approximately

three servings of soya-containing foods is

required each day (25g daily with 6.25g

in each serving). While this may seem very

challenging, the huge range of soya products

now available in supermarkets and the profusion

of good quality recipes for cooking with soya are

encouraging. New habits take an average three

weeks of repetition to become established, and

introducing a new soya option every three to

four weeks should enable motivated individuals

to achieve the recommended intake within three

to four months of embarking on the soya habit.

Soya products include milks, yogurts, cheeses

and desserts, snack bars, grains, beans and

flour, tofu, dried and frozen textured soya protein,

ready meals, meatless sausages and burgers,

tempeh and miso. Soya flour can substitute

usual flour by up to a quarter in baking. Alpro’s

chocolate dessert proved particularly popular

with the children in Dr Widhalm’s study! Calcium

and vitamin D fortified soy dairy products are

recommended for children.

The conference speakers and sponsors provided

much ‘food for thought’ – metaphorically and

literally - during the two days. Between talks,

delegates were invited to sample many soybased

snacks and drinks in the exhibition hall,

and very satisfying they were too ... nevertheless

on exploring Bruges later it was hard to resist

the lure of those wonderful Belgian chocolates!

Gill Stokes

On behalf of H·E·A·R·T UK, I would like to

thank Alpro for kindly sponsoring me to attend

this informative conference.


finance

The Art of Giving

With only a few weeks to go to Christmas

most people are thinking about gifts and

shopping and so while you are in the giving

mood I quite unashamedly want to draw your

attention to some of the most effective ways

of giving to charities.

The Gift Aid scheme is one way that UK

taxpayers can enhance their donations to

charities. Please note, however, that it is only

available to taxpayers so if you do not fall

into that category Gift Aid is not for you. The

scheme is available to all taxpayers which

includes individuals, pensioners, sole traders,

a partnership or a company but here I wish

to focus primarily on individuals. The basic

principle of Gift Aid is that when a taxpayer

chooses to donate to charity the amount

involved is deemed to be made out of income

which has already been taxed. This is why Gift

Aid is not available to non taxpayers as any gift

from a non taxpayer will be made from untaxed

funds. It’s rather like the interest earned

on a bank or building society

account which the investor

normally receives after basic

rate income tax has been

deducted at source.

If Gift Aid is used the charity is able to reclaim

the basic rate tax from the Inland Revenue. For

example Mr A, who is a standard rate taxpayer,

decides to donate £100 to his favourite charity

and informs the charity of his intention. If the

charity does nothing then it will receive just

the £100. However, if the charity asks Mr A

to use Gift Aid for his donation then it will be

able to reclaim the difference between £100

and the gross amount before basic rate tax has

been deducted. With basic rate tax at 22%

the gross amount before tax is £128.20p and

so the charity can reclaim £28.20p i.e. nearly

30% extra on the gift of £100. This is not an

insignificant amount especially when the

gifts are a lot larger. And the beauty

of Gift Aid lies in its simplicity; no

complicated forms but just a short

declaration to complete stating that

you wish to make donations under

the Gift Aid scheme. It probably only

takes a couple of minutes at the

most and one declaration will cover

all the gifts you make for whatever

period you wish, both retrospectively

and in the future. Moreover, there is no

downside to Gift Aid. Not only does the

charity receive more money but also

if the donor taxpayer is in the higher

rate bracket the donor can reclaim the

difference between the basic rate and

the higher rate tax thereby reducing the

tax liability.

Originally Gift Aid did not cover

membership subscriptions and there was

also a minimum amount below which

Gift Aid could not be used. However,

now those rules have been scrapped and,

subject to a few rules, you can now give

any amount, large or small, regular or

one-off and the charity can reclaim

the tax. Donations can also be made

in cash or by cheque, postal order,

direct debit, standing order or debit

and credit card. It can also be used

in association with sponsored fund

raising events such as the London

marathon as long as each sponsor has

made a Gift Aid declaration.

Another form of effective charity giving is the

Payroll Giving scheme. In contrast to Gift Aid

this does not require the charity to reclaim tax

amounts as the gifts are provided out of gross

income. It does however involve cooperation

from your employer. If your employer already

participates in the scheme then just let them

know that you wish to make donations to

charity in this way. It operates by the employer

deducting from your gross monthly salary the

appropriate amount and handing it to a Payroll

Giving agency approved by the Inland Revenue.

The agency then distributes the money to

the charity of your choice after deducting a

small handling charge; however, this charge is

normally no more than 4% or 35p per donation

whichever is the greater and sometimes you will

find that employers are prepared to meet the

charge thereby enabling the charity to receive

the full amount. If your employer has not yet

embraced Payroll Giving then why not ask them

if they would be interested in setting it up. They

may well think that it’s a very good idea!

Finally it is worth remembering that gifts to

charities reduce the value of your chargeable

estate for inheritance tax purposes. These

can be either lifetime or testamentary gifts.

And if you wish to donate investments such

as land or equities which would normally be

subject to capital gains tax in cases where they

have increased in value then such gifts would

potentially reduce any gains and liability.

If you wish to research these topics further then

it’s worth visiting the Inland Revenue website on

www.inlandrevenue.gov.uk/charities/ or calling

their special charities helpline number on 0845

302 0203 between 8.30am and 4.30pm,

Monday to Friday.

Happy Christmas!

Mike Foxton

December 2004

digest

Page 7


globalinx

Spain: Obesity, the contradiction of our developed world. Why?

Obesity has grown along with our plentiful

society, as a condition that bears the clear

manifestation of modern life, and it could be

defined as the result of carelessness combined

with one of the main characteristics of our

society today: “abundance and fullness”;

and also with a lot of ignorance. How is it

possible?

During and after the second world war people

went through years of scarcity fighting to

survive; only natural products were available

with a lot of work and effort, not only to grow

food: wholegrains, legumes, vegetables and

fruits, but to prepare the dough for bread on

the table every day. At that time obesity was

rare. Of course, the better off ate more and

looked in better health than poor people; just

the opposite of what occurs today: “the less

money people have in the so-called developed

world, the likelier they are to be overweight”.

People eat too much high-calorie food and

frequent snacking seems to be the norm

nowadays; after all, from childhood we are

often encouraged to consume too much. We

need common sense to understand that if we

do not exercise and we eat too much, we get

overweight. If we learn to eat healthy food

such as beans, lentils and chickpeas etc.

instead of diets packed heavily with sugar,

salt and fat, which are too light in nutrition,

we will improve our diet and our stomach

will get full earlier. Probably, food and drug

companies, instead of trying to find a magic

food or drug to melt the weight away, should

invest large amounts of money promoting

nutritious health products, and in the long run

everybody will gain.

According to public health experts, today’s

children may historically be the first generation

whose life expectancy is projected to be less

than that of their parents. What a matter of

great concern for us adults, because we should

be responsible for what they eat: but such a

terrible epidemic should require governments’

attention as well. We are not talking about

aesthetic reasons, but about the risk of heart

disease, stroke, diabetes and high blood

pressure, among other illnesses, accounting

for 8% of health costs in the EU. A large

amount of money should be spent in order

to take preventive measures such as lifestyle

changes. Certainly, it might not only help to

control this epidemic but also to improve our

quality of life. School boards should reinforce

healthy eating habits and consider physical

and dietetic care as important as the academic

education, avoiding junk food menus and soft

drink vending-machines - teaching kids to eat

sensibly, be more active, and watch less TV.

Probably the environment created by our

developed and industrialised countries is the

price paid for progress. And here we are,

returning to our initial point: during a time of

scarcity we had to overcome anaemia; in a

time of abundance; obesity, aggravated by a

poor diet and physical inactivity, is going to be

a leading cause of death, which means that

development has encouraged us to ignore such

basic things as moderation, discipline and

solidarity. If mass production of food reduces

prices, then “we should eat less and instead

help those who have nothing but hunger”.

Maria-Teresa Pariente

Fundacion Hipercolesterolemia Familiar, Spain

Email: colesterolfamiliar@terra.es

Web: www.colesterolfamiliar.com

New Zealand: Expanding portions – diminishing health returns

Keeping or attaining a healthy weight is one

aspect of lipid management which many

people find a bit of a challenge. This is not

helped by the current practice of larger “value

added” sizes or special offers on larger packets

especially when it comes to confectionery and

baked goods which are also high in saturated

fat and sugar.

A project conducted in conjunction with

the National Heart Foundation of New

Zealand examined one specific aspect of this

“challenge”, in a situation where alternative

choices may be limited. The study assessed

the availability of single serve, packaged snack

foods, their serve sizes and positioning in

service stations. The study was conducted as

part of a Post Graduate Diploma in Dietetics at

the University of Otago.

Confectionery, muesli bars and biscuits were

compared for size and energy density with

similar multi-pack counterparts available in

supermarkets.

In all 81 chocolate confectionery bars, 35

muesli bar varieties & 26 biscuits were

Page 8 digest

December 2004

collected from 8 service stations to ascertain

the size & nutrient content.

Recent guidelines have recommended that

treats be consumed only 2-3/week and size

of servings limited to approximately 145 kcal

(600 kJ). However, on average, the service

station items exceeded these recommendations

by between 170-250 kcal (700-1060 kJ). A

large sized “cookie” weighing 100gm provided

492 kcal (2060 kJ) and was equivalent to

11 standard sized biscuits. In comparison

two standard biscuits would provide 90kcal

(380kJ), which is within the recommended

treat size. The amount of saturated fat in the

larger products was correspondingly high. A

50gm chocolate bar contained nearly 9 gm

saturated fat and a 120 gm bar over 21 gm

saturated fat.

The range of snacks available clearly has the

potential to negatively affect heart health

especially when healthier alternatives of fresh

fruit, small packets of plain dried fruits or

plain unsalted nuts, plain unsalted popcorn,

suitable low fat savoury snacks or low fat dairy

products are not available.

It is clear that people in a hurry are going to

choose a quick & easy option hence the appeal

of prominently displayed, individual items

which are perceived as “value for money”. The

in store product position may also play a role in

product choice and confectionery, in particular,

was found to be in areas of high foot traffic.

Attempts to change the environment by

providing healthier alternatives & signposting

them, having an energy cap on snacks which

carry the Heart Foundation’s tick of approval,

and generally providing a range of these

products in smaller serving sizes would go

some way to addressing the present situation.

Alexandra Chisholm, University of Otago,

Dunedin, New Zealand

David Monro, National Heart Foundation of

New Zealand, Auckland

Stephen Stevets, Dietitian, Auckland,

New Zealand


globalinx

Netherlands: “Paradigm shifts”

In the years ahead, western health systems

are facing an ever surmounting demand,

mainly due to the steep increase of overweight/

obesity and the ageing of societies. Obesity is

significantly associated with type 2 diabetes

- 70% in those with a body mass index (BMI)*

of 27 and over, hypertension (56% idem) and

high cholesterol (47% idem). Not or, or - but

and, and! Type 2 diabetes - also associated

with Familial Combined Hyperlipidaemia- is

a very complex disease, with a high degree

of co-morbidity, and with a silent pre-clinical

development time of between five and ten

years. More than half of all affected are not

aware of developing a very severe risk, which

is equivalent to manifest cardiovascular

disease. Two out of three people with type 2

diabetes will lose many years of life due to

cardiovascular complications. On average only

one in three with type 2 diabetes get proper

medical treatment. If weight was controlled

equal to or below a BMI of 25, about two out

of three at risk then wouldn’t need any medical

assistance at all! The gloomy outlook is the fast

rise of obesity (and type 2 diabetes), particularly

among the young generation.

Western populations grow older

As the average age of populations in Europe is

growing rapidly (29.5 years in 1953, 37.7 in

2003 to 49.5 in 2053) all western antiquated

health systems and economies will sooner or

later collapse under the spring-tide of demand.

Treatment of rare diseases and prevention and

risk-control of diseases in the third world will

have to suffer because of that. Intervention

and disease treatment, mainly focused at a

late stage of clinical development, is a very

expensive affair with only limited room for real

benefits (about one third of health budgets are

spent in the last year of life). As cell-biology is

developing more and more into an information

science, prevention of diseases in its early

stages will have to become the new mantra. The

second paradigm shift will be a focus -also in

primary care- on the family risk, as opposed to

the individual, as is the current approach now.

In the Netherlands one in four men is not

surviving to pensionable age (all over the

world women are better protected by nature

than men). That situation will not be much

different in other EU-countries. Cardiovascular

disease is the main cause of death in the

western world. So the main strategy will

have to concentrate on how to prevent the

most prevalent population diseases (and

co-morbidity) in their earliest stages. In the

meantime we know that most diseases have a

strong genetic component, so the most likely

effective approach will be to focus preventive

efforts on ‘vulnerable’ families.

A decreasing number of youngsters

to support the elderly

Not only are western populations ageing - they

will also live much longer in this century. By

2075 the average life expectation is expected

to hit one hundred years. At the same time

we will see a steady decrease in fertility and

a declining birthrate. That means that fewer

youngsters will have to provide for much more

elderly, living many years longer than today.

Compared to youngsters, dependency costs

of elderly are about threefold more expensive.

For that reason we cannot afford any longer

to lose young talent and/or experienced brains

unnecessarily. Only with an as large as possible

healthy pool of talent can we attain high

standards of prosperity all over the world.

Health = wealth

Early diagnosis, based on early biomarkers,

and prevention of diseases will have to

become the name of the game. A much more

sophisticated application of ICT in healthcare,

growing impact of life sciences and a much

better informed and empowered consumer will

bring us into a new era of improved health.

This will also dramatically change our lifestyle.

Today’s well supported ignorance of what we

eat, drink and do will be transformed into an

abundance of practical data and integrated

consumer support-systems on how individuals

can achieve and sustain an optimum quality

of life. About, for instance, energy density

and other important health related aspects

of processed food products. That way health

budgets can be employed to cope with

inescapable severe and rare diseases; also

in the third world. The mutual co-operation

of our three organisations as a fore-runner in

Europe for raising awareness and promoting

preventive treatment for those with inherited

high cholesterol, in particular for Familial

Hypercholesterolaemia, will guide us into the

era of preventive medicine.

Bloedlink Foundation in the Netherlands is

wishing you and your family a happy Christmas

and good health in 2005.

Adrian van Bellen, Chair, Bloedlink Foundation,

The Netherlands

www.bloedlink.nl

* Body Mass Index = weight in kg divided by

height in metres squared.

A normal BMI for adults is 20 – 25.

late news

Priority Medicines Project – IAPO urgent plea for patient involvement

London, United Kingdom, 19 November

2004 -- The International Alliance of Patients’

Organisations (IAPO) today urges the Dutch

Government, in its Presidency of the European

Union, to act upon its commitment to involve

patients in research prioritisation and to install

concrete mechanisms for comprehensive

patient involvement. In addition, IAPO

challenges Luxembourg and the United

Kingdom, in their role taking the Presidency in

2005, to ensure that these mechanisms are

implemented and adhered to.

The Conference garnered momentum for

a discussion on how to improve research

prioritisation and the pharmaceutical

innovation process. This momentum must

be harnessed and the recommendations

developed to the benefit of patients, industry,

research and governments. The subsequent

developments of this initiative must ensure that

the commitment made at the Conference is

not forgotten. Patients with long term chronic

conditions and the organisations that effectively

represent them – patients’ organisations – must

be involved in every step of the process – not

just in treatment guidelines but in all health

policy including regulatory processes, because

ultimately the decisions that will be made will

affect patients’ lives.

December 2004

digest

Page 9


cardiovascular matters

Heart failure – options for medica

“Heart failure” is a descriptive phrase that encompasses the symptoms

and signs of cardiac dysfunction. “Symptoms” are the patient’s

experience of the condition; “signs” describes the doctor’s clinical

findings. Symptoms of heart failure include breathlessness, tiredness

and ankle swelling. In addition, it is increasingly recognised that sleep

and mood disturbances may accompany heart failure. During a medical

examination the doctor may find “signs” of fluid retention or cardiac

dysfunction, which include dilation of the veins in the neck, evidence of

fluid in the lungs, enlargement of the liver or ankle swelling.

Heart failure occurs when heart muscle function is abnormal. This usually

affects the left ventricle - the main engine of the heart. Occasionally

other medical problems such as anaemia, thyroid dysfunction, infection

or abnormality of fluid balance may impose a strain on the heart and

precipitate an episode of heart failure.

There are two predominant mechanisms of heart muscle dysfunction. The

first is a reduction in the ability of the heart to contract; which leads to a

decrease in the amount of blood pumped around the arterial system. The

most common cause of such pump (or systolic) dysfunction is previous

heart attack. Rarer causes include viral illness, alcohol excess and very

occasionally familial heart muscle abnormalities.

The other major mechanism is through failure of relaxation of the heart.

This is due to stiffening of the heart muscle. By far the most common

cause of such “diastolic” dysfunction is a combination of age and elevated

blood pressure, which causes a thickening of heart muscle and with this

increased fibrous tissue. As a result normal heart relaxation is slowed,

which means that it is increasingly difficult for the heart to fill properly.

Both “systolic” and “diastolic” heart dysfunction occur in about 2% of the

population, in a proportion of individuals the two mechanisms overlap.

When a patient presents with heart failure it can be difficult for a doctor to

distinguish the exact heart muscle abnormality on clinical grounds alone.

Echocardiography is particularly helpful is establishing the underlying

cause and guiding treatment.

Treatment

Fluid balance

There are two main components to the treatment of an individual with

heart failure. The first is to restore normal fluid balance. In simple terms

this means that the total fluid intake must equal the total fluid loss. In

heart failure there is a tendency to retain fluid; if the net balance becomes

positive, then symptoms of ankle swelling and breathlessness (fluid

accumulation in the lungs) may occur. If too much fluid is lost then people

may become dehydrated and occasionally dizzy, particularly with standing.

To achieve this balance it is best if the patient monitors the amount of

fluid they take in so as to establish for themselves their ideal fluid intake.

In order to encourage fluid loss the majority of patients with heart failure

require a water tablet or diuretic (e.g. furosemide and bumetanide)

which helps the body lose salt and, with this, fluid. An excessive intake

of salt can cause the body to retain fluid and worsen the symptoms of

heart failure. Some medications may exacerbate heart failure by

causing fluid retention; these include certain painkillers

(like ibuprofen) and some of the newer

diabetic medications (the “glitazones”).

It is important to check with a doctor

if symptoms change after a new

medication has been introduced.

Every patient with heart failure should

identify their optimum weight (when

they are in stable fluid balance with no

evidence of fluid retention) and monitor

their weight on a daily basis. If their

weight increases by more than 2-3kg in

48 hours it is likely they are retaining

fluid. Similarly if their weight decreases

by the same amount then they are at risk

of becoming dehydrated.

Specific medicines

The second phase of the treatment of

heart failure is specific to the underlying

cause. For people who have “diastolic”

heart failure the priority is usually to

achieve adequate blood pressure

lowering. Patients with “diastolic” heart

failure are often prone to a fast and irregular heartbeat (atrial

fibrillation). This can make them feel particularly unwell since heart

filling becomes even more impaired as the heart beats faster. Control of

heart rate is therefore important.

The treatment of “systolic” heart failure has been far more thoroughly

investigated. There are four types of medication which have been shown

to improve symptoms and prolong survival in patients with systolic

heart failure.

Page 10 digest

December 2004


l treatment

Angiotensin converting enzyme inhibitors

Angiotensin converting enzyme inhibitors (ACE inhibitors – e.g. enalapril,

perindopril, ramipril), form the cornerstone of the treatment of systolic

heart failure. They act in two ways. The first is by relaxing arteries within

the circulation, which makes it easier for the weakened heart to eject

blood. The second is to switch off hormonal systems, which encourage

the kidneys to retain fluid and salt. These hormonal systems are part

of the body’s natural response to a fall in circulation. However in heart

failure they are switched on inappropriately and over time become

increasingly deleterious to the heart and circulation. The introduction of

ACE inhibitors has transformed the management of systolic heart failure.

Anyone with weakened pump function (systolic heart failure) detected on

echocardiography should be receiving these medications. They are usually

given in conjunction with a diuretic. It is important that kidney function is

checked one week after ACE inhibitors are started or the dose increased

and thereafter every 4 – 6 months.

Beta - blockers

About five years ago further major studies in patients

with systolic heart failure demonstrated even greater

improvement in both survival and symptoms when

patients were given a beta-blocker in addition

to an ACE inhibitor and diuretic. Betablockers

had previously been thought

to make heart failure worse, probably

because they were given at too high a

dose too quickly. What we have learned

is that patients with heart failure derive

great benefit if beta-blockers are introduced at

very low dose and the dose is gradually and

progressively increased.

Like ACE inhibitors, beta-blockers switch off

hormonal mechanisms activated by the body

during a reduction in circulation. They are

usually started under specialist supervision;

care is needed when increasing the dose

and fluid balance must be monitored. It is

not uncommon for patients to feel tired or to

develop minor degrees of fluid retention whilst

starting on beta-blockers. It is occasionally

necessary to increase diuretics for a brief period.

It is very important to persevere with beta-blocker

treatment. Strong evidence has demonstrated the

combination of ACE inhibitor and beta-blocker (with a small dose of

diuretic) not only helps to improve symptoms but also reduces dilation of

the heart that is seen with systolic heart failure. Many of the patients I see

have very dilated hearts when they first come to the clinic. Once they are

fully established on treatment we frequently see that their heart size has

reduced; several also report a great improvement in the symptoms. In the

UK the beta-blockers available are carvedilol and bisoprolol.

It is important to realise that at present we believe that ACE inhibitors and

beta-blockers need to be taken lifelong.

Other treatments

Two further types of treatment have also recently been shown to further

improve survival and reduce the chance of hospital admission for patients

with systolic heart failure. Both work by opposing the same hormonal

system as the ACE inhibitors. The first, spironolactone, was originally

developed as a diuretic. It is particularly helpful in people who continue

to have severe symptoms or have difficulty in management of fluid

retention despite other treatments. Spironolactone is a powerful drug: it

is most important that kidney function is checked on a regular basis. In

my practice I start at a very low dose taken on alternate days so as to

minimise this risk. Spironolactone can occasionally cause breast tissue

discomfort, particularly in men. Where this occurs a recently developed

alternative, eplerinone, can be substituted.

Angiotensin receptor blockers (ARBs) are “first cousins” of the ACE

inhibitors. Very recently one of these, (candesartan), has been shown

to be a useful alternative to an ACE inhibitor where these cause side

effects (the most common being a dry cough that occurs in about 10%

of people). There is also evidence that, in certain patients, ARBs can be

added to patients already on optimal treatment where symptoms remain

difficult to control. Many specialists already prescribe ARBs to patients

who cannot take ACE inhibitors. Whist ARBs do not yet have a formal

license for use in heart failure in the UK; this is likely to change in the

near future.

Conclusion

The medical treatment of heart failure offers several different options,

each with a specific action. Optimal treatment requires co-ordination of

care between the individual and clinicians with specialist skills. There are

several possible combinations of medications, which require supervision

and monitoring.

Increasingly we see the care of heart failure as being a dynamic process

where medications are adjusted, both by the patient and specialist,

according to the status of the patient. To facilitate this there is growing

interest in electronic monitoring systems for patient, as well as the

development of nurses with specialist skills who can support individuals

with heart failure in their own environment.

A further article in the Digest will discuss the organisation of care and

support for patients with heart failure, and address the most recent

medical and technical advances in heart failure including pacemakers and

heart support devices.

HF McIntyre

Consultant Physician, The Conquest Hospital, Hastings

Honorary Consultant Cardiologist, The Royal Brompton Hospital, London.

December 2004

digest

Page 11


personal account

Heart Failure and complementary

Following heart failure in 1998, David describes how he used Reiki

energy healing to help avoid a heart transplant.

Another November

Since leaving the RAF in 1993, I had become a freelance consultant

working mainly in logistics and management development. November

1998 had started out as another ‘normal’ month. There were a couple

of Management Development workshops in Newbury, while most of the

time was spent as part of a project team based in Lancashire, developing

support processes for the Hawk Advanced Training Aircraft facility being

supplied by British Aerospace for the RAF at Newcastle, New South

Wales.

A RAF reunion dinner in London on Friday, 20 November, was followed

by a night in a stiflingly hot hotel room and on Saturday I thought I’d

caught a chill. That evening saw us enjoying dinner with local friends. On

Monday morning I drove the 202 miles to Lancashire. By now, I felt a bit

under the weather: probably a touch of flu or, more likely, as I was not a

heavy drinker, a delayed hangover.

Tuesday morning and I met up with one of the Australians on the project.

As we walked down the road from the car park, I had to ask Arnie to slow

down as I was out of breath. By Wednesday, I had to stop and catch my

breath just walking up one flight of stairs! I resolved to do more exercise.

On the Wednesday night I retired to my hotel room early. Breathing was

now difficult. If I coughed, it was as though I was drowning. Although

dozing, I was afraid to go to sleep in case I coughed in my sleep and

stopped breathing. My one thought was to return home to my wife Sue,

and to be within striking distance of the excellent general hospital at

nearby Aylesbury. I was OK if I sat still - it was moving which appeared

to cause difficulties, so why not sit down - in the car? At 1.30 am I

checked out of the hotel for a pleasant night drive back down the deserted

motorways.

I arrived home at about 6.00 am. Once out of the car, I could barely get

through the front door and slumped gratefully and apologetically into an

armchair. Sue didn’t believe that I had a bad case of flu and called out

our local practice duty doctor. He was round within half an hour. He left

me with some pills and advised that he would be contacting someone.

The ‘someone’ had things moving quickly and by that afternoon I was with

the senior cardiac consultant at Stoke Mandeville Hospital who introduced

me to his ultrasound scanner; and that showed that my heart was making

the funny noises. I did not have flu - I had viral cardiomyopathy and

cardiomyolitis or - in plain language, heart failure.

In no time at all was I whisked through A & E and tucked up in bed on the

cardiac ward, on oxygen, wired, dipped and drugged and feeling rather

surprised at the turn of events November was turning out to be. I was told

that they thought the specialists had seen me in time, but I would be in

the cardiac unit for five days.

The above saga is included in some detail to describe what it felt like for

me to experience heart failure, the speed at which it can arrive and the

deceptively innocuous initial symptoms.

In my case I made a quick recovery and after about 3 weeks rest at home,

I was working in the study writing manuals and back on the road in the

New Year (once I was declared fit enough to have my driving licence

back). Over the next few months I kept taking the pills and going for

regular check-ups.

In June 1999 I flew out to Australia for two weeks to check on progress

with the project at Newcastle. On checking with my GP, he advised that

the trip should not present any problems, indeed with all the additives in

my system, I was probably in better shape than most! Meanwhile, the

cardiac consultant seemed pleased and all appeared stable.

Once more with feeling

A year passed and June 2000 found me scheduled for another trip to

Australia. Although I felt a bit tired, I still went, hoping that a change of

scenery would shake the cobwebs out of the system. However, soon after

my return, I started to swell up and quickly became breathless. When we

were out shopping, I had to keep telling Sue to slow down!

We went back to see the consultant. Pills were changed. I put on

and then lost nearly 20 pounds (9 kilos) in six weeks! However, I was

obviously still far from fully fit. In August we were told that there had

been no significant improvement and now the only sensible thing was a

heart transplant while I was still strong enough for the surgery. This came

as a bit of a shock as that wasn’t in the script.

The wheels started moving for referral to the specialist transplant unit at

Harefield Hospital. This is when I made an important decision. I would

use Reiki.

A chair and a cat and Reiki

For those of you unfamiliar with Reiki, it is a form of natural healing.

Reiki (pronounced Ray-Key) can be translated to mean the passage of

Universal Energy. If our energy or life force is low, then we are more likely

to become sick or stressed. Reiki healing seeks to recharge the natural

healing energy.

This form of healing originated in Tibet many centuries ago and was

rediscovered in Japan in the late 1980s by a Japanese scholar called Dr

Mikao Usui. To treat someone using Reiki, the client lies down or may

remain seated. The only clothing you need removed are your shoes. Reiki

healers lay their hands gently on or over various parts of the body in a

sequence of positions. Please don’t ask me for a scientific explanation.

It’s a bit like gravity; I know it exists, I know what it does but I have never

seen it and I don’t know how it works.

I had been introduced to Reiki through our cat Miffy. In June 1998,

shortly before my heart failure, Miffy was rushed to the vet with a stroke.

The initial diagnosis included a sheared optic nerve and the prognosis was

not good. Meanwhile, one of Sue’s friends, Verity Richards, had become

a Reiki healer and was working with animals. Verity worked on Miffy

with considerable success. Not only did the cat’s sight recover but over

a period of just a few weeks, Miffy went through all the stages of growing

up from kitten to cat but speeded up as, helped by Verity, it ‘unscrambled’

her brains.

Reiki healing

I felt that I couldn’t ask Verity for Reiki. At that time she was very busy

with a full-time job and her animal healing. I know that I wanted lots

of Reiki and at regular intervals. Luckily, Sue was using a local holistic

therapy clinic and through them I was recommended a Reiki therapist at

Page 12 digest

December 2004


Healing by David Powell OBE

Aylesbury. On 4 September the healing hands of Sandra Bradshaw, Reiki

Master, entered my story.

