“Maid of Athens, ere we part,Give, oh give me back my heart” This plea from Lord Byron, the poet, was referring to spiritual, rather than physical heart. Even so, had he lived and died in the 21st century rather than the early nineteenth, he should have been concerned about the state of his heart and coronary arteries even when he wrote these lines in 1809. Byron frequently ate too much and drank heavily and his deformed foot limited the amount of physical exercise he could take, despite his being a famed swimmer. Although his bedroom hummed with activity, he didn’t sleep well.

We shouldn’t copy the lifestyle of Lord Byron. Nor should we hope that all would be well if we reformed our work schedule so that we had more time at home and the occasional long weekend and had six to eight hours sleep a night, the optimum pattern for a long life. Diet, the exercise regime and drinking pattern all need review long before someone reaches the coronary age group. It is always safer to plan prevention than pray for a cure. There are some risk factors associated with heart disease and strokes that we can neither alter, nor for which we can be held responsible. No one can help being a man, but males are more likely to suffer heart disease and strokes earlier in life than women. A female’s hormones, while she is still of reproductive age and hasn’t yet had the menopause, protect the coronary arteries and preserve the strength of the heart muscle. Ten years past the menopause, a woman is as likely to be in the cardiologist’s clinic as a man. Whether old or young, male or female, everyone should stop smoking, reduce their cholesterol levels, acquire a thinner waist, make certain that their blood pressure is normal and take sensible exercise.

A healthy diet needn’t be unpleasant. Brussels sprouts may be disgusting to some but there are so many vegetables now on sale that it is no hardship to find five portions of fruit and vegetables a day that are palatable. Adopting a low-cholesterol, high-fibre, low-salt diet with plenty of fresh vegetables and fruit and little calorie-dense convenience foods, is a good start to any campaign to live longer and thereby avoid being one of the six million people worldwide who die of cardiovascular disease.

Although the intake of fatty foods should be reduced, there are two essential fatty acids, omega 3 derived from fish oil and omega 6 fatty acids from oily plants. The ideal diet has the correct balance of omega 3 to 6. As a rule, people’s diets have an adequate amount of the latter rather than the more beneficial omega 3, which has the power to keep old men’s hearts beating, while being equally valuable at the other end of life when it can stimulate the brains of their grandchildren. To ensure an adequate intake of omega 3, everyone should have oily fish at least twice a week. Cod and halibut are excellent sources of protein, but what the heart needs is oily fish; these include herrings, mackerel, tuna, sardines, salmon, trout and anchovies. Those who can’t always manage the two portions of oily fish a week can always take a daily omega 3 fish oil capsule. The Eskimos, who have a fish-based diet, have the healthiest hearts in the world.

We need protein. The best is in meat, but the downside of succulent steaks, pork crackling or Welsh lamb is the saturated fat that is hidden between the meat fibres. Conversely, game, whether venison, rabbit or pheasant, has very little cholesterol laden fat between the muscle fibres. When enjoying a steak or rack of lamb, the fat should be cut away from the lean meat. Eggs should be rich in omega 3. A low-fat diet should reduce overall cholesterol levels, and in particular that of the lethal form of cholesterol - Low Density Lipo-protein. LDL is the dangerous cholesterol that clogs the arteries of the brain, and thereby causes a stroke, or the coronary arteries, thereby leading to a heart attack. The overall blood cholesterol level should be below five, the LDL below 2.85. Too much salt increases the blood pressure and can also lead to heart attacks and strokes. There is enough salt in the diet without adding any extra. It is easy not to use salt at the table, more difficult not to do so in the kitchen. A ten per cent reduction in the national intake of salt would save over 6,000 UK lives a year and prevent 6,000 non-fatal strokes and heart attacks. If we reduced the intake of salt from the present 10 grams per person per day in the UK to three grams, a thousand lives a week would be saