A serious health problem plagues Greater Manchester almost ‘more than anywhere else in the country’, according to an expert cardiologist. The doctor has warned that people in the region could fall victim to potentially fatal heart conditions and has given his best advice on how to avoid them in the future.
There are many reasons the heart can be placed under strain, leading to higher chances of heart disease and heart attacks. Jaydeep Sarma is a consultant cardiologist based at Wythenshawe Hospital and has told the Manchester Evening News all about what to look out for in your day-to-day life.
The doctor revealed that the lifestyles and living conditions of people in Greater Manchester might make us more prone to health concerns with dire consequences - but shared how you don’t need to join an expensive gym or buy expensive food to make a difference.
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Why Greater Manchester is more at risk of serious heart problems
Longstanding regional inequities have made Greater Manchester’s health worse in comparison to other parts of the country. Historically, the region has been poorer than parts of the south of England, meaning more families are left struggling and councils have been disproportionately underfunded, particularly during austerity.
The kind of jobs that are available in Greater Manchester and the transport options Greater Manchester can afford to run are among the issues having a knock-on effect on the health of the population. For example, manual jobs in areas less well-connected to public transport mean workers might have to drive to work, rather than being able to walk or get exercise heading to a bus stop.
"There's a clear problem within Greater Manchester that seems to affect us more than other cities,” explains Mr Sarma. “Certainly there's, there's a north-south divide.
“One of the things that we are aware of as doctors is that when we talk to people, lifestyle choices and pressures in their workplaces or in their daily lives, do sway the sorts of choices that they make in terms of transport.
“[They sway the choices] in terms of choosing how much or their ability to exercise, their dietary choices in terms of food types, and indeed, the way that they cope with things like stress in the workplace or at home, which might be related to food choices and other habits, including things like alcohol or tobacco consumption.”
If you’re more stressed by a difficult job with long hours and lower pay, you might be more stressed and turn to alcohol and tobacco consumption, says the doctor. Again, having an impact on your health.
“All of these are fundamental principles of good old common sense, healthy living, you don't need a cardiologist to tell you this sort of stuff. But it does play into the fact that cardiac disease is heavily represented here in Manchester, arguably, more so than most other places in the country.
"It's only places like Glasgow, Tyneside, Teesside, and Blackpool that seem to have as much concentration of disease.”
The effect of the north-south divide is shocking - “it could be the difference between having a heart attack in your 60s versus having a heart attack in your 70s or 80s,” adds the doctor.
“[Where you live] plays into things like social class and access to health care and the ability to look after yourself, what sort of services around you, what sort of pressures are, are there, what sort of food you eat, what sort of habits you have been brought up with, and what sort of food choices and the health choices you're making as an individual.”
You don’t have to pay lots of money to get results
The cost of living crisis has made people examine every bill, including changing what they shop for or whether they pay for exercise. Mr Sarma says that you can change your life and get healthier in ways that are not only free, but could actually save you money.
Habits that you start in your late teens and early twenties can come back to haunt you and make things like coronary artery disease - leading to angina and heart attacks - far more likely.
“As cardiologists, we worry about people who might not be as active as they ought to be,” he continued. “We talk about trying to maintain some sort of activity on a daily basis, ideally, conscious of the fact that that doesn't work for a lot of people because they've got busy lives. But trying to make sure that when we have discussions with our patients, we're asking them to try and fit it in.
“Instead of taking a car, try to think about using public transport, try to think about walking an extra stop when picking up a bus or a tram, thinking about making sure they make time for themselves either before or after their work to do even a brisk walk.
“That sort of activity is as good as doing more formal exercises, it's about trying to start simple and work up to more formal exercise.”
Fitting in even basic exercise into your day can work wonders for not only physical health, but mental health too - which many people saw take a hit during the pandemic.
“We're not trying to say that everyone needs to be a marathon runner or go off and do an aerobics class,” explains the expert. “It is about recognising that some people will do very little actual exercise in a day because their timetable is not structured around that.
“Exercise impacts on physical well being but also affects mental well being. A walk in the fresh air every day, even if the weather is as dreary as it is in the middle of winter can be beneficial for your mental health.
“That does impact cardiac disease as well, we know that because there have been studies in the past.”
You are what you eat
As far as diet is concerned, ‘it’s everything you’d expect from a heart doctor’, says Mr Sarma. “It's about trying to reduce the consumption of bad fats, animal fats and saturated fats and trying to reduce the amount of processed food that people eat, trying to reduce the amount of junk food that people eat, and trying to be reasonably aware of where your food is coming from.
“[It’s about] not eating too much salt and sugar, and maintaining that as part of a healthy lifestyle.”
