In this episode, I really want to go over, what I can offer you to help you get the best outcome for your health care. Because my belief is heart attacks are preventable. And I want you to live as well as possible for as long as possible by avoiding preventable heart attack.

So what I'd like to put to you is, what if I were able to share what I do in my office every day with my patients if I were able to share that with you? It's taken me nearly 10 years to get that feel and understand what I'm doing, where I've become comfortable with the latest technology and the latest evidence. It's taken work, determination, and I do it on a daily basis with my patients. And now I believe I'm in a position to share with you. It's about discovery, understanding where you are now, putting an assessment in place again, getting a feel and understanding for your current state.

Putting together a health plan and action plan, and then following through on that journey. Almost any successful journey has those same sort of steps, made with different names, reflect but the same process. We've put that together in the Healthy Heart Network because we know that the statistics are compelling. A death almost every 30 minutes in Australia, over 50 people a day dying from coronary artery disease. And it's not getting less. It's getting more. I know that there's a very good chance you've been touched with the sadness and the consequence of heart attack either through family or friends.

We know that information about heart disease turns up in the newspapers and magazines, on the radio, on the news all the time, particularly on social media. And some of that information, those sound bites, are they reliable, are they really what you should be basing your best health care on? It's confusing, isn't it?

So we know heart attack is common. I've talked in the previous episodes about what heart attack is. It's a rupture of a plaque. We've touched on the significance of cholesterol, blood pressure, smoking, family history. These are all characteristics which culminate in a risk of heart attack. But we've also talked about how heart attacks can occur out of the blue, surprisingly, in people who otherwise appear fit and well. And we've also talked about bringing precision to our evaluation so we can literally be in a position to prevent heart attacks. I've talked about the current paradigm, and here's a picture to remind you of the sort of image risk calculator might give us for a man in his early fifties, a low risk of heart attack as long as it's not the man who has the heart attack. Remember, this is a population-based risk assessment tool. It doesn't help us with the individual. It's really telling us that the characteristics represented would be related to a population with the rate of event is six percent over five years. That's a population-based assessment. That's not an individual.

We know that these healthy heart checklists that turn up in the media and papers and magazines, they reflect keeping an eye on your blood pressure, managing your weight, eating healthy, not smoking, all these givens for good heart health. But they don't, of their own, guarantee that you won't run into problems. Even famous people run into strife. The answer lies in going to the source by going from a population-based assessment to you as an individual and literally taking control by looking at the health of your arteries. I've shown you this picture already, but you can see the green circle, no calcium, in the two red circles, evidence that there's something going on. Once we have that information, we could start to know what the next best steps are for preventing a problem down the line. Again, clear looking arteries, again, arteries with calcification. We talked about heart attack, and we talked about stress tests. And importantly, I explained that you don't need to have narrowed arteries or symptoms to have a heart attack. Forty percent of all heart attacks occur on plaque that is not limiting flow in that artery up until the point that that artery ruptures, forms a clot and then closes off. If you really understand that you will realize that this is a silent killer and we have to do something different to our current paradigm to detect those people at risk, because the process of heart attack, whether you've got advanced or relatively early plaque, is the sign.

Well, my practice through my rooms and the Healthy Heart Network has helped people. It's helped people who want to reduce their risk of heart attack. It's helped people who have a high cholesterol and just don't understand the pluses and minuses, the pros and cons of taking stands. I've helped people who have had side effects from cholesterol lowering medications. I help people who come from families with a bad heart. Many people come and see me because they’ve had a friend or an acquaintance died, somewhat unexpectedly from a heart attack, and they want to get checked out knowing if it could happen to them.