By now my booking for Harefield had arrived. I was to report for four days

of heart transplant assessment on16 October.

Sandy began weekly Reiki treatments; apparently I was taking in a lot

of energy.

A final boost from Sandy on the Saturday before I went into Harefield.

Meanwhile, I was in a real funk, especially over the angiogram which

would involve pushing a camera up my arteries – whilst conscious!

However, to help me, Sandy had taught me how to think of a beautiful

place and introduced me to the wonderful Bach Rescue Remedy.

On Monday I checked in at Harefield to begin a programme of swabs,

blood tests, X-rays, ultrasound, electrocardiograms etc. However, by now,

just after six Reiki sessions, I was actually beginning to feel quite good!

On the Tuesday I had a ‘difficult’ time with one of the Harefield team

whose job included helping me come to terms with the big question: ‘Why

do you think you are here?’ My suggestion that it was ‘just in case?’ and

‘I am sure that there are far more deserving people who need a transplant’

did not go down too well. I had to accept that I was now on the first rung

of the transplant process. I was ill and I wouldn’t have been referred to

Harefield unless a heart transplant was the only option. After two hours of

counselling, I was agreeing that I had started the process and that my life

depended on a transplant if a donor could be found in time.

“Compared with a visit to the dentist for a filling;

give me an angiogram every time.”

Wednesday arrived and I had to face the dreaded angiogram. With Rescue

Remedy for starters – and I was visualising being in my beautiful place

– the headland overlooking the Gap (the entrance to Sydney Bay, I will

spare you the details). Suffice to say that compared with a visit to the

dentist for a filling; give me an angiogram every time. Furthermore, where

the camera had been inserted in my groin, there was just one small red

mark: no bruising, no after-effects at all.

The final day of assessment and I was told that, surprisingly, things were

quite good and perhaps they would just keep me under periodic review for

the time being. I now had to learn a new mantra: ‘I am not going to have

a transplant – yet!’

For ten months I continued with fortnightly Reiki treatment. The skill

of doctors and their clever pills were curing, I adopted a more balanced

lifestyle with less rushing around, more exercise and the Reiki were

healing.

A new ‘problem’ was that sometimes the Reiki healing became out of

step with the curing resulting in low blood pressure. This was corrected

by reducing my cocktail of pills. This led to a still ongoing cycle of Reiki,

low blood pressure, doctor reduces the pills, more Reiki, normal blood

pressure, Reiki, low blood pressure and the doctor reduces the pills!

Moving on

By the summer of 2001 something or someone was telling me that the

time had come to move on to being a Reiki Healer. Not only did this

mean that I could start exploring a new journey of helping others, but one

of the features of Reiki would be that I could self-heal, and I now normally

give myself four or five half-hour treatments each week.

David Powell

H·E·A·R·T UK wishes to stress that prescribed medication should only

be adjusted under medical supervision and patients should inform their

doctor if they are receiving complementary therapies while undergoing

medical treatment.

diary date

National Salt Awareness Day 2005

Consensus Action on Salt and Health

(CASH) are pleased to announce that their

next National Salt Awareness Day will be

held on Wednesday 26 January 2005. The

theme will be salt and the older population,

chosen because they are such an important

vulnerable and forgotten group. A salt survey,

looking at older people’s understanding of salt

in the diet, is currently being undertaken by

CASH, and the results will be highlighted for

Salt Awareness Day.

New resources being developed include a

traffic light labelling guide, factsheet, article

and poster.

The main event will take place at the House of

Commons at lunchtime, on an invitation only

basis, and will be co-chaired by MPs Debra

Shipley and Kerry Pollard. CASH very much

encourages health professionals throughout

the UK to hold their own events, displays

or activities and packs will be available in

December.

For further information and details of available

resources, visit websites:

www.actiononsalt.org.uk and follow the salt

awareness link.

www.hyp.ac.uk/cash/awareness/awarenessday

December 2004

digest

Page 13


CVD prevention

Education - the key to unlock patient

empowerment and condition shared responsibility

Despite the well-known benefits derived from the education and

empowerment of patients, for many years this has been largely

ignored. Patient education is the key to shared responsibility and better

understanding of a patient’s condition. Done correctly this leads to a

more successful outcome in the management of a patient’s illness in the

longer term.

As the modern world is driven by rapid access to information, the key

to effective education is moving knowledge from the people who have

it to the people who need it. Learning no longer needs to be a passive

experience; it can be enhanced and made more effective by interactive

involvement.

Multi-ed Medical produces a range of interactive medical education

that aids the standardisation of education and management for specific

disease areas. Included in this series are interactive CDs on a variety

of heart conditions including: hypertension, angina, palpitations, heart

attacks and heart failure. There are also patient versions available on

other conditions such as diabetes and hormone replacement therapy

(HRT) and the menopause.

The programs incorporate not only text but also pictures and animations

accompanied by a voice-over. In combination with similar programs

utilised by GPs and hospitals, the programs aim to standardise the

information given to patients. This differs from the ‘ad hoc’ information

that can be accessed from other sources such as the Internet.

Good management of chronic diseases depends very much on all

those involved, but especially the patients and their carers having the

appropriate information. Providing adequate information to patients with

complex medical conditions is a challenge to all healthcare professionals.

The programs produced by Multi-ed Medical in conjunction with

healthcare professionals are unique. They provide standardised and quality

information in a format easily understood by everyone who uses them.

The cost for each title is £14.99 (plus £2.50 postage and packing).

To order, please contact:

Tel: 0845 606 7 606

Web: www.multi-ed.co.uk

Address: 5 Pinfold Close

Bickerton

North Yorkshire LS22 5JW

(Quote H·E·A·R·T UK when ordering)

H·E·A·R·T UK thank Multi-ed Medical for their generous donation of three

sets of the cardiology titles as prizes for the charity’s members.

Page 14 digest

December 2004


spotlight on ...

Spotlight on ... Professor Paul Durrington

“So the last annual Medical and Scientific

Meeting of H·E·A·R·T UK in Bath was its

eighteenth! Hard to believe, because it seems

like only yesterday that I was anxiously

awaiting the arrival of the 90 or so physicians

and laboratory scientists with an interest in

lipoprotein disorders we had managed to

drum up to attend the inaugural meeting in

Manchester in 1986 (Reported by Professor

Barry Lewis in The Lancet 1986; ii: 172). There

was much discussion about what we should

be called but finally British Hyperlipidaemia

Association was chosen. The BHA was born at

a time of the most intense and unreasonable

controversy. Its first two chairmen, Professors

Jim Shepherd and Gil Thompson, breached the

defences of the cholesterol sceptics and directed

in their troops with great effect, although the

major battle against the sceptics was not

won until 1994 with the publication of the

Scandinavian Simvastatin Survival Study. The

wider acceptance of the scale of the value of

cholesterol-lowering and its full clinical potential

and population impact continues to be an uphill

struggle, with many ‘authorities’ still harbouring

reactionary beliefs. I regard the major

contribution that the BHA has made in its 18

years has been the influence it has had on other

societies with a cardiovascular interest, leading

to the joint recommendations for the prevention

of cardiovascular disease. Our next task must

be to expand not only the clinical speciality of

Lipidology, but to develop the careers of basic

scientists with a research interest in the subject.

The BHA was not the only organisation created

in the 1980s. The charitable foundation

created by Katherine Broome, in memory of

her husband, led to two important initiatives.

One was the Familial Hypercholesterolaemia

Association, later the Family Heart Association,

created to represent the interests of patients

with high risk hyperlipidaemias. The FHA and

the BHA throughout their existence maintained

close links and finally in 2003 these were

formalised with the creation of H·E·A·R·T UK

representing the interests of patients with

lipid disorders; and the nurses, physicians,

nutritionists and laboratory scientists with an

interest in treatment and research into these

disorders. The Simon Broome Foundation also

supported a second initiative, the creation of

the Simon Broome Register. The brainchild of

Professor Jim Mann (now in New Zealand),

this too has been an outstanding success.

Accredited Lipid Clinics have for more than 20

ProfessorDurrington in characteristic pose (sketched

at the BHA Annual Meeting in Belfast 1994)

years pooled information anonymously about

people with severe hypercholesterolaemia and

hypertriglyceridaemia in a central register in

Oxford where it is maintained by Professor

Andrew Neil. The most valuable finding to

come from this has been the extraordinary

improvement in life-expectancy of patients with

familial hypercholesterolaemia since statin

therapy became available, so much so that the

latest publication from the Register will show

that life-expectancy is now normal. This is partly

because of the decrease in coronary deaths due

to statins, but also because of lower rates of

cancer than in the general population, probably

due to a healthy life style. This finding underpins

the current Department of Health drive to

introduce cascade family screening to ensure

that people with FH receive optimum therapy.

It is good to see that much of next year’s annual

meeting of H·E·A·R·T UK will be devoted to

people with diabetes. With the adoption of the

lessons from two major British statin primary

prevention trials in diabetic patients (HPS

and CARDS) we may soon too see similar

improvements in their long-term survival.

If I was to be given one wish for the future

success of H·E·A·R·T UK, it would be that

healthcare professionals and patients alike

should go all out to encourage more people to

join its patient section.

Paul Durrington is Professor of Medicine at

Manchester University. He was treasurer of

the BHA from 1986-1988 and its chairman

from 1992 to 1995. From 1995 to the

present he has been Medical Director of the

Family Heart Association and from 2003

chairman of H·E·A·R·T UK Medical Scientific

and Research Committee from which position

he will retire in 2005. He was elected to the

Academy of Medical Sciences in 2001 for his

contribution to lipid research and the treatment

of dyslipidaemias.”

The first BHA Committee (1986)

Back row, left to right Mike Laker, Gil Thompson,

John Betteridge, Paul Miller, Barry Lewis.

Front row, left to right, Paul Durrington, Jim

Shepherd, John Reckless

December 2004

digest

Page 15


food and drink

Seasonal recipes

Our friends and colleagues in Europe and New

Zealand have kindly contributed to this edition

of the Digest by sharing with us some of their

favourite Christmas and seasonal recipes.

We would like to take this opportunity to send

them our very best wishes, and, along with all

H·E·A·R·T UK members and our readers,

peace and happiness in 2005.

Baked turkey (or chicken) with spicy

lemon sauce (serves 8)

An easy, light and healthy main dish for which

you need the following ingredients:

Ingredients

3 kg turkey or equivalent weight in chicken

(about 350 grams per person)

4 lemons

a pinch of salt

freshly ground black pepper

olive oil

4 cloves of garlic (finely chopped)

2 table-spoons of finely chopped ginger root

For the sauce you need:

250 ml chicken stock

4 teaspoons of lightly grated lemon skin, just the

surface (zest)

150 ml lemon juice

6 table-spoons of sugar

50 ml dry sherry

4 teaspoons soy sauce

1 / 2 teaspoon chilli sauce

1 / 2 table-spoon ground Sichuan-pepper

a pinch of salt

Method

1 Preheat the oven to 220 degrees C (for

chicken, 180 degrees C).

2 Put the turkey, stuffed with four halves of

lemon and sprinkled with the juice of the other

two lemons, into the baking-dish.

3 Pepper and salt the turkey.

4 Brush the turkey with olive oil.

5 Put the turkey into the oven and baste

regularly with the juices in the baking-dish.

Adjust temperature if necessary and cook

for about one hour (about 50 minutes for

chicken), or a little longer, to get a coretemperature

of about 70 degrees.

6 Put all the sauce ingredients in a bowl, except

garlic and ginger.

7 When cooked, set turkey aside to rest and

keep warm in tinfoil.

8 Leave two spoons of the cooking juices in

the baking-dish (discard the rest) and fry the

garlic and ginger fast without burning the oil

and letting garlic and ginger to colour.

9 Add all other sauce ingredients from the bowl

and gently stir, gently scraping the pan to

incorporate the full flavour of the stock.

10 Thicken the sauce if necessary with a little

mixture of cornflour and water.

11 Taste to check seasoning, carve the turkey

or chicken at the table and serve the lemon

sauce separately.

From Adrian van Bellen , The Netherlands

Filo Xmas Mincemeat Parcels

Ingredients

1 packet filo pastry

1 bottle or jar vegetarian Xmas mincemeat

OR mixed fruit lightly moistened with

orange juice

1 / 4 cup oil (Grapeseed or Canola oil)

Non-stick muffin tray (for large muffins)

Method

1 Heat oven to 160-180 degreesC.

2 Take 4 sheets of filo pastry, place on a clean flat

surface and brush the top sheet with oil, then

cover with another 2 sheets.

3 Cut the prepared pastry into 4 squares,

approximately 10 cm x 10 cm

Place a large spoonful of Xmas mince or mixed fruit

in the centre of each square.

4 Brush the edges with low fat milk.

5 Draw the edges together towards the centre and

“nip” together to form a frill or twist to form a top

piece.

6 Place the “packet” in a well in a large non-stick

muffin tray or on an oven tray, sprayed with oil.

7 Continue until the tray is full.

8 Bake in a moderate oven for approx 20 minutes

until the tips of the filo pastry parcels are just

golden brown.

Further trays may be filled in this way until all the

filo pastry & Xmas mince is used up

Allow the parcels to cool slightly then place on a

cooling rack until cold

Store in an airtight container

Dust lightly with icing sugar just before serving

Note:

Remove only 4 sheets of filo at a time from the

packet, as filo pastry tends to dry out very easily.

It is also important to work as quickly as possible

to prevent the tops of the Mincemeat Parcels from

drying out before you get them into the oven.

From Alex Chisholm, New Zealand

Page 16 digest

December 2004


Red Cabbage with apple, nuts and

dried fruits

Ingredients

2 pounds of red cabbage

Olive oil (1 teaspoons of olive oil)

One onion, chopped

4 garlic cloves, chopped

Selection of dry fruits such as dates and raisins;

nuts, and one fresh apple.

Method

1 Steam the cabbage in water for 1 / 2 an hour in

a pressure cooker.

2 Drain thoroughly.

3 Fry the onion in a pan with one tablespoon

of the olive oil on a low heat, for about 15

minutes until golden coloured.

4 Add the chopped garlic to the fried onion and

fry together briefly.

5 Add the contents of the pan to the drained

red cabbage.

6 Now add the dried fruits, nuts and the apple

(cut in small pieces).

7 Cover and continue cooking on a low heat for

10 minutes, stirring to prevent burning.

