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Inspiration Information Support Summer 2021
Coping through tough times
Build resilience when your world
turns upside down
Carbs: good or bad?
Get the lowdown on carbohydrates
Reaching
upwards
Meet the people celebrating
60 years, thanks to research
Breathing easy
How you can manage
your breathlessness
Covid’s impact
Readers share their
road to recovery
British Heart Foundation
Contents
Summer 2021
News Nutrition 32
4 Your letters 20 Recipes: pull out and keep
Caesar salad, ratatouille
Editor’s letter
5 Behind the headlines flatbreads and butter
Does too much sleep raise your bean salad
Welcome to the Summer issue of Heart Matters.
risk of a heart attack?
23 Ask the expert This is a very special issue, as we celebrate
6News Plant milks, and the BHF’s 60th birthday. So we met up with
Heart attack risk identified by new protein for breakfast three inspirational people who are also 60
technology, and new ways you
24 Carbs: good or bad? years young to help us celebrate. Wendy, Helen and
can fundraise and volunteer
Understand carbohydrate Neil (page 16) show that whatever age you are, and
types and whether you need whatever your heart condition, you can have new
Medical
to cut down hobbies, new experiences and new ambitions. For
8 Why I had the vaccine them, as for the BHF, 60 is just the start.
Three readers explain what they’d 26 Healthy eating, made simple
Coping in turbulent times
say to someone who isn’t sure yet
29 Breathe easier
What you really need to know
about eating a balanced diet 16 We’ve also taken the opportunity to look back on what
our research has achieved over the last 60 years, as
well as what we’re still working on (page 12).
24
Breathlessness can be difficult to Living well
live with: learn how to manage it 60 years young
11
Fear of needles Coronavirus continues to have an impact on many of
34 Ask the expert
How to cope if you struggle our lives, including for Suki and David (page 36). On
Understanding your echo report;
12
with injections page 32, Heart Matters readers share tips on coping
calcified arteries; and weight
32 Coping in turbulent times with turbulent times. And on page 8, three people with
gain when you have heart failure
Ways to cope when life gets heart conditions share with us why getting the vaccine
unpredictable or difficult is important to them. Don’t miss this if someone in your
Celebrating 60 years
life isn’t sure about getting the vaccine yet.
12 Pioneering research Research
How we’ve saved and improved As you may have spotted, the pandemic meant that
lives over six decades 40 Taking part
we couldn’t bring you your Spring issue, so we’re
What it’s like to be in clinical
pleased to be back. Our income has been badly hit
16 Sixty years young trials and how they’re making
Meet the people also celebrating a difference
by the pandemic, but we’re working hard to keep
their 60th this year, thanks to bringing you Heart Matters for free. To help us do this,
research 43 The latest research you may see that future issues include information
New projects we’re funding Carbs: good or bad?
about products or services from the BHF as well as our
Real life partners. And if you’d like to support us, every donation
is welcome. Visit bhf.org.uk/HMdonate, or donate by
36 Covid’s impact
phone at 0300 330 3322, or send a cheque payable to
Suki and David share their
‘British Heart Foundation’ to British Heart Foundation,
journeys to recovery 60 years of pioneering research 2300 The Crescent, Birmingham B37 7YE (if possible,
please include a covering note that mentions Heart
Matters). And a huge thank you to those of you who
Have your say on Heart Matters Online exclusives have already donated.
Go to bhf.org.uk/heartsurvey Visit bhf.org.uk/HMmag
to tell us what you thought of this issue. You could win a £50 John We’d love to hear from you about whether this issue
Lewis or Amazon voucher! Or post comments to Editor Sarah 10 tasty low-salt recipes
• has helped you, or any feedback you have. Email
Brealey at the address on page 4. HMeditor@bhf.org.uk, write to us at the address on
5 lessons we’ve learned from lockdown
• page 4, or take our survey at bhf.org.uk/heartsurvey.
Quiz: How much do you know about carbs?
•
Heart Matters is published by the British Heart Foundation, Greater London House, 180 Hampstead Road,
London NW1 7AW. ISSN17459753 The British Heart Foundation is a registered charity in England and Wales
(225971) and in Scotland (SC039426). Views expressed in this magazine are not necessarily those of the British • Get Covid-19 updates at bhf.org.uk/coronavirus
Heart Foundation. The BHF does not endorse third-party products and services featured in Heart Matters.
Information is correct at time of going to press. © BHF 2021. G204/0621 Covid’s impact Sarah Brealey, Editor
2 I Heart Matters bhf.org.uk I 3
News News
We love to read your emails,
letters and tips, so keep writing:
Your
HMeditor@bhf.org.uk or The Daily Mail, 17 May 2021
Heart Matters, "Chilly spells can give you a heart
British Heart Foundation, attack"
180 Hampstead Road, According to research published in
letters
London NW1 7AW the journal Heart, lower temperatures
are linked to more cases of people
having cardiac arrests.
The Daily Mail covered this study
with the unfortunately misleading
headline, “Chilly spells can give you
a heart attack.” The study focused on
Appreciating scars watching a football match. The heart to help (Winter 2020) and by the cardiac arrests, which is when your
I had a heart valve replaced at the attack caused a cardiac arrest - the people who use CPR to try to save a heart suddenly stops pumping blood
end of October 2020, so much of the club had a defibrillator, and the physio life, sometimes successfully but sadly around your body and your brain is
magazine’s content is so relevant to used that and CPR to try to help my sometimes not. starved of oxygen, causing you to fall
me. I was particularly interested in the husband until the ambulance Andrew Low unconscious. While heart attacks are
article on scars, ‘Marks of change’, arrived 15 minutes later. Kenton, Middlesex one of the main causes of cardiac
(Winter 2020). I am very proud of Although he did not survive, arrests, they are not the same thing.
mine. For me it says: ‘Look what I it was a huge Positive way The study found that lower
have survived.’ In fact, I was quite comfort to know I would like to compliment you on temperatures and big drops in
disappointed that there are no stitch that everything the excellent job you all do, not only temperature within one day were
marks to make it show up more! Thank had been done to keeping us informed of new treatments, linked with more cases of cardiac
you so much BHF and Royal Brompton save him. Another trials, and research but in making us arrests.