A lot of people also just want to know what's going on with their hearts. A bit like you might get your car serviced and if you think about it, you don't wait till your car breaks down to get a service. You go and get it checked so you avoid the need for a tow truck at a breakdown. I see people who want to know more about cardiac imaging and some of those people who also joining the Healthy Heart Network. I really deal with people who believe prevention is better than cure, and I'm passionate about that. And I'm pleased to say I even have some doctors who are part of this process who want to improve their own knowledge, but also want a resource for their patients. So what options do you have? Well, you can Google your way to health, literally searching for the answers that I'm hoping to provide you. Well, it turns out that the Internet and the information superhighway can be a quagmire or could be littered with potholes. And I know that there are plenty of people who offer information which may not be well substantiated in data and may not be reflective of years of experience. Look, your alternate option is to invest in a program that guides, educates, and informs you to your very best health care, based on evidence, based on experience, based on someone who's reliable in that sphere. A specialist who has credibility in dealing with that sort of process.

Well, I've put together the Healthy Heart Network for exactly that, and I'm extending an invitation for you to join. Please get started. Get started now. The link is just below. It's easy to follow. But let me tell you a little bit more about it. If we were able to confirm that your risk of heart attack was low, as you think it might be, would that be worth it? But what if we were able to show you that your risk of a heart attack was much higher than you thought it actually is, and you were able to then put in place procedures, therapies, treatments to reduce that risk and avoid a heart attack? Would that be worth it? Well, of course it would. What if we were able to explain the significance of your elevated cholesterol? Would that be worth it? What if we were able to make it clear as to whether you should be on Statins or not? Would that be worth it? And what if you were getting the answers from the Healthy Heart Network that you just weren't getting from your own medical providers? Would that be worth it? Well, again, let me extend an invitation for you to join me in the Healthy Heart Network. We've got the details for signing up below. There is a 30-day guarantee. There's every intent for us to give you the best possible outcome. If this is not for you, that's absolutely fine. If for some reason on day twenty-nine, at the twenty third hour, at the fifty-ninth minute you want to pull the pin, there is no harm from our side. We really just respect you, your decisions. But we want to see the best for you. Remember, at the end of the day I really want to see you live as well as possible for as long as possible by supporting and educating you through a process to allow you the opportunity to avoid a heart attack.

So the real question is, while traditional risk assessments like rolling a die, you have to ask yourself, is your life worth the gamble and what are you going to do to be more precise about it? Quick tale of two people. These are imaginary, of course.
First of all, imagine our first protagonist, Dave. He's in his fifties. His mum had problems with his heart. Dave carries a little bit more weight than he should. Doesn't exercise quite as much as he'd like, but he does a little bit. His wife makes sure he eats healthy and looks after himself. His blood pressure's been fine. He's seen his local doctor. He doesn't smoke, but basically said that he was a bit concerned about his heart risk because of his family history. His local doctor said, “Look, why don't we do a treadmill test”, and sent him off just to be sure he passed the treadmill test with flying colors. Well, just under a year later, in fact, six weeks before Christmas, Dave, after leaving the gym, walked into the car park, had a heart attack, and dies out of the blue. Everyone says what a great guy he was. His wife loved him, how he lived life to the full. But he left two children behind. His wife misses him. His children miss him. And the world continues to turn.

Let me contrast that to another fictional character, and I will just again mention that Dave was fictional. We're going to call this gentleman Jeff. And Jeff is just, he's a sensible guy. He's someone who you sort of know when you catch up with him, is thinking and thinks clearly. He's also in his 50s, has a professional job, looks after himself, looks after his family, and just seems to have a good balance. He's often getting the exercise done, the work done, and he spends good family time. He's the sort of guy you can admire for his success in finding some of that balance. He tells you, because there's some hot issues in his own family that he's done a little bit of research and gone to check it out. He spoke to his local doc and found some resources that helped guide him to the best available information for his own heart health. Since that time, he's been able to clearly define his risk of heart attack and institute appropriate therapies to mitigate that risk. Without any fuss, with the right information, and the right assessment, getting on the right medications and the right follow up, he's put in place an appropriate plan for heart attack prevention. Jeff lives happily ever after.