Stop smoking
Greater Manchester is attempting to introduce a smoking ban in public places, with people smoking in selected city centre outdoor spaces being asked to stub out their cigarettes or leave the smoke-free zone as part of a new pilot project.
However, smoking is still a major contributor to heart attacks within the region, says the doctor.
"Unfortunately, one of the greatest triggers for heart attacks in our community is continued cigarette smoking. It's something that's very difficult to deal with, it's very difficult to kick the habit.
“It's actually not about nicotine so much. That's what makes you want to have a cigarette, but it's actually about inhaling smoke. And that's something that is a big problem.
“It's not as big as it used to be in the UK, certainly smoking rates are falling, but actually inhaling particular material - dirt, dust, smoke from a bonfire, smoke from pollution as well - all of that inflames your lungs. It also gets into the bloodstream and it upsets your heart, it inflames the heart, and it lays the ground for future heart attacks.
"That's why we were really keen for people to get away from tobacco and we are supportive of people taking up nicotine supplementation. We don't promote vaping, but we do promote other things like patches and tablets that will help people stop smoking.”
There’s no such thing as healthy alcohol consumption
Consultant Jaydeep Sarma says any kind of alcohol consumption is not going to be good for your health, adding that cutting down can be another money-saving goal.
"On alcohol, we're learning that maybe there's no such thing as a healthy level of alcohol consumption, unfortunately, for many people. Even if you like a drink or two, it's probable that if you have no alcohol at all, it's the safest thing to do. Certainly [nothing] over drinking one, maybe two drinks a day, and preferably having two or three alcohol free days per week.
"Anything beyond that starts to raise risks of things like high blood pressure. I can directly make the heart weak, the heart muscle can become weaker by direct alcohol toxicity. It also worsens things like irregular heartbeats. If you've already got high blood pressure, it makes the high blood pressure very difficult to control.
"Going back to diet, alcohol has got a lot of calories. So if you do drink regularly, you're probably taking a higher calorific intake than you realise. Just by drinking a couple of pints of beer versus a different kind of drink, you're probably adding quite a lot of carbohydrates into your diet.
"Then if you happen to be on the borderline of diabetes, that's gonna start to upset things. All of these risks become additive. We're keen to make sure that people build good habits from an early age to prevent them getting into trouble in their 50s and 60s and later.”
Complications in the cost of living crisis
Not only does the cost of living crisis make fitness classes unaffordable for many, financial pressure can also add to people’s daily stress levels. That has an influence on heart health too, says Mr Sarma.
“There's a very famous study called the Whitehall Study that was done years ago, which showed that people who are under a lot of stress at work seem to have an earlier onset of heart disease and we're more prone to things like heart attacks, and the less stress or the better you can cope with stress, the less likely that is going to be.
“That's that's easy for me to say and it's really, really hard for patients to deal with. A lot of people have very difficult lives at the moment, especially with the cost of living crisis and changes in inflation and so forth.
“But it is actually quite an important part of staying healthy and keeping a healthy heart. And it feeds into things like blood pressure and diabetes, all of which will affect your heart.”
Seek treatment
Finally, the doctor says that if you are worried about your heart, seek help. Mr Sarma has shared what to look out for and who to seek help from.
"The thing that we classically worry about is chest pain. The British Heart Foundation used to run a campaign where there was a photograph of a man with a belt around his chest, it was squeezing his chest, because that's what most people say when they're having an angina attack or a heart attack.
"We've sort of moved on from that concept in terms of how we explain symptoms because firstly, it's not just men, lots of women get symptoms of heart disease as well and may think to themselves well, I'm not that bloke off the BHF ad so it's not really anything to worry about.
"Women don't complain as much, they tend to be more stoic. There are also a lot of people who don't seek help possibly because of fear of what might happen.
"We worry about chest discomfort that comes on during physical activities, walking upstairs, walking uphill, carrying shopping. It could be across the front of the chest, it could be even in the neck or the jaw. Sometimes it radiates to the back or to the arms, left arm in particular.
"If it comes and goes with exercise - it goes when you rest and relax, and it comes on again when you're walking briskly, or walking against a strong headwind, walking in chilly weather - then we think to ourselves is this actually a sign that maybe the heart's not getting enough blood? Is it aching or getting a sort of cramp sensation, which we call angina?
"People who get chest pain that doesn't go away or comes on with it doing nothing at all, we worry about because that could be what we call unstable angina and might be leading up to a heart attack.
"If it's happening intermittently, that's the sort of thing where you want to have a chat with your GP or a practice nurse rather than coming to casualty. If you've got pain that comes on at rest with no provocation, it's significant and it's not getting any better. Then you do need to ask for help and that's when you need to think about coming to hospital and asking for a paramedic review.”
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