Hospital for continuing to research and reason to start feel someone is interested in us and our It also found that cardiac arrests
improve the treatment of heart patients CPR as soon as possible. conditions. It can be very isolating and The Sun, 5 May 2021 were more likely to happen on
- you are much appreciated. Lesley Barnes difficult dealing with heart issues. "The ‘sleep formula’ that can slash risk research has not been published, the Sundays, Mondays and public
Murray Simmons Greenford, Greater London You don’t want to worry family and of heart attack and stroke" authors said that people who slept six holidays than other days of the week.
Oakley, Hampshire friends, so having your magazine lay It’s long been known that there is a link to seven hours had the lowest risk of a The study analysed data for over
Deeply moved out all the facts in its lovely positive way between lack of sleep and your risk of heart or circulatory problem (such as half a million people in Japan who
The importance of CPR Thank you for the magazine. I was is so important. l look forward to the heart disease or stroke. But according a heart attack or stroke). had cardiac arrests out of hospitals
Thank you for your article on CPR deeply moved by the stories of the next edition. to recent research from the United Much of the press coverage of between 2005 and 2013. It’s important
(Winter 2020). My husband died of nurse who has been struck down by Janet Price, States, too much sleep can affect your this story was based on a press to note that it simply showed an
a heart attack five years ago whilst a heart condition and dearly wants Cwmbran, South Wales risk too. release, issued before the study was association between cold weather
The study followed 14,000 Americans presented to the American College and cardiac arrests. It didn’t prove
over several years. Participants were of Cardiology. Before a full study cause and effect, i.e. that cold
divided into three groups: those who has been published, it’s hard to weather in itself is responsible for
Shared experience I felt. To my surprise he totally understood slept less than six hours a night, those understand the details of the findings, causing cardiac arrests.
I was interested to read Megan how I was feeling. He promised me, if it who slept six to seven and those who and how significant and accurate
MacKintosh’s story about scarring was possible, he would cut from the side slept more than seven. Although the full they are. THE BHF VIEW
(Winter 2020, pictured). Back in 1970 of my chest, so any scarring could not Chloe MacArthur, Senior Cardiac
I was in the same position as her. be seen. After surgery I will never forget THE BHF VIEW Nurse at the British Heart
I was just 22 years old and facing my surgeon telling me that I got my wish, Getting a good night’s sleep is important for good health. When it comes to Foundation (BHF) said: “This study
open heart surgery for a hole in the and that all went well with the op. our heart and circulatory health, this study suggests there might be a sweet is interesting as we know that the
heart (atrial septal defect). I was I’m so glad that I talked to my spot between getting too much and getting too little sleep. But it’s difficult to weather has the potential to affect
horrified by the thought of what sort surgeon. Although it might not be say this for sure based on one study, which hasn’t even been published in full, the heart...But the most important
of scarring I might be left with but possible for a scar to be hidden in every so may not yet have been peer reviewed by other scientists. What’s more, this thing for any of us to focus on is
did not want to seem vain, as it was case, do talk to the doctors involved, type of research can’t prove cause and effect, and we wouldn’t suggest you managing our underlying risk
a life-saving operation. I was given they do listen. change your habits based on this research. of heart and circulatory disease
some advice to tell the surgeon that Maureen Bettison The research shouldn’t trigger alarm bells for those of us who might have by having a healthy, balanced
was going to do the operation how Halstead, Essex the occasional bad night’s sleep or long lie-in. However, if you are really diet and getting enough physical
struggling with your sleep, it’s important to talk to your GP. activity.”
4 I Heart Matters
bhf.org.uk I 5
News
New technology
CaRi-Heart can perform Join Team 60 Dates for
your diary
a deep-dive into heart
scans, using artificial
intelligence
To celebrate our 60th year,
we’ve come up with some fun
fundraising ideas. Why not host July & August
a 60s-themed dress up day Live & Ticking: online events.
or a quiz night, walk or run 60 We’ll be celebrating our
intelligence. It identifies areas miles in a month, or take up 60th anniversary, covering
of inflammation in the heart’s something new for 60 days? some exciting research topics
blood vessels, which can be a If you’re celebrating your 60th including heart surgery and
potential early warning sign for too, you could ask for donations statins. Book your place at
a future heart attack. for your birthday. Set up your bhf.org.uk/publicevents.
The scientific work behind virtual collecting tin and get
CaRi-Heart was initially carried ideas at bhf.org.uk/team60. 22 August
out by BHF researchers at The Vitality Big Half. Join our
the University of Oxford. The team on the closed roads of
‘Invisible’ heart attack risk technology was tested in a
BHF-funded study involving
Win this necklace
BHF shops need you
London, passing the iconic
Tower Bridge and Cutty Sark,
around 4,000 patients who F.Hinds and Chappelle are for this exciting half-marathon.
identified by new technology were followed for nine years
after their original scan. At least
donating five per cent of sales
of all heart-themed jewellery
After months of closing during lockdown, we’ve
reopened our shops, recording more than £1 million
Find out more at bhf.org.uk/
thebighalf or call 0300 222 5719.
one in three patients who had until 23 July to support our life- in sales on the first day of reopening in England and
Research we’ve funded has led to check the blood vessels a CT coronary angiogram and saving research. See in stores or Wales in April this year. We need your quality items 12 September
to a new technology that can that supply their heart for were initially considered low visit fhinds.co.uk and chapelle. more than ever. Every sale supports our vital work as Brighton Marathon and 10K.
help identify people at high any narrowed or blocked risk were shown to have a much co.uk. To mark our partnership, we seek to recover from the devastating impact of Choose to run the full marathon
risk of a heart attack, whose areas. About three quarters higher risk after CaRi-Heart they are giving away this the pandemic, which has seen our net income cut in or 10K, join our team and enjoy
risk was previously undetected of the time, the scans find was applied to their scan. So 9ct Gold Open Heart Ruby half over the last year. the coastal views along this
by routine scans. Those no significant narrowing of this technology could mean that necklace worth £325. To be in There are also new ways to volunteer with scenic course. Find out more at
identified with these ‘invisible’ these coronary arteries, so thousands more people every with a chance of winning, visit our shops. Those who enjoy a bit of DIY can help bhf.org.uk/brightonmarathon or
early warning signs can be people are sent home without year get offered the treatment bhf.org.uk/fhindsprize before with our furniture assembly service, which allows call 0300 222 5719.
monitored more closely and treatment. But some of them will they need. midnight on 23 July. customers to buy prebuilt items from us. We are
given the right preventative go on to have heart attacks at CaRi-Heart has now also looking for volunteers to test donated electrical 29 September
medication, potentially saving some point in the future. received European safety items and online sales volunteers to help grow our Heart Hero Awards 2021: online
their lives. Now a new technology, accreditation, meaning it can presence on online selling platforms. event. Tune into our virtual
CT coronary angiogram CaRi-Heart, can perform a be used by doctors across the Find out more about donating items or awards ceremony at 7pm to
scans are a fairly common test deeper dive into the scans UK and Europe and rolled out volunteering at bhf.org.uk/how-you-can-help or pop hear the incredible stories and
for people with chest pain, using a type of artificial across the NHS. into your local store. the innovative fundraising
activities that have taken place
over the past year from our
shortlisted finalists. Register at
News bites scientists at the University of
Cambridge have identified 12
Drug could prevent Covid
lung damage
to treat tapeworm – helps
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health.