So the Healthy Heart Network, I hope, is for you to feel that need to give you the opportunity to best heart health care. But as part of the Healthy Heart Network, we really are committed to giving you the best opportunity for the best patient outcome. And let me offer you some bonuses, and I think these are just fantastic. So first of all, a healthy heart journal. I've got one here. It's just fantastic. It allows you to work through our course with lots of feedback, lots of detail, colored pages, and your chance to really get a deep dive into understanding how we're going to prevent you from having a heart attack. We've also got Know Your Real Risk of Heart Attack as a hard cover book. It’s an absolute ripper. It's come up really nice and hardcover and we will send that through to you. That's value just thirty dollars by itself. We will send you the full resources on a USB of the e-book and audio book for Know Your Real Risk of Heart Attack, valued at over twenty dollars, at twenty-five dollars, in fact. So a nice, easy, electronic based way for you to engage with that book. You get, of course, access to all the courses on the platform at no extra cost. And that's our privilege to share that with you.

The guys from Nutrition for Life will offer a complimentary dietary assessment that's worth nearly fifty dollars just of its own. Also from Nutrition for Life, a low carb, healthy, fat living e-book series valued at fifty dollars as well. So some great stuff to get you going. And he's one again from the Nutrition for Life Guys. It's a low carb, healthy, fat online startup program valued at two hundred dollars. If you are signing up for Nutrition for Life with this, you'd be out of pocket to get this great resource and we're going to include it as part of your journey, as a bonus. There's the sugar detox course valued at twenty dollars. We include a diet and nutrition guide with bonus recipes. Here it is. This is a great little book again, of its own, with lots of information really nicely laid out. There's even part from the recipes that are in there in some of those are really interesting. There's some really nice stuff on exercises and stretching some yoga poses. I've been amazed at the team being able to put together this resource just for you.

We've got the Healthy Heart Network TV show on DVD, so not everyone is comfortable using streaming. Some people still use DVD. And if you want to share the Healthy Heart Network TV show with friends or family, you'll get it in a DVD form valued at nearly fifty dollars. We've also got the Healthy Heart Network course set valued at nearly three hundred dollars. Now you can access this all on the website, but it's so nice to have it in this beautifully presented box so you know where it is, and you can use it as you wish. You don't even need to be online to be able to access it. And lastly, and this is an optional bonus for those people who may need a scan as part of their assessment, we include the virtual heart scan consultation valued at nearly one hundred dollars, absolutely free. Now, that all sounds like a heck of a lot, but really, we're all about wanting to make sure you have the best possible resources so that you may live as well as possible for as long as possible by avoiding a heart attack, because I believe a heart attack is preventable.

Please join us. I would like to thank you for your attention. Take care. And bye for now.

>>> Join The Healthy Heart Network https://healthyheartnetwork.com/page/join. <<<<<

Hi, my name is Warrick Bishop and I'd just like to make something clear - that the information I'm sharing with you at this stage is to my knowledge as accurate and complete as possible. It is also a representation of my own approach to the clinical situations I deal with with my own patients. It's really important you don't rely on this information in isolation, but that you use this information in conjunction with your own medical practitioner, who really is in the best place to provide you with your specific medical requirements and needs. The intent of this information that I've been providing is really to allow you to be informed and be educated around heart health so that you can get the most meaningful conversation with your medical provider, for your best outcome. I wish you the best of health.

I believe that heart attacks are preventable, but there are steps and there is information you need to understand to get there. But let's take a step back and let's think about the history.

What I'm going to talk about is scanning the heart. And one of the things we do, scanning the heart, is looking for calcium within the arteries. So what's the background to that? Interestingly, back in 1927 a fellow called Link first described calcification in the arteries of living subjects. That's nearly 100 years ago. So this idea of knowing that we might find calcium in arteries is not new. In about 1960 or thereabouts, a couple of researchers in the United States looked at taking X-rays of cadavers who died from coronary or heart attack, and they found 80% of those patients had calcium in the arteries, closely or starting to closely link the issue of calcification in arteries with problems with the heart. Some years after that, a group in England led by a doctor called Oliver used fluoroscopy or cine cameras or, if you like, almost video Xray, to look at the heart of subjects with coronary artery disease and found calcification.

