Heart Trouble in Middle Age

New Zealand Listener, Volume 14, Issue 364, 14 June 1946, Page 23

Heart Trouble in Middle Age

(Written for "The Listener’ by DR.

H. B.

TURBOTT

Director of the Division

of School Hygiene, Health Department)

HE expectation of life is increasing, and this is allowing diseases of the heart to show up as a major cause of our death rate, as the years go by. Some of the heart damage dates from the earlier decades of life. A proportion of the heart trouble of middle life and onwards is due to rheumatic. fever infection in childhood or adoleseence. After the attack the heart muscle and valves are left permanently damaged in some-especially after recurrences. The heart enlarges, and tries to pump the blood round as well as it did before the rheumatic fever, in spite of leaking valves. This state may continue for life, or the strain may prove too great and symptoms of heart failure appear in middle life after some period of extra stress or some unusual activitysome extra effort in the garden, a scamper for a tram or bus. As we do not know the cause of rheumatic fever we cannot prevent the disease yet. We can prevent or reduce recurrences by using the sulphonamide drugs and so lessen heart damage. But rheumatic fever remains an enemy of our hearts. Another concealed enemy, entering the body in youthful days, usually, and appearing in mid-life or later as a ravager of the heart, is entirely preventable. This is syphilis. It selects the large artery from the Heart, the aorta, together with the heart valve that regulates the flow of blood into it, and permanently damages them unless treatment is undergone early after contracting the disease. The damage rarely shows up till midlife, and by then the hope of cure is gone. This kind of heart disease should never happen. Syphilis is preventable and, even if caught, is curable in the early stages. The person who catches this disease and does not report for

treatment, and continue treatment till cured, has about a 1 in 5 chance of dying very prematurely from heart disease. Another cause is the hardening of our arteries that occurs with increasing age. In some folk this is so marked in the arteries supplying the heart muscle itself that they cannot carry enough blood to let the heart do its work. They often get roughened inside as well. These arteries are the coronary blood vessels, and from this kind of damage in them we get the sudden heart failures from coronary blockage or insufficiency. The disease angina pectoris is due to a blood clot in these arteries. In other people it is other organs that suffer from hardening of the arteries. But the heart stands up poorly to this kind of personal attack through its own arteries, and many of the sudden strokes, with death, are due to coronary clotting or thrombosis. Sensible quiet living is the only way to lessen this enemy’s attack. We. do not know the cause of the earlier than usual development in mid-life of this hardening of our arteries. Still another cause of premature heart failure is high blood pressure developing in the third or fourth decade of life, This high blood pressure puts strain on the heart’s pumping capacity. Working at high pressure, worry, or anxiety keep the pressure high and sooner or later the heart fails. Moderating activity, avoiding strain and stress, are the requirements if high blood pressure folk want to keep good hearts into old age. The warnings middle age folk get of heart failure from any cause are ‘the shortness of breath, pain over the heart, palpitation, discomfort on lying down, and swelling of the feet. When these things happen, a remodelling of activity under medical guidance is the key to continued, useful and often long life within the. limit allowed by the heart,