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Mindful
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Causes of ‘silent’ strokes changes to
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To To
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6 I Heart Matters bhf.org.uk I 7
Medical
Why I got compared to a proven vaccine? Having
the vaccine is not just a lifesaver in
the vaccine
terms of preventing the illness, but is
also vital to help prevent those potential
lasting or long-term effects.
I have been self-isolating through
the pandemic. It’s been difficult, and I
know I’m not the only one. We need to
suppress the virus through vaccination
so we can all start to get back to some
kind of ‘normal’.
– and what I’d say to someone who isn’t sure yet If I was speaking to someone unsure
about getting the vaccine, I’d want
to understand why they feel that way.
Three people with heart conditions tell us why getting the Covid-19 vaccine So if it’s because people are unsure
about the vaccines being developed
mattered to them, and what they would say to anyone who feels hesitant so quickly, it’s about explaining how no
steps were skipped and it’s been done Kelvin Pitman, 71, from Newbury, is a retired director in
properly. I think UK research and our research and development. He had a heart attack in 2008,
scientists and regulatory bodies are has atrial fibrillation and has a pacemaker.
among the best in the world. I have
Zena Forster, 65, from total faith that everything has been For me, getting the vaccine was important to protect myself, my wife, and my
examined carefully and that there is the daughter who lives on her own and is in our ‘bubble’, as well as to protect anyone
Newcastle, is a retired
ongoing monitoring. else I might come into contact with.
NHS patient manager. If it’s because people are worried I also want to be able to see my other daughter, her husband and our three
She has familial about side effects, I think it’s just really grandchildren. They live in Dubai and we haven’t seen them for 18 months. We
hypercholesterolaemia (an important to be clear that the risks if want to do anything that will make it safer and more possible to see family and
inherited condition which they are there are very low, compared friends, as soon as we can.
leads to very high cholesterol) to the benefits of not getting Covid-19. I also wanted to help build up herd immunity, which I think is very important.
and has had a stroke and a Whether or not you trust the We want to get to a point where society can open up without worrying about
government, there should be trust in more waves of the virus. So it’s important that as many people as possible are
heart attack.
what the scientists and the people who vaccinated.
have actually done the work on the
Getting the vaccine was important vaccines are saying.
to me to protect myself, those around Vaccines have achieved so many We want to do anything that will make it safer and
me and my community. It’s not just good things. When I was growing up in
about yourself but protecting all the the 50s, you would hear about people more possible to see family and friends, as soon as
people you might be in contact with in with polio needing an iron lung to we can.
daily life. I would feel terrible if I was breathe or being fitted with callipers to
responsible for passing on Covid-19 to walk. The availability of a vaccine has Another important point is to try to limit the spread of new coronavirus variants.
someone else. eradicated that in the UK. Every time someone gets infected, there is potential for a variation to occur. So
I had the virus in early 2020, and Getting the vaccine is about the less transmission you have, the less chance there is for mutations, and the less
have had ongoing symptoms since protecting ourselves and each other. chance for new strains to spread.
then, including some issues with my I think for some people, there’s a religious element – they think that if they have
heart. So, for me personally, getting the faith they will be protected, so they don’t have to worry. I do have a fairly strong
vaccine is also about being protected faith, but I see it in a different way. God has given us this vaccine to protect us.
from getting it again – I’ve been through It’s not just about The chances of catching Covid, and the chances of life-threatening
it already and definitely don’t want to yourself but protecting complications from the virus, far outweigh what seems to be an incredibly small
get it again. risk of any serious side effects if you have the vaccine. Overall the risk of something
We know it can have lasting effects,
all the people you might happening to you after a vaccine, compared to usual life or getting Covid-19 itself,
so why would you want to take the risk be in contact with. is very small.
8 I Heart Matters bhf.org.uk I 9
Medical Living well
Joy Akinsanmi, 27, from London, works in communications. She was born with Marfan syndrome, Overcoming your
fear of needles
an inherited condition that can cause heart defects.
in the news are probably linked to an
immune reaction, and aren’t the kind of
I did read a lot about clots I take warfarin to prevent. Overall,
the different vaccines I understood that the benefits of having
Having an injection can be difficult, but there are some simple
and how they’ve been the vaccine still outweighed the risks.
I talked a lot about it with my ways you can make it easier. Rachelle Beaven offers some tips
developed. I wanted grandma, who really didn’t want
to feel as informed as the vaccine. She was apprehensive:
because she’s older she remembers lots
If the thought of having an injection
or blood test makes you anxious,
or an object in the room may help.
You could also try listening to music
possible about having of things that have happened to the you’re not alone. Up to one in 10 through headphones, or answering
the vaccine. Black community and she felt scared. I people have a fear of needles. maths questions in your mind –
think it helped that I was honest about We know that this fear can make whatever works to distract you.
my own apprehensions and reasons it hard to face injections, blood
informed as possible about having for choosing the vaccine. I said “I’m tests or vaccines, even though they Positive thinking: It can help to focus
the vaccine. human, I’m nervous, it’s new, but this may benefit your health. The good on the positive reason why this is
Having had heart surgery to is what we know and I’m willing to try news is that there are some simple happening – whether it’s to protect
correct complications of my Marfan this. And if you get to the point that you techniques which can help to you from a virus, or to look after your
syndrome, I have experience of my are in a hospital bed really unwell with overcome it. health. Remember that it will be a very
life being saved because of medical Covid, you’d look back and wish you quick, temporary discomfort – which is
interventions that wouldn’t have had the vaccine.” So putting it into that Preparing for your appointment well worth it for good health.