So how does calcification get into the arteries? Well, I've got a cartoon here which might just help a little bit. You can see if you look at this cartoon that the artery wall has a number of layers. It's got an inner layer, a middle layer, and an outer layer. Cholesterol will sit on that inner layer and may be drawn into the middle layer and start to accumulate. As that cholesterol accumulates, other cells move in. And one of the cells that's particularly important is a so-called macrophage, which is like the gobble guts, so cleaning up cell of the body. That macrophage goes in, and it finds that cholesterol and gobbles it up. In fact, it gobbles so much that it swells to a size that it ruptures. And because macrophages have enzymes inside them to help them digest other particles, proteins and cellular debris within the body, those enzymes are released, they cause local scarring, and that local scarring forms an architecture or a scaffold for calcium to deposit. So the deposition of calcium in the arteries is closely linked with the deposition of cholesterol within the arteries prior.

So how do we find CT? We find calcium in the arteries, we use a CT scanner. So CT stands for computer tomography and really means that we're using a panel of X-ray to take thin slices, that we stack together to reconstruct images. So we use C.T. or CAT scanning, and you may have heard of that. They’re broadly available. But for the use of scanning calcium, they quite broadly details.

Let me show you some of the pictures we get. Here’s a heart. You can see the heart is the lump in the middle here, at the front or the top of the picture is a white bar, if you like, that's the sternum. At the back of the picture is the vertebral body and on the side are the ribs. But the bit in the middle is the heart. You can see this particular heart doesn't have any calcification in that because the calcification shows up as white on C.T. X-ray. Look at these. These pictures clearly show that that blob in the middle of the heart has calcium within the arteries. This starts to give us more information about that individual patient. So some people say to me, well, why do we bother imaging the arteries? Why don't we just do a stress test here?

Let me talk you through why that's the case and let me explain why just being fit and healthy doesn't necessarily protect you from a heart attack and why I've been so strong about putting this information in your hands, because many of my colleagues historically and still use stress testing to evaluate risk. Let's go through that.

Here's a picture of an artery going to a piece of heart muscle. If we think about the development of plaque within those arteries, then early plaque formation doesn't limit flow. It's early. It's not progressed. It's not causing flow limitation, so we can get no flow-limiting plaque. In this situation, patients have no symptoms whatsoever because there's no limitation of the blood flow.

Let's contrast that to people who have advanced or more advanced plaque within their arteries, plaque that is tight enough that when the individual increases their workload, not enough blood can get through. And so that leads to maybe chest pain or shortness of breath. These individuals have symptoms, but this is pretty advanced plaque. We're going to call that flow limiting plaque. If we were to section through or cut through non-flow limiting and flow limiting plaque to look at the constituents, we would see that they basically made up of the same thing, which is a build-up of cholesterol covered by a fibrous cap separating the contents of the blood from the contents of the buildup of plaque.

Well, what happens with a heart attack is that that fibrous cap separating the cholesterol laden plaque from the contents of the blood passing through, that plaque cap ruptures. And when that ruptures, the contents of the blood can come into contact with the contents of the plaque. And that's not meant to happen. The body suddenly puts in train, a response to stop what it thinks is a situation where the body could be bleeding, and it forms a clot. That clot or thrombus can block the artery completely and if it does, stops all blood to the muscle beyond or supplied by that artery giving rise to a heart attack. The word we use actually is a myocardial infarction but heart attack is a bit of a generic term and will serve our purpose for now.

Now he's very important information and I want you to understand. When we look at the autopsy findings of people who have had heart attacks, it turns out that approximately 60 percent of heart attacks occur on flow-limiting plaque. So quite advanced. But the scary, surprising, and really important bit I want you to understand is that 40 percent of heart attacks occur on plaque that is non-flow limiting. These are plaque not advanced enough to have narrowed the arteries, but are advanced enough to be unstable and rupture.