8 Add a little extra olive oil if required

From Maria-Teresa Pariente, Spain

Pfeffernüße

(German Christmas Cookies)

Ingredients

2 cups brown sugar

2 eggs

1 tsp baking soda

1 tbs hot water

1 cup chopped nuts (walnuts, hazelnuts or

almonds – grind nuts finely)

2 tsp ground cinnamon

1 tsp ground nutmeg

3 cups sifted all-purpose flour

1 cup powdered sugar (icing sugar) for rolling

cookies in

Method

1 Mix the sugar with the well-beaten eggs.

2 Add the soda dissolved in hot water, the nuts and

sift in the spices with the flour. Add more flour if

needed to make a dough stiff enough to roll.

3 Roll out until the dough is about 1 / 3 inch thick.

4 Cut into tiny rounds about as large as a ten pence

coin and bake in oven at 400°F until golden brown.

5 Take out and roll at once in icing sugar.

From Marianne Wightman

Sarah’s Australian Christmas

Tea Cake

Ingredients

4 oz stoned raisins

4 oz sultanas

12 oz currants

rind & juice of half a lemon

4 tablespoons wine

3 / 4 pint tea

4 oz glace cherries

4 oz blanched almonds

2 level teaspoons mixed spice

4 oz low-fat margarine

1 tablespoon thick honey

4 oz soft dark sugar

4 oz cooking chocolate

8 oz low fat cake crumbs

1 lb gingernuts (crushed)

2 oz ground almonds

Method

1 Mix the dried fruit in a saucepan with the

spice and lemon juice. Pour the tea over, add

the lemon rind and simmer gently for 15 – 20

minutes

2 Drain thoroughly, then place the dried fruit,

cherries, almonds and wine into a container

with a tightly fitting lid. Leave for at least two

hours or overnight

3 Put margarine, sugar, honey and chocolate

into a bowl and melt over a pan of hot water

4 Put the cake crumbs and crushed biscuits into

a mixing bowl and mix in the ground almonds.

Add the fruit and chocolate mixtures and mix

thoroughly

5 Press into a greased and line 8” round or 7”

square tin and chill for a few days

6 Cover with marzipan or ice with cold fondant

7 Store in a tin with tightly fitting lid in a freezer

or refrigerator

To be eaten within a week unless deep frozen.

(Sarah tends to only make half this mixture, as it

is very rich and you only need small slices!)

From Sarah Livingston

Apple tart

Ingredients

1 pound of apples (a mixture of eating and

cooking apples)

2 pieces of bread roll (those used for

hamburgers)

One or two tablespoons of sugar (depending on

the sourness of the apples)

One egg

Apricot jam

A glass of skimmed milk (200 ml.)

Method

1 Mix together the milk, sugar and the egg in a

blender.

2 Put the mixture in a mould like the one in the

picture below (greased with a bit of oil).

3 Put the 2 breads into the mixture (in the

mould) and crush them lightly with a fork.

4 Slice the apple and place in mould.

5 Place on a low shelf in the oven (high during

the first ten minutes).

6 Cook for a further 10 minutes on medium

heat (160 – 180 degrees C).

7 Remove from oven and leave to cool.

8 Turn out onto a plate and cover with a thin

layer of apricot jam.

9 In the middle of the tart, put a splash of

sherry or a little strawberry jam.

From Maria-Teresa Pariente, Spain

Addendum – October 2004 Digest

We were very grateful for the advance

publicity you gave to our forthcoming

book, Eating for a Healthy Heart (Digest,

October 2004). We wondered, however,

whether we could take up a small space

in your columns to clarify the nature of

the Nutritional analysis for the Vegetable

stock. In the early draft of the book from

which the article was taken we provided

two analyses, one for the total ingredients

(i.e. before the vegetables were strained

out) and the second for the clear stock. The

full analysis appeared in the article, but

unfortunately the analysis for the strained

stock did not. Since this might have caused

some confusion, we would like to offer

reassurance that in addition to being very

low in salt, the amount of fat and calories

in the clear, strained stock is negligible!

December 2004

digest

Page 17


letters to the editor

DEAR EDITOR

I recently read in a magazine that I shouldn’t have grapefruit juice with

my statin. In fact, according to the article, the consequences could be

fatal. Why is this and is it true??

Grapefruit is broken down in the body via a specific pathway or route through

the body. This is the same pathway that several of the statins also follow

(known as cytochrome P450). The statins that follow the same pathway as

grapefruit juice include atorvastatin (Lipitor) and simvastatin (Zocor). The fact

that the statins compete for this pathway with the grapefruit juice means that

the net result is a rise in the level of the statin drug in the bloodstream. For

example, if you take 10mg of one the statins above with grapefruit juice it

could potentially be equivalent to a 40mg dose.

The advice given by the manufacturers is that ‘no more than two small glasses

of grapefruit juice should be drunk per day with statin therapy.’

There are no cases on record that have led to the death of a patient taking

statins and grapefruit juice.

DEAR EDITOR

We are bombarded with information on saturated fats and unsaturated

fats,but can you tell me a bit about trans fats please, and explain why I

should be avoiding them?

Trans fats occur naturally in small quantities in meat and dairy products

but they are also formed artificially when manufacturers hydrogenate fat or

oil. Hydrogenation entails transforming the vegetable oil into a solid fat by

changing its chemical structure - in other words it becomes a trans fatty

acid. The hydrogenation process also destroys some of the poly- and monounsaturated

fats in vegetable oils that help lower LDL (‘bad’)cholesterol.

Trans fatty acids not only raise LDL levels but they also lower HDL (‘good’)

cholesterol levels. Therefore it is best to avoid them.

At the moment, it’s impossible to know how much trans fat is in the food

we buy. Foods that contain partially hydrogenated or hydrogenated fat or oil

could contain a lot, or very little, trans fat. Also many foods don’t even have

ingredient lists - making it even harder to avoid trans fats.

The major sources of trans fats are some hard margarines, fast foods and

some crackers, biscuits, cakes, pastries, hard cheeses , meat pies and

other processed foods. The only sure way of avoiding trans fats is to rely on

freshly prepared foods and avoiding processed foods as much as possible. .

DEAR EDITOR

At the age of 51, I was a little concerned (thinking, as we all do, that I

was quite a healthy specimen), when in April this year I was sent to see

a heart specialist at the Priory Hospital in Birmingham. This man was Dr

James Beattie.

After carrying out tests he referred me to a colleague of his, Dr Robert

Cramb, a Consultant Biochemist at the University Hospital, Birmingham

and who also consults at the Priory Hospital.

This letter is not a medical enquiry but a thank you that I hope you

will print.

These two doctors, with charm, grace and patience saw me through

all the investigations that had to be done. They must answer the same

questions over and over again, but not once was I made to feel silly or

irritating to them – my angel was certainly sitting on my shoulder the day

I was introduced to these two doctors. My fear was turned to laughter

and the tests informative, and it would be nice, in an ideal world, if

others, finding themselves treated by such wonderful, dedicated doctors,

could be persuaded to say their ‘thank yous’ in donations to help continue

this life-saving work. Thus a donation to H.E.A.R.T UK seemed a fitting

thank you to bring this period of time full circle, so to speak.

Mrs B A Lycett

We heartily join you, Mrs Lycett, in thanking Dr Beattie and Dr Cramb for all

their hard work - it so refreshing to hear of praise for those working at the

‘frontline’ in the health service. We are delighted that you took the trouble to

write and affirm the positive when we so often only read frequently unjustified

negative news.

Thank you too, for your kind donation to the charity in recognition of your good

experience; it seems appropriate to direct it towards the Birmingham Family

Support Centre fund that you may have read about in October’s Digest.