existed without research. So that gives perspective, she agreed to have it. If you are worried or anxious you
me faith in research and the way Everything has risks, but it’s about may feel sweaty, sick, dizzy or light- After the appointment
things are tested. whether the benefit outweighs the risks. headed. Practising deep breathing Most people are relieved to find that
I’m on warfarin, which means I was really scared before my heart can help in the days before your the experience was quicker and much
there is more risk of bleeding from the surgery when I was told that there is appointment. Try this exercise: Talk it through: Let the person who easier than they thought it would be.
vaccination, but you can have it as a five per cent risk of dying from that • Take a long, deep breath in is treating you know if you are feeling It can help to reflect on or write down
long as your INR levels are controlled. particular procedure. But when I looked through your nose. nervous. They will make sure you are as how it went, so you can remember
Because I’m on warfarin, the first into all the options, I thought OK, the • Let it flow into your belly, as far as comfortable as possible, answer any what worked for next time.
I was apprehensive about getting the vaccination centre I went to refused benefit of me going ahead with the you comfortably can. questions you have and distract you If despite trying these techniques,
vaccine, but for me, it seemed like to give me the vaccine, so I went to a surgery outweighs the risks. I think the • Slowly exhale through your nose. from the process by chatting to you. If your fear of needles is causing
the better choice to have it instead of different centre to have both my first same sort of thing applies to deciding • Repeat the exercise for three to you’re feeling faint, they can help you to ongoing anxiety or you are avoiding
continuing to live in fear of the virus, and second dose. The staff there were on the vaccine. five minutes each day. lie down if you’d prefer to. healthcare because of it, speak to
which I’ve been told I’m extremely lovely and made me feel safe, and If people are not comfortable, I’d your GP. They may be able to refer
vulnerable to. Before getting the being on warfarin didn’t cause any suggest they research the different If you are worried about pain from Distract yourself: Try not to focus on the you for treatment such as behavioural
vaccine, I felt super apprehensive problems with the vaccine itself. options, and speak to people they trust the needle, you can apply a numbing needle. Focusing on a positive memory therapy.
about leaving home at all. Once I I was more apprehensive about the about their concerns, whether it’s a GP cream before the appointment, to
had the first dose, I felt a bit more second dose because by then there or care team, or someone they trust dull the feeling. You can get it from a
comfortable. I went out to eat – were concerns about blood clots. I’ve generally in life. pharmacy or on prescription. (Don’t What can I do if I start to feel faint?
outdoors, but it was the first time I’d had a blood clot before, and also forget to tell the person who’s treating If you begin to feel lightheaded and are worried you might faint, practising applied
felt able to even do that for more than a blood clot would be a particular Illustration: Kotryna Zukauskaite you where you have applied it.) tension could help to regulate your blood pressure to avoid fainting.
a year. problem for me because I have a How to practise ‘applied tension’:
I think it’s important for people to mechanical heart valve. But luckily Find out more At the appointment • Sit comfortably.
get vaccinated to protect themselves because I’m on blood thinners, I could Get answers to your Covid-19 Relax: As you sit down, relax your • Tense the muscles in your arms, upper body and legs for 10 to 15 seconds until
and allow themselves to live as speak to my great anti-coagulation questions, from the second dose shoulders and arms - the more you feel warmth rising to your face.
normal a life as possible again. team at St Barts Hospital, who know to side effects, at bhf.org.uk/ relaxed you are, the less you will • Relax your muscles for 30 seconds.
I did read a lot about the different me and my risk factors, and I also coronavirus. notice the needle. Remember your • After 30 seconds, repeat the tensing exercise until you feel the warmth in your
vaccines and how they’ve been did my own research. I realised that slow breathing exercises. Counting face again.
developed. I wanted to feel as the rare type of clots that have been your breaths can also be helpful. • Repeat the exercise five times.
10 I Heart Matters bhf.org.uk I 11
Celebrating 60 years
60 years of
pioneering
research
How we’ve saved and improved lives over
six decades – and the challenges we’re
now taking on
This year we celebrate 60 years of our Since the 1960s, the
life-saving research – from heart attack
care to treatments for stroke, and from
annual number of heart
understanding the causes of vascular attack deaths in the UK
dementia to the best care for people
with congenital heart disease.
has more than halved.
Transforming heart attack
treatment with specialist care
In the 1960s, the treatment for people
who had suffered a heart attack was
bed rest and pain relief. Most of them At the time, the lack of treatments
died within a year and many others meant that after a heart attack many
went on to suffer long-term health people developed a life-threatening
problems, such as abnormal heart heart rhythm, leading to cardiac arrest
rhythms and heart failure. (in which the heart stops pumping
It was Desmond Julian, who became blood around the body). In the early
a BHF Professor and later our first 1960s, few heart attack patients - even
Medical Director, who radically those in hospital - survived a
changed how heart attack patients cardiac arrest.
were cared for. When a visiting junior The BHF funded equipment for Dr
Illustration: Matt Herring
doctor in Australia in the early 1960s, he Julian to set up a coronary care unit
was one of the first people in the world in Edinburgh in 1967, working with Dr
to propose specialised units for cardiac (later BHF Professor) Michael Oliver.
care, which have since transformed Dr Julian showed that having heart
care for heart attack patients across patients on one ward, monitoring them
the globe. continuously, and having the right
12 I Heart Matters bhf.org.uk I 13
Celebrating 60 years
equipment and staff on standby for for vascular dementia that work by drug called tenecteplase might help congenital heart disease by carefully one of the first people to recognise the Dr Babu-Narayan and colleagues
emergencies, would increase survival draining waste fluid from the brain. treat strokes. Professor Keith Muir at the mapping the anatomy of different importance of caring for the growing worked out how heart scarring seen
rates. His measures included training University of Glasgow is running a trial heart defects and showing how these number of adult survivors of congenital on imaging scans can be used to
staff in cardiopulmonary resuscitation Stopping the damage caused to compare tenecteplase with alteplase affected the heart’s electrical system heart disease, pioneering ‘GUCH’ – predict which adults with repaired
(CPR), and having defibrillators at by stroke in thousands of people, to see which that coordinates the heartbeat. This Grown up Congenital Heart Disease tetralogy of Fallot need an implantable
hand, so that if a cardiac arrest did Strokes cause around 34,000 deaths is best at helping them recover from has enabled surgeons to avoid putting – care in the UK and Europe. The BHF cardioverter defibrillator (ICD), which
happen, the patient had the best a year in the UK, and are the single ischaemic stroke. Professor Muir and a stitch where it could disrupt an funded Professor Somerville to create could save their life if they experience a
chance of being revived. biggest cause of severe disability. his team are also being funded by us electrical circuit in the heart, making a follow-up system for survivors of life-threatening heart rhythm.