Think of our fun runner in the very first episode of this miniseries. That fun runner put on his shoes that morning, feeling fit and well and looking forward to running a 10 km run. He hadn't been training with regular symptoms. He didn't have flow limiting plaque, up until the point that that plaque ruptured halfway through his race and he dropped dead by the side of the road. It's very important to understand the difference between flow limiting and non-flow limiting plaque, and that both can give rise to heart attack.

Sixty percent on flow limiting lesions, 40 percent, nearly half, on plaque that's not limiting blood flow, to the time it ruptures. Now, let's think about stress testing. When we stress test someone, we're putting them through a treadmill test and we're increasing their oxygen demand. And really, we need more blood to flow down the arteries to get to that heart muscle and supply the heart. Now, that means that a stress test will only pick up the flow limiting plaque because it's the flow limiting plaque that will have a limitation to flow when we increase the need for extra oxygen, extra energy for that heart muscle. Well, here's the scary thing. Treadmill tests are not a perfect test.

They will pick up 85 percent of narrowed arteries. We call it 85 percent sensitive. It will pick up 85 percent out of 100 narrowed arteries and 85 per cent specific. That means that 85 percent of the time, if it says there's a problem, it's correct. So it's not a perfect test. But if we think that through if we're picking up eighty five percent of the 60 percent of heart attack, then in actual fact we're only picking up fifty one percent of potential heart attack candidates. And if you think 51 percent, then we could achieve a 50 percent pick up rate just by tossing a coin. Doesn't sound such a good test when you put it that way. And remember, this is in people with flow limitation. So what do we do? Well, we remember that 40 percent of heart attacks are occurring on non-flow limiting plaque, undetectable by functional testing, by treadmill testing. The pickup of non-flow limiting plaque by stress testing is zero. The proof in that is the stress test that I did on our fun runner in 2003, only to see him have a heart attack in 2005.
Remember, it's the process that's occurring on the plaque, whether its flow limiting or not, which is rupture of that fibrous cap covering it and that content of the blood coming into contact with the contents of the plaque, kicking off a reaction that forms a clot. So treadmill testing, the reality is they can be good for detecting people who have symptoms. So if we do have people who appear with symptoms on exertion, then we can probably produce those symptoms and we may get clues that the heart's involved. So it's a good test for that. And I use it regularly for that. Not a bad test for fitness if you really want to assess how fit and well someone is, but you don't need to do that in a medical way. You could do that down the gym.

But the take home message is treadmill testing is not a great guide for the health of your arteries. So the current approach is to use a risk assessment tool, and I've just told you that that's a population-based tool that tells us the rate of an event within the population that doesn't help us with being precise about the individual. We tend to think of that population-based assessment as a roll of the dice because it literally is probability-based and I want to move to more precision care where we assess you as an individual, when we look at your heart, what's going on inside you and then matching exactly that with the plan for your best health care.

So in the fourth episode of this miniseries, I want to share with you the best heart health plan I've put together so that we can walk you through that process because it is all about you living as well as possible for as long as possible by avoiding a heart attack.

I believe heart attacks are preventable. Appreciate your attention. I'll see you at the next episode.

>>> Join The Healthy Heart Network https://healthyheartnetwork.com/page/join. <<<<<

Hi, my name is Warrick Bishop and I'd just like to make something clear - that the information I'm sharing with you at this stage is to my knowledge as accurate and complete as possible. It is also a representation of my own approach to the clinical situations I deal with with my own patients. It's really important you don't rely on this information in isolation, but that you use this information in conjunction with your own medical practitioner, who really is in the best place to provide you with your specific medical requirements and needs. The intent of this information that I've been providing is really to allow you to be informed and be educated around heart health so that you can get the most meaningful conversation with your medical provider, for your best outcome. I wish you the best of health.

