Everyone over 40 should have heart disease risk assessments, says expert

Prevention can reduce the risk of some illnesses associated with older age. File picture

Heart disease risk should be assessed for everyone from 40 onwards, with most strokes now preventable, a leading geriatrician has said.

Healthcare workers have called for more action on prevention, saying stroke is one of the main causes of long-term disability and death in Ireland. 

Professor Rónán Collins is a consultant in geriatric and stroke medicine at Tallaght University Hospital. He is also clinical lead for the HSE’s national clinical programme for stroke.

“How you age healthily is important, so is how you add life to your years, not just years to your life. Many of the things that hit us in later life are a result of high blood pressure being undetected, or it is an undermanaged risk factor.” 

Prevention can reduce the risk of some illnesses associated with older age, he indicated.

“Hypertension is a leading cause of poor eyesight in later life, high blood pressure is a leading cause of heart failure in later life, it’s a leading cause of kidney failure in later life, and it’s a leading risk factor for dementia,” he said.

Mr Collins called for cardiovascular risk prevention clinics nationwide, saying this would tie in with the EU Safe Hearts plan. “High blood pressure is probably a risk factor in about 70% of all strokes,” he said.

“That would suggest that maybe up to three-quarters of strokes might be preventable if we got a better handle on cardiovascular risk factors, particularly high blood pressure. If I was minister for health, I would be inviting everybody for a proper cardiovascular risk assessment when they’re aged 40."

He called for “a deliberate decision to detect earlier, act earlier and more consistently” across HSE regions.

Nora Cunningham is an advanced nurse practitioner and SPAFI nurse lead at University Hospital Limerick. SPAFI is Stroke Prevention and Atrial Fibrillation Ireland.

“We’re really good when someone has had a stroke with the acute side of treatment, but there is so much we could do to prevent people having a stroke or for people who’ve had a stroke to prevent another stroke,” she said.

Many of her patients had a mini-stroke (a transient ischemic attack), and she said: “It’s like their warning sign.”

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She can look at “risk factors and lifestyle measures, things they can do to prevent another stroke". This can include quitting smoking, more exercise, a switch to eating a Mediterranean diet, and reducing alcohol.

“They all will help reduce blood pressure, hypertension as well without ever taking medication,” she said of the lifestyle changes.

Meanwhile, the University of Galway is developing a plain-language, patient-friendly programme to help support the new clinics.

This is being informed by how people describe their blood pressure, and anyone who wants to take part in this throughout the summer can contact: [e-mail]