In its first year the unit reduced A stroke happens when the blood to take part in an international clinical surgery safer. congenital heart disease, to identify
deaths by more than 30 per cent. supply to part of the brain is cut trial testing whether tenecteplase BHF-funded advances have helped which factors make a difference to their Pioneering pacemakers
Soon hospitals around the world were off, causing brain cells to become improves recovery in people with mild more children with congenital heart long-term survival. People with a very slow or irregular
following their example. damaged or die. This is usually strokes, who are not usually offered disease to grow up and grow older. Since then, we have funded more heartbeat may need a pacemaker.
Since the 1960s the annual number because of a blockage in one of the clot-busting drugs. Even mild strokes But this has come with new challenges. research to find out how best to care Pacemakers work by sending electrical
of heart attack deaths in the UK has brain’s blood vessels (an ischaemic and mini-strokes can lead to lasting Many survivors require lifelong care, for adults living with congenital heart impulses that stimulate your heart to
more than halved, thanks in part to stroke), or when a blood vessel bursts, disability, so this study could lead to a as some are at risk of heart failure and disease. In 2011, we funded Dr Sonya beat with the correct speed or rhythm.
Professor Julian’s vision and the work of causing a bleed in the brain (a new way to treat this kind of stroke. sudden death from unexpected heart Babu-Narayan at Imperial College Around 50,000 people are fitted with a
the coronary care units now established haemorrhagic stroke). rhythm disturbances. London, to refine ways of identifying pacemaker in the UK each year.
throughout the country. The very first research funded by the Improving care for people with In the 1970s and 1980s we funded which adults born with tetralogy of In the 1950s, cardiologist Aubrey
BHF in the 1960s was to support BHF congenital heart disease, from work by Professor Jane Somerville at Fallot (a complex heart defect) could Leatham and his technician Geoffrey
Understanding the causes of Fellow Dr Enid Joan Acheson at North birth to adulthood the Royal Brompton Hospital. She was be at increased risk of sudden death. Davies worked to develop a prototype
vascular dementia Staffordshire Royal Infirmary to identify Each day in the UK, around 13 babies pacemaker. In 1960 they implanted
Vascular dementia is the second most the causes of strokes, which were little are diagnosed with a congenital the UK’s first internal pacemaker.
common type of dementia, affecting understood back then. Since then we’ve heart condition, which means a heart There were many challenges with
around 150,000 people in the UK. funded millions of pounds of research problem they are born with. Before the the early versions of pacemakers. The
It’s caused by reduced blood flow to to better prevent and treat these life- BHF was founded in 1961, the majority first prototypes needed relatively high
parts of the brain, which damages voltages to pace the heart, which were
and eventually kills brain cells in the painful. Leatham and Davies overcame
affected area. The reduced blood flow Before the BHF was founded in 1961, the majority this problem by creating devices that
can be caused by a stroke or mini- had better contact with the heart
stroke or by narrowing and blockage of of babies born with severe congenital heart disease muscle, so that lower voltages could be
the smallest blood vessels in the brain. died before their first birthday. Today, more than used. Even so, early pacemakers were
People with vascular dementia have still bulky and required a traumatic
few treatment options and there isn’t eight out of 10 survive to adulthood. operation to open the chest, in order to
much evidence to say which treatments sew electrodes directly onto the heart.
are best. The BHF is working with Almost as soon as the BHF
other funders, including Alzheimer’s threatening conditions. of babies born with severe congenital was formed, we began funding
Society and the Stroke Association, to This has included a large clinical heart disease in the UK died before Aubrey Leatham’s research into the
understand more about the disease trial which showed that statins can help their first birthday. Today, more than development of pacemaker technology
and find new ways to treat or prevent it. to prevent strokes, both in people with eight out of 10 survive to adulthood. at St George’s Hospital in south
For example, we’re funding Professor high cholesterol and also in those with BHF Professor Sir Magdi Yacoub London. Within five years, Dr Leatham’s
Roxana Carare at the University of ‘normal’ cholesterol levels. developed a surgical technique in team had successfully treated several
Southampton to explore whether the We’re now looking at how to improve the 1970s to repair transposition of the hundred patients.
brain’s methods of removing waste treatments for stroke. Giving a “clot- great arteries (which means the heart’s Their pioneering work has helped
substances are linked to vascular busting” drug to break down the clot major blood vessels are swapped or pave the way for today’s miniature,
dementia. Tiny pathways in the walls and restore blood flow through the reversed). This life-saving operation, sophisticated pacemaker devices that
of the small blood vessels in the brain in the first few hours after an called the arterial switch, is now used can transform people’s quality of life.
brain are used to carry away toxic ischaemic stroke can greatly improve by surgeons across the world and is
waste products. Dr Carare is studying the chances of recovery. Right now, successful in over 95 per cent of cases. Find out more
how this system goes wrong in mice doctors use a drug called alteplase, Throughout the 1970s and 1980s, Read more stories on incredible
and whether it causes dementia. but we are funding clinical trials BHF Professor Robert Anderson helped research and how you can join in our
This research could lead to drugs looking at how a newer clot-busting to improve surgery for children with 60th birthday at bhf.org.uk/birthday.
14 I Heart Matters bhf.org.uk I 15
Celebrating 60 years
60 years young
This year we celebrate 60 years of the BHF. Wendy Cook, Helen Cawthorne and
Neil Davidson are also 60 this year – a milestone they might not have reached
without research. They tell their stories of survival to Charlotte Rastan
Helen Cawthorne
Helen, from Derbyshire, found out she had an inherited heart condition after
she had a cardiac arrest in the swimming pool on Valentine’s Day in 2011.