Well, heart attack is all too common. We know that. But what are the significance of things like raise cholesterol? We hear it in the media all the time. Should we eat eggs or not eat eggs? If there's a high cholesterol in the family, is that good or bad? There's a lot of confusion out there. What do we do with blood pressure? What is a perfect blood pressure? I think most of us know that you shouldn't smoke, but what is the impact of smoking on heart disease and risk of heart attack? What should you do about it? And what do we mean by family history? Well, does that mean that anyone in the family at any age has had a heart attack, or is it more specific than that?

What a heart attacks appear to come out of the blue? And what if we could be more proactive in preventing heart attacks occurring? Well, that's what I'm all about. You would know as well as I do that we see stuff in the media all the time. Here's a picture of a checklist that turned up in a magazine or a newspaper. It's got all the stuff on there that we all know about, things like keeping your blood pressure down, not smoking, being active, maintaining your weight and eating well. Well, of course, people do that over and over, but people are still dying from heart attacks. So what's the gap? What's the missing link? Why is just doing these simple things not enough? It's not enough even for the stars, the famous people who you would think have the resource to do better and prevent themselves from running into troubles. So let's break that down and think about what our current model of care is, and then we can talk about how we can improve on that. What I'd like to do is start off with a risk calculator, and these are pretty standardly used right across the board for trying to understand an individual's risk of heart attack. Let's go through it.

If you listen to the first miniseries episode, you remember, I spoke about a fun runner who literally had a heart attack during a fun run. Well, let's use characteristics that are pretty similar to what the fun runner had. He was male. He was in his early fifties. His blood pressure was just a shade elevated. His cholesterol was pretty unremarkable, and his good cholesterol was also pretty unremarkable. He didn't have diabetes and his ECG didn't show features of LVH, which means Left Ventricular Hypertrophy or thickening. If you look at the image there, you'll see that the risk estimated by this risk calculator, six percent of an event over the next five years and in fact, gives a green thermometer, providing some reassurance. But of course, that doesn't make sense because our fun runner actually had an event.

He had a heart attack, and he would have died had it not been for people around who resuscitated him. So let me put to you the way I think we should be interpreting this risk calculator. Instead of saying that it indicates a risk of six percent over the next five years, what we should say and what I should have said to this man in 2003 is this, I should have said, “Fun runner, based on your characteristics, this risk calculator is telling me that if I take 100 men with the same characteristics and follow those 100 men for five years, six of those men, i.e. a 6% will have a heart attack.” I just don't know who out of the hundred are the six, because over the next five years, your event rate will either be zero percent, nothing happens to you or one hundred percent as it actually did happen for the fun runner. Let me see if I can present that in a slightly different way. Here’s a cartoon which is lighthearted but serious. This is the 50-year-old male 100 voice choir and the choir master standing out the front and he says, “Okay, guys, I've spoken to the doctor, and he says 10 to 15 of you will have a heart attack in the next ten years. Can I just ask that it's not all the tenors?”

Well, what if we took that 50 year old man, 100 voice choir, and we could literally look at each of those individuals taking a picture of their arteries to try and see whether they're healthy or not, looking at the inside, no longer trying to guess from a roll of the die on a risk calculator. If we could look straight into their heart, straight into their orders and see what's going on. What a difference that can make. Well, here are some pictures showing us hearts where there's an indicator of something going on. You can see a green circle- no problem. In two red circles, something going on in the heart, in the arteries, something to give us more information, to be more precise for those individuals. Because what I'm all about is the current medical literature in combination with utilizing current technology. I've been doing this for about ten years and I'm passionate about finding problems before they occur. I think I mentioned in the first miniseries video that I often say to my patients, “I have two skill sets. One is to fix you up after you've had a problem. But I also have the skill set of preventing a problem in the first place. What would you rather me use?”