DEAR EDITOR

I always find my stress level rising at this time of year – quite a common

complaint I’m sure, especially in the build-up to Christmas! Any tips to

help me help myself?

There are various stress-busting measures that should help over Christmas

and beyond! Here are a few:

• Avoid over-commitment – make time for yourself and don’t be afraid

to say no!

• Take time to plan

• Relaxation tapes, videos and books; yoga and breathing exercises

• Remove yourself from a stressful environment wherever possible, and keep

physically active

• Don’t suppress your problems – talk through with a trusted friend or

colleague

• Limit your caffeine and alcohol intake – and don’t smoke

• Complete the day with a warm soak in the bath

You may be pleased to hear that we will be featuring more on stress and

relaxation in the New Year!

Page 18 digest

December 2004


membership

H.E.A.R.T UK HELPLINE AND

MEMBERSHIP ENQUIRIES

Please note that our helpline

01628 628 638 is available from

Monday to Friday 9.30am to 3.30pm.

Our experienced team of nurses and

dietitians will be pleased to answer

your call.

Out of hours please leave a message

and telephone number on our

answer machine.

H.E.A.R.T UK DIGEST

Editor:

Gill Stokes

Associate Editorial Team:

Julie Foxton, Baldeesh Rai, Marianne

Wightman, Emma Buitendag

email: ask@heartuk.org.uk

web site: www.heartuk.org.uk

advertising: 01628 628 638

fax: 01628 628 698

main office: 01628 628 638

CARDIOVASCULAR DISEASE PREVENTION VII

The Conference Centre, Kensington Town Hall, London, UK

8th February – 10 February 2005

Oral presentations by distinguished speakers, discussion sessions and

scientific posters will cover key topics in cardiovascular disease prevention.

Important Deadline:

Reduced registration fee: 3rd December 2004

To register online visit:

www.hamptonmedical.com

For further details email: cvdp@hamptonmedical.com

Sponsored places are available

H.E.A.R.T UK, 7 North Road,

Maidenhead, Berkshire, SL6 1PE

Omission - October

2004 Digest

The editor wishes to apologise for an

omission in the article entitled: “HDLcholesterol

– treatment advance” that

featured in October’s Digest. Dr Tony

Wierzbicki, H·E·A·R·T UK Trustee, was

not duly accredited as author of the article

and of the desirable levels in the, as yet,

unpublished revised Joint British Guidelines.

Membership news

Just for your interest...

Did you know that this edition of the Digest

has been circulated to 116 Lipid Clinics, each

receiving a box to distribute in their waiting

rooms, 1899 members of H·E·A·R·T UK, who

receive the Digest directly to their home, and in

addition, a further 700 or so copies will be sent

out to individuals who contact the charity for

advice and support by way of phone or letter.

We have heard from many of our valued

members that they pass on their bi -monthly

Digest to friends and relatives ... with this in

mind and the number of times the Digest is

read in hospital waiting rooms, it would be

impossible to estimate the number of readers

the HEART UK Digest has each month.

But it would be fair to say that the number is

considerable and forever growing! Now that is

good news for your charity!

Emma Buitendag, Membership Manager

Pomegreat

Pomegreat, a delicious juice drink made from

pomegranate - a fruit known for its health

benefits – would be a refreshing addition to

your shopping list during the festive season. It

is available in 1 litre cartons and is enriched

with vitamins A, C, E and folic acid, and one

glass has the same polyphenol (an important

antioxidant) content as two glasses of red wine.

December 2004

digest

Page 19


ook review

‘Adam’s Curse’ by Bryan Sykes

Bantam Press

I first heard of Brian Sykes when he was

interviewed on Radio 4 about his first DNA book

“The Seven Daughters of Eve”. I was fascinated

by his thesis that all women in the world can

be traced back in direct line to only 14 women

(the seven being the European links), and so I

bought the book.

Although I did not understand all the science

described in it, I enjoyed the storylines and

grasped enough information to fuel my interest

in genetics and family history along the

maternal lines.

I was therefore, equally interested when I

heard that “Adam’s Curse” had hit the book

stands. This book I found much easier to read

and understand (although some of the more

detailed scientific information still goes straight

over my head!), in fact I even found myself

laughing out loud in parts – it is written in a

much more relaxed and amusing way whilst

losing nothing of the basic sombre message of

the eventual demise of man – sooner or later!

Brian Sykes held my attention from the

moment he confirmed that “men are basically

genetically modified women” and described our

evolution as a “gigantic and long-running GM

experiment”! Any feminist will love the way he

describes what drives men to behave like men

and how from the minute mankind learnt to

settle and farm the previous matriarchal way

of life shifted firmly to patriarchal rule. Men

began herding and breeding selected breeds

of cattle and did the same with women to

promote their own lineage.

Tracing male DNA from Genghis Khan, the

Vikings and Somerled the Scot, the most

fascinating premise is that unlike the stable

and long route for matriarchal DNA back to the

relatively few daughters of Eve – Adam’s trail is

extremely short and broken.

To try to overcome the inevitable breakdown

and demise of the now fragile Y-chromosome

the choices presented and their implications

make for a variety of very interesting options for

every level of feminist.

If you want to know your choices in the sex of

your children, the reasons behind your man’s

attitudes – read this book – you’ll be fascinated

and amused. I highly recommend it.

Sarah Gee

Digest reader offer: ‘Adam’s Curse’ can be

ordered for £5.99 including p&p (rrp £7.99)

by contacting the following:

Bookpost plc

PO Box 29, Douglas, Isle of Man IM99 1BQ

Tel: 01624 836000

Please quote ‘heartuk’ when ordering.

diary dates

9 – 10 DECEMBER

5th Nutrition and Health Conference

Excel Conference Centre, London

Contact: tel/fax: 020 8455 2126/6570,

email: admin@nutritionandhealth.co.uk

*12 DECEMBER

74th EAS Congress

Seville, Spain

Contact: tel: +34 954 226 160, fax: +34

954 228 070, email: viajestavora@arrakis.es

7 – 8 FEBRUARY 2005

1st National Conference on Obesity & Health

Manchester Conference Centre

Website: www.obesityandhealth.co.uk

*8 – 10 FEBRUARY 2005

Cardiovascular Disease Prevention VII

The Conference Centre,

Kensington Town Hall, London

(further information on page 19)

Contact: Hampton Medical Conferences, tel:

020 8979 8300, fax: 020 8979 6700, email:

cvdp@hamptonmedical.com ,

website: www.hamptonmedical.com

*6 – 9 MARCH 2005

American College of Cardiology Annual

Scientific Session

Orlando, Florida

Contact: Website: www.acc.org

*23 – 26 MAY 2005

British Cardiac Society Annual Meeting

Manchester

Contact: Email: enquiries@bcs.com

30 JUNE – 1 JULY 2005

H·E·A·R·T UK 19th Annual Medical &

Scientific Meeting:

‘The Metabolic Syndrome: An Imminent

Challenge’ and ‘Lifestyle Issues in Metabolic

Syndrome’

University of Glamorgan, Wales

Contact: Natasha Dougall, Wheldon Events,

tel: 01922 457 984, fax: 01922 455 238,

email: natashadougall@wheldonevents.co.uk ,

website: www.wheldonevents.co.uk

*For health professionals

Page 20 digest

December 2004

Although H . E . A . R . T UK has endeavoured to ensure the accuracy of the entire publication, no liability will be

accepted by the Trust, Officers or members of staff, for information and opinions herein given.

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