“I first found out I had a disease the condition and managing it. Foundation, sharing my story to raise
of the heart muscle called ARVC When I was recovering, I got a dog, awareness. And I’m on the Patient
(arrhythmogenic right ventricular Spike, and we go for walks every day. Information Panel - we’re a group of
cardiomyopathy), when I woke up in Because of my heart condition, I do people who use our experience of heart
hospital after a cardiac arrest. find walking uphill difficult. It still hurts and circulatory disease to shape the
The quick actions of the lifeguards when someone jogs past me, because work of the BHF. I want to help in any
giving me CPR and using a defibrillator triathlons were such a big part of my way I can, so that others benefit.
on me saved my life. Valentine’s Day is life. ARVC is something that can’t be In 1965 my father’s mum died
now my second birthday. My partner cured, but I’ve shown you can still have suddenly on a bus when she was in her
Mick and I say it’s the day that I lived, a life. I see life in a lot more detail now. 60s. We think it was probably the same
not the day I nearly died. I’m not whizzing past like I used to. condition I have, but it was not really
I was told I would need an I’m such an outdoor person. Mick known about then. Things have moved
implantable cardioverter defibrillator and I love to go walking in Yorkshire, on hugely, thanks to research.
(ICD) as I was at risk of another cardiac on the very edge of Wharfedale, a When you get an unexpected
arrest. I used to compete in triathlons huge limestone valley. You look over diagnosis you can crumble, but
and duathlons at an international there and the world just melts away. It’s sometimes you’ve got to have a Plan
level for Great Britain from 1993-2001. stunningly beautiful. B. You’ve got to be thankful for what
I had to give it up and I wondered if I am retired now, as I want quality you’ve got and for the beauty of the
my life would ever be normal again. years. I volunteer for the British Heart world.”
Would I be able to go back to work as
a teacher? Would I have to be escorted
everywhere?
I took things really slowly and built I see life in a lot more detail now. I’m not whizzing
back up. Mick and I would go for past like I used to.
walks and at first I could just reach the
metal gate in the local park and back. Some people with ARVC get few symptoms, but others are more severely
Gradually my confidence grew, and I affected. We are funding research to try to find out why it can vary. At Keele
returned to work. University, researchers are creating 3D heart tissue models that can be used to
My heart condition is genetic, so my investigate the underlying biology of ARVC. This could help us identify people
two brothers are screened regularly. at high risk of developing severe ARVC and eventually lead to new ways to
Helen’s heart condition means she can’t run any
One good thing is that my two nieces treat the disease.
more but she loves walking in the countryside
with her partner, Mick, and dog, Spike and nephew are seeing me living with
16 I Heart Matters bhf.org.uk I 17
Celebrating 60 years
Wendy Cook Neil Davidson home, but by December I was well
After the sudden deaths of three Neil, from Halifax, had a cardiac arrest and would have died without CPR. enough to travel to Australia to
brothers, Wendy Cook was diagnosed Now he’s driven to spread CPR training and to fundraise for defibrillators so see Oliver.
with familial hypercholesterolaemia more lives are saved. I call Oliver my life saver. It’s very
(FH), a genetic condition that causes emotional. He had learnt CPR when
high cholesterol from birth and can “I started feeling unwell in March 2017. Oliver told Janice to ring 999. They he was 15, as part of a PE lesson, and
lead to a heart attack at an early I was getting night sweats and had no manhandled me to the floor and Oliver now I’m dedicated to spreading CPR
age. She now takes statins and is energy, just feeling rotten. I went to the started CPR on me straightaway. He skills as far and wide as I can. I work
celebrating a birthday that she GP who sent me straight to hospital for carried on for 21 minutes until the with the Resuscitation Council UK and
thought she might not reach. lots of tests. They told me I had to go on first responder turned up and used a Yorkshire Ambulance Service to spread
antibiotics for endocarditis, an infection defibrillator on me to shock my heart awareness and I do voluntary training
“Philip was the first of my brothers to of the inner lining of the heart, and that back to a normal rhythm. in the community. The CPR training kit
pass away, and the inquest said he it had affected one of my heart valves. I was several weeks in hospital, and from the BHF is always in my car.
had died of ischaemic heart disease. While waiting for surgery to replace in that time I had the surgery to replace I’ve set up a community fund to raise
He was 45. Then three years later my mitral valve, I had a cardiac my mitral valve. I couldn’t even walk money so we can get a trainer to teach
we lost my brother Paul to the same arrest. It was 3am on 31 July 2017 and at first and was in a wheelchair on the community groups CPR. My birthday
condition, and then another brother, apparently I was gasping for air. My wards, but I walked out of hospital on 7 party in November is going to be a
Michael, two years after that. That wife Janice shouted out for Oliver, one September and started my life again. It comedy night to raise money for it. It
left me, my brother Tony and sister of my two sons. He lives in Australia but was a second chance for me. seemed like the best thing I could do to
Christine. It all happened so fast I didn’t just happened to be home on holiday. I took things very slowly when back mark my 60th.”
have time to come to terms with it all.
After Paul died, I contacted my GP
and that’s when she first mentioned FH.
I was 52 and had never heard of it, but
it was clear that heart disease was in
the family and my cholesterol was high.
I went on statins and my cholesterol
came right down. I just take my tablet
before I go to bed. The fact that statins
can give you a future is amazing. It
means my family don’t have to go
through all that again.
After Michael died, my GP sent me
for genetic testing and the results came
The fact that statins can give you a future is
back saying I have an altered gene. amazing. It means my family don’t have to go
It’s not one of the main genes already
known to be linked to FH but they said
through all that again.
in future, with more research, they may
be able to link the gene to FH. The BHF has been a major funder of FH research, particularly through our
It’s my 60th birthday in July. I’m not support over 30 years for the leading UK expert in FH, former BHF Professor
a party kind of person - I would like Steve Humphries.
to celebrate in a quieter way with my Professor Humphries and his team discovered many of the genetic defects which
husband Paul and family. I am just cause FH, leading to a blood test for the faulty genes, so doctors could diagnose
glad to get to this age. It’s such an or rule out FH. They also showed that genetic testing for family members of a
achievement in our family to reach 60. person with FH (a process called cascade testing) helped to spot more people In the UK thousands of people die every year following a cardiac arrest in
My nephews and nieces all have with the condition. Identifying people who have FH and cascade testing of their home. We’ve been supporting CPR training for decades, and in 2014
their cholesterol tested. I am looking family members is now an NHS priority. we started a campaign to save more lives each year by creating a ‘Nation of
after myself, but I would like the next We’ve also helped to fund clinical trials that have demonstrated the ability of Lifesavers’ through CPR training. We’ve also been pushing for CPR training to
generation to be really aware and statins to reduce the risk of heart attack, heart disease and stroke. Statins have be added to the secondary school curriculum, which has now been achieved
the generation after that. I am saved the lives of many people, both with and without FH. in most of the UK.
definitely hopeful.”