I believe it's really important to improve heart health, and the way I do that is through education and support because I believe we can save lives and there is a way to do things better. So how did I get here? How did I get fired up, engaged and passionate about trying to save lives, trying to help you live as well as possible for as long as possible? Well, the fun run a story really kicked it off for me. It made me realize I had to look for better ways. I realized that I need to be open to changes in technology. And that occurred when I found that change in technology and it was all about scanning the heart. I started to share that information with my colleagues, local cardiologists. I had to say I was early, an early adopter of that technology. To a large degree, I felt like a pioneer receiving the arrows. I also went and shared this information with the local doctors. And honestly, because it was still early and the cardiologists in the town hadn't picked up and supported the use of this technology, the local doctors, the family doctors really didn't embrace it either. From a platform of some frustration, wanting to get this message out there, I decided that the person who is most, is going to benefit the most, from knowing the information is the patient. And I then set out to give patients that information in their hands so that they could be best informed to make the best decisions about their own health care.

So this is where I am. I'm sharing with you because I know that not all doctors are familiar with the technology and how it could help you. I'm also aware that the best educated patients get the best health care. So let me educate you to your best health outcome.

So I want to show you a path to your best heart health. Join me in part three of the miniseries to learn about how we scan the heart to evaluate risk of heart attack. I'll see you there. In the meantime, I believe heart attacks are preventable. And thank you for your attention.

>>> Join The Healthy Heart Network https://healthyheartnetwork.com/page/join. <<<<<

Hi, my name is Warrick Bishop and I'd just like to make something clear - that the information I'm sharing with you at this stage is to my knowledge as accurate and complete as possible. It is also a representation of my own approach to the clinical situations I deal with with my own patients. It's really important you don't rely on this information in isolation, but that you use this information in conjunction with your own medical practitioner, who really is in the best place to provide you with your specific medical requirements and needs. The intent of this information that I've been providing is really to allow you to be informed and be educated around heart health so that you can get the most meaningful conversation with your medical provider, for your best outcome. I wish you the best of health.

That story was way back in 2005, was on a weekend day, I was heading to work, and they happened to be a fun run in progress as I was driving. I noticed there was a commotion. In fact, an ambulance and people gathered. I thought they must have been a problem. So, I stopped to offer assistance. I am a doctor after all. It turned out that a man in his early fifties, one of the participants of the fun run, had literally had a heart attack and dropped dead by the side of the road. Obviously, there were two ambulance officers in attendance. There was a front runner who was a doctor, and one who is a nurse who also stopped to offer assistance, and myself. We worked on this man and we were able to get his heart beating again. We got him in the back of the ambulance, he got to the local hospital and received a lifesaving stent.

Now, his story was so notable that he made the front page of the local newspaper just a couple of days later. And, of course, not wanting to be too proud I took that newspaper into work to show the staff what I had been involved with over the weekend.

After all, it was a really good outcome.

My secretary, however, was quick to point out that I'd seen the very same man some 18 months earlier. I was shocked. I went back and looked at the notes and I had reassured this man after a treadmill test that everything was okay, literally to be standing over his dead body some 18 months later.

Well, my name is Dr. Warrick Bishop. I have a serious interest in preventing heart attacks. I'm an author of several books, and I'm on a mission to try and allow you to live as well as possible for as long as possible by preventing heart attack, because I believe that heart attacks are preventable.

I was devastated when I found out what had happened to this man and that I had reassuring literally a couple of years earlier. I'd felt like I'd failed him. I went back and looked at his notes, but really I'd done everything right within the guidelines at the time. It was all we could do- is put people through a treadmill test, but it really challenged me, as you might imagine. I just felt that it wasn't good enough. And I became incredibly aware of how our evaluations at that time in 2003 were potentially costing lives.

That meant that I was open to better ways, new technology, and I started to become more focused on prevention being better than cure. And now I'm convinced that we can do better.

