Editorial

Early this year, medical professionals attended a seminar focusing on heart disease in Malta. Undoubtedly, cardiovascular disease is a major cause of avoidable premature death.

The seminar was aptly entitled Cardiovascular Disease: Are We Doing Enough? And, no doubt, the question cannot be more topical, given the prevailing situation in this country.

Cardiovascular disease is Malta's biggest killer and there was unanimous agreement that not enough is being done to reduce the modifiable risks of this disease.

Julian Mamo, an epidemiologist and the president of the Malta Association of Public Health Medicine (MAPHM), was spot-on when he spoke of "a formidable challenge (because) cardiovascular disease goes beyond health to areas such as education, culture, social wellbeing, trade and planning among others". According to the National Statistics' Office's Demographic Review of 2005, a staggering 44.3 per cent of deaths were caused by diseases of the circulatory system. This is slightly more than the European Union average that is 42 per cent of all deaths.

Several professionals, including GPs and cardiac specialists, participated in the seminar, examining both preventive and therapeutic measures and evaluating current services and practices with a view to develop recommendations.

In a nutshell, the most important causes of heart disease and stroke are an unhealthy diet, physical inactivity and tobacco use, as Albert Cilia-Vincenti, a former human disease mechanisms teacher at universities both in Malta and in London, explains so thoroughly elsewhere in this issue.

Established research has found that risk is mostly linked to smoking, physical activity levels, alcohol consumption, obesity, cholesterol levels and blood pressure. The underprivileged and lesser educated are even more at risk, as they are much more likely to smoke and eat higher levels of saturated fats, salt and sugar. It is of utmost importance that this segment of society is given special consideration. Every study points out that those who are least inclined and able to adopt healthy lifestyles and seek early treatment are the ones most likely to suffer of cardiovascular disease.

Unfortunately, modern lifestyles have wreaked havoc with the traditional Mediterranean diet and the Maltese consume an inordinately high level of saturated fats, sugar and salt. Prof. Ellul-Vincenti says the growing numbers of pastizzi (cheesecake) outlets confirms what the Maltese people's staple food is increasingly looking like.

Motorised transport and mechanised equipment have made life easier, but at the price of a steep reduction in physical activity. We are now too accustomed to drive up to the front door of any place we need to go to.

Apart from opting to drive our way anywhere we go rather than walk, irrespective of the distance, we are also leading a more sedentary life than ever before: The TV, the computer, or rather the internet, and game consoles keep us stuck to our chairs for hours on end.

With regard to diet, consumer awareness has to be raised and people helped to choose what is in their best interest. It has been conclusively shown that traffic light labels are the best way of identifying the foods we should eat less often.

On a positive note, late last month, a group of public-spirited individuals decided to set up a Heart Foundation. Heart surgeon Alex Manchè praised the initiative as he felt such a philanthropic body would provide funds for specialised services and equipment that are not readily available. More importantly, he stressed that the foundation would also help to raise awareness on prevention of heart disease.

As pointed out in the seminar mentioned above, there is a lot that can be done. This is not the sole responsibility of the authorities. We need a coordinated effort that involves committed social groups that can raise funds and support cardiovascular control programmes.

A reduction in the incidence and mortality caused by cardiovascular disease can become a reality.