18 I Heart Matters bhf.org.uk I 19Pull out and keep
Pull out and keep
Ratatouille flatbreads Watermelon,
with harissa butter bean and
Preparation time: 15 mins Cooking time: 10 mins
Serves: 2 Not suitable for home freezing
orange salad
Preparation time: 15 mins Cooking time: none
Energy Carbo- Fibre Sugars Fat Saturates Salt Serves: 2 Not suitable for home freezing
1007kj hydrate 6.9g 8.2g 6.0g 1.5g 0.55g
240kcal 34.1g Low Low Low Low
12% 23% 9% 9% 8% 9% Energy Carbo- Fibre Sugars Fat Saturates Salt
% = an adult’s reference intake 1116kj hydrate 10.5g 20.0g 6.5g 3.7g 0.66g
How we made it healthier 266kcal 33.5g Low Low Low Low
Griddling the vegetables rather Ingredients 13% 35% 22% 9% 19% 11%
% = an adult’s reference intake
than frying keeps the fat content 1 small aubergine, trimmed and thinly sliced
down. Using harissa gives a great Ingredients
flavour to the soft cheese, reducing the 1 medium sized courgette, trimmed and
300g (10oz) wedge of fresh watermelon
need for salty seasonings and sauces sliced (or a red pepper cut into thick strips).
– but check the labels and choose 400g tinned butter beans, 235g drained
the harissa with least salt. Fresh 1 small red onion, peeled and sliced into
weight
herbs such as coriander thin rings
also add flavour. ½ head fennel, very thinly sliced
2 tsp olive oil
80g (3oz) piece cucumber, diced
50g (2oz) low-fat soft cheese
1 orange, peeled and segmented
½ tsp harissa paste (choose the lowest-salt
version) 50g (2oz) feta cheese, crumbled
2 small flour tortillas (wholegrain if possible) 1 tbsp fresh mint, roughly torn
1 medium tomato Dressing:
1 tbsp fresh coriander, chopped Juice of ½ orange
1 tsp honey
Method 1 tbsp fresh mint finely chopped
1 Toss the aubergine, onion and courgette or pepper
slices with the olive oil. Heat a griddle pan until
piping hot, reduce the heat to medium then cook the Method
1
vegetables for 10 minutes until tender, turning them Remove the rind from the watermelon and slice
over after 5 minutes. thinly. Arrange around the edge of a serving platter.
2 Meanwhile, mix together the soft cheese and
harissa. Spread each flour tortilla with half the soft
cheese mixture, top with the griddled veg.
2 Toss together the butter beans, fennel, cucumber
and orange segments and pile into the centre of
How we made it healthier the watermelon.
Beans are a good source of fibre
3 Finely dice the tomato and scatter over the
vegetables with the coriander.
and protein, and low in fat, so
they are a great ingredient to turn a 3 Scatter with feta cheese and torn mint.
4 Either eat like a pizza or roll up as tightly as you can
to form a wrap. Eat straight away or, for a picnic
salad into a more substantial meal.
Feta cheese is high in fat and salt, 4 Mix together the orange juice, honey and mint
and drizzle over the salad. For the perfect
packed lunch or picnic,cut the watermelon smaller
so we use just a little in this
or packed lunch, wrap in baking parchment, twisting and mix with all the other ingredients before piling
salad.
each end tightly. into suitable containers or jars to transport.
20 I Heart Matters bhf.org.uk I 21Pull out and keep
Nutrition
Healthier Caesar salad
Preparation time: 15 mins Cooking time: 25 mins
Serves: 2 Not suitable for home freezing Ask the Send in your nutrition questions
Email: HMeditor@bhf.org.uk
expert
Write to: Heart Matters, British Heart
How we made it healthier
Foundation, 180 Hampstead Road, London
We made a tasty yet creamy
Energy Carbo- Fibre Sugars Fat Saturates Salt NW1 7AW
dressing out of roasting garlic
1770kj hydrate 5.6g 9.2g 19.4g 3.6g 0.49g
and blending with fat-free 425kcal 22.5g Low Med Low Low Call our Heart Helpline: 0300 330 3300
yogurt – it has a fraction of 21% 19% 10% 28% 18% 8%
the fat of a traditional % = an adult’s reference intake
Caesar dressing.
Ingredients
2 chicken breasts
½ tsp cumin seeds Are plant milks just as good for you, or better, than dairy?
½ tsp smoked paprika Plant milks such as almond, oat and soya Dairy milk contains more protein
are becoming an everyday addition to many than some other plant milks, although
200g tomatoes, halved
people’s diets - either instead of or alongside dairy most of us get more protein than we
4 cloves garlic, peeled products. need so this isn’t necessarily a big
Non-dairy milks vary in the nutrients that they consideration. Soya and pea milks have
3 sprigs fresh thyme provide, and don’t have the same combination of more protein than most other plant milks,
Victoria Taylor nutrients as dairy. However, there are other food and a similar amount to cow’s milk.
50g (2oz) slice ciabatta bread or any other rustic loaf is the BHF’s sources of all the nutrients that are found in dairy Try to avoid plant milks that have added sugar
1 tsp rapeseed oil Senior Dietitian products, so any differences aren’t necessarily a and/or salt. (While dairy milk does contain natural
with 20 years’ problem as long as you plan your diet so that it sugars, these are milk sugars which are not the kind
1 small head cos lettuce, thickly shredded experience includes other sources. that we’re recommended to cut down on.)
There are differences between brands as well There may be no harm in switching to plant milks,
3 tbsp fat-free Greek style natural yogurt as between different types of plant milk, so it’s a but there is no nutritional reason to stop drinking
Freshly ground black pepper good idea to check the nutrition label. Try to choose cow’s milk either. Dairy milk is nutritious and while
one that has been fortified with calcium, B vitamins protein and calcium content is well known, we are
(riboflavin and B12), vitamin D and iodine. That’s still developing our understanding of how its unique
Method because for most of us, dairy products are a source package of nutrients can affect our health.