We all know the statistics. They’re enormous. Coronary artery disease is one of the biggest killers in Australia. It takes 50 or more people per day. And every 30 odd minutes we lose another life to this condition. I don't have to go through those statistics with you. There's a good chance you've already been touched either through family or friends with the sadness and the consequences of heart attack. We see the headlines in newspapers all the time. And to be honest, sometimes it's a little bit confusing. We hear about the number of people dying. We hear the statistics, but we also hear these little snippets like eggs are good for you or eggs are bad for you, or blueberries are good for you or blueberries are bad few, or women have a worse cause with heart attack than men. All sorts of information come through. What do we hold on to?

Well, heart attack is confusing and challenging. The question is, could it affect you? Could it affect a family or friend? We see from the media that stars, famous people, get affected, often without warning. We know that heart attack can lead to death but can also lead to being incapacitated. And the biggest question is, could it happen to you or a loved one? We know that over 90 percent of all Australians have at least one risk factor for heart attack. How do we deal with that information? Because heart attack is too common. What does heart attack actually mean? What are the significance of an elevated cholesterol or a raised blood pressure or smoking history or even a family history, for that matter. And why do heart attacks appear to occur out of the blue?

The fun runner, whose story I told you, that man put on his sandshoes that morning feeling well. He was looking to run 10 kilometers. He didn't feel like someone who was going to drop dead by the side of the road during his run. The question I think we need to keep asking is, can we prevent heart attack? And I believe we can. So my goal is to help you to live as well as possible, for as long as possible, by avoiding unexpected heart attack. Because what I've realized after doing this for years is that people can look fit and well on the outside, but still have a heart attack. You've heard those stories. Man walks out of the gym, obviously looking feeling well, has a heart attack and dies. The fun runner who looked fit and well until the moment. I realized that the way we currently deal with evaluating risk is a bit like rolling a die. And I think our lives are more important than to gamble. And I also realize there's a lot of confusion about what the right thing to do is, and what cholesterol means. Should we be on cholesterol lowering tablets?

These are things that are really important and hold us back. I'd go so far as to say there are three secrets to unwrapping and dealing with those issues. One is that technology has changed the way we undertake traditional risk assessment. But not everyone knows about that technology. We know that there are doctors who are just not familiar with using this technology. And that makes sense. When a new tool becomes available, it takes a little while to get used to it.
And the last secret is for you to get the best results, you need the best support, and that includes information and education. Because our current paradigm is what we call a risk calculator, and that takes characteristics or details around an individual and puts into a risk calculating calculator. I've got a picture of one here on the screen. We're here looking at a man who's fifty-three years of age. This is very much like the fun runner, in fact. That blood pressure that's just slightly elevated a non-smoker, a very average cholesterol and an average good cholesterol. No diabetes and a normal ACG. Well, the risk calculator tells us that the risk of heart attack for this man is six per cent over the next five years. And in fact, if you're looking at the picture I’ve got, you'll see that's a green thermometer, which would give us nothing but reassurance.

But if this was the risk calculator I'd used for my fun runner in 2003, and it was wrong. So, what I want to do is talk about how we can do better. And what I want to do is share with you who gets the best advice. I want to discuss with you the sort of test, testing and thinking, that is currently used routinely by NASA astronauts and presidents of the United States in America, and why would you be interested to find out if that was appropriate for you. Because what I want to do is show you a path to your best health. Come and join me in part two of the miniseries to learn how we evaluate risk of heart attack and how we can do better. Let me walk you through the next steps because I believe heart attack is preventable.
Thank you for your attention. Take care and bye for now.

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Hi, my name is Warrick Bishop and I'd just like to make something clear - that the information I'm sharing with you at this stage is to my knowledge as accurate and complete as possible. It is also a representation of my own approach to the clinical situations I deal with with my own patients. It's really important you don't rely on this information in isolation, but that you use this information in conjunction with your own medical practitioner, who really is in the best place to provide you with your specific medical requirements and needs. The intent of this information that I've been providing is really to allow you to be informed and be educated around heart health so that you can get the most meaningful conversation with your medical provider, for your best outcome. I wish you the best of health.