1 Preheat the oven to 200C/180 fan/Gas 6. Line a baking tray with
non-stick baking parchment. Mix together the cumin and paprika
and rub over both sides of the chicken breasts. Place onto one side of
of these nutrients. If you choose unfortified plant
milk (organic plant milks for example) these will not
generally contribute as many nutrients to your diet
So, in short, from a nutrition point of view there
isn’t a strong reason why any specific milk is “best”.
It’s about the nutrients in each and whether you will
the baking tray. as dairy milk. have other sources of them in your diet.
2 Add the tomato halves to the other side of the tray cut side up,
add the garlic cloves between the tomatoes and lay the thyme
sprigs on top. Cook for 25 minutes.
What’s a good source of protein to have for breakfast?
The good thing about Most of us are getting the Making your porridge with
3 Brush both sides of the bread with the oil, then cut into cubes.
Add to the oven for the last 10 minutes of cooking time.
including protein in your
breakfast is that it can help you
to feel more satisfied, so could
recommended amounts of
protein, partly because there
is protein in more foods than
milk instead of water or having a
poached or boiled egg instead of
jam on your toast will increase the
4 Carefully lift the chicken onto a board and slice on the diagonal.
Pile into a serving bowl. Add the tomatoes to the chicken.
help you to be less tempted to
snack mid-morning. Being aware
of the protein in all your meals
you might think, including in
breakfast foods like wholemeal
bread and bran flakes. But if
amount of protein you’re eating.
Try not to regularly eat
processed protein foods such
5 Place the cooked garlic into a small blender, add the yoghurt
and any cooking juices from the tomatoes and blitz to a smooth
dressing. Season with black pepper.
can be helpful if you’re trying to
lose weight or maintain a healthy
weight, but this doesn’t need
you do want more protein, there
are better sources, such as
eggs, baked beans and
as bacon and sausages (and
vegetarian alternatives), smoked
salmon and other smoked fish,
to mean a high-protein diet, low-fat (unsweetened) as these may be high in salt and
6 Add the lettuce to the chicken and tomatoes and toss well. Drizzle
with the dressing and scatter with croutons.
unless this is what works for you. yoghurt. sometimes saturated fat too.
22 I Heart Matters bhf.org.uk I 23Nutrition
Carbs:
good or bad?
Carbs can be controversial, but do you need to avoid them?
Senior Dietitian Victoria Taylor explains
What are carbohydrates? which the body uses for energy, but What’s the problem with carbs?
Carbohydrates or ‘carbs’ are often starchy carbs provide a slower release Although carbohydrate foods can be
given a bad press. Aside from the of energy than sugars because they are good for us, surveys show that we’re not
fact that there are no “bad” foods in larger molecules which take longer to making the healthiest choices when it
moderation, it’s not really fair to treat break down. So that’s better for keeping comes to the type we’re eating. Most of
all carbs as the same. The reality us well fuelled for our daily activities. us are eating too much sugar – which
is that there are different types of The fibre in wholegrain and high- can contribute to a high calorie diet
carbohydrates – sugars, starch and fibre starchy foods can help prevent and therefore weight gain. So instead
fibre – and these have different effects constipation and maintain a healthy of cakes, biscuits, sugary drinks and
on our health. gut – and gut health is increasingly sweets, choose healthier snacks like
There are carbohydrates in most understood to be important to our fruit and veg or low-fat plain yoghurt.
of the foods we eat. But when we talk overall health. Research has also Fruit and dairy products do contain
about carbohydrates, we usually mean shown a link between diets high in sugars, but these foods offer other
benefits such as fibre or protein as well
as a range of vitamins and minerals.
• A medium slice of wholemeal bread
Most people in the UK don’t eat as much fibre as is Are low-carb diets healthier? or a medium apple both contain.
recommended to benefit our health. Low-carbohydrate diets have grown around 15g (½ oz) of carbohydrate
in popularity for losing weight. They • Half a pint of milk contains 13g (½ oz)
are also used by people with type of carbohydrate.
starchy foods and sugary foods. Starchy fibre and a lower risk of heart and 2 diabetes to help manage blood • A 50g bar of chocolate contains
What’s the bottom line?
foods, like pasta, rice, potatoes and circulatory disease, type 2 diabetes sugar levels. A low-carbohydrate around 30g (1oz) of carbohydrate. Carbohydrates provide us with
bread, should make up just over a and bowel cancer. diet with 130g (4 ½ oz) or less of total important nutrients, and don’t need
third of our diet. Sugary foods, such as Most people in the UK don’t eat carbohydrate per day has been Because carbohydrates are in so to be cut out of our diets. Reducing
sugary drinks, biscuits and cakes, don’t as much fibre as is recommended to shown to be safe and effective in many foods, you’ll need to plan your carbohydrates can be a useful strategy
need to be included in a healthy diet - benefit our health, so swapping to the short term for weight loss and diet carefully to make sure you get all for some people trying to lose weight or
but many of us eat them regularly, and wholegrain versions of bread, rice, diabetes control. the food groups you need for a healthy manage type 2 diabetes.
it’s ok to enjoy them in small amounts. cereals and pasta is an easy step However, it doesn’t suit everyone balance of nutrients and enough fibre. Choosing wholegrain, high-fibre
towards better health. The type of and hasn’t been shown to be better If you do have diabetes, you should starchy carbohydrates and cutting
Why do we need carbs? soluble fibre in oats has also been long-term than other approaches, such discuss any changes to your eating down on sugary foods will help you to
Carbs give us energy. In a healthy found to help reduce cholesterol as a Mediterranean-style diet, so think habits with the health professionals have a healthy digestive system as well
balanced diet, most of our energy levels, so porridge or no-added-sugar about what will suit you best. who are helping you to manage it. If as looking after your heart health.
comes from wholegrain and high-fibre muesli are a great way to start If you are keen to try a low- you’re taking any medication which
starchy carbohydrates, like oats, whole- the day. carbohydrate diet you’ll need to look could increase the chances of you
grain bread or pasta, brown rice, Wholegrain and high-fibre at all the foods you eat that provide having low blood glucose, this might Test your knowledge
and new potatoes (with skins on). All starchy carbohydrates also provide B carbohydrates, not just sugary and need to be monitored more carefully or Try our carbs quiz at bhf.org.uk/carbs
carbohydrates break down to glucose, vitamins, folate, zinc and magnesium. starchy foods. To give you an idea: be adjusted.
24 I Heart Matters bhf.org.uk I 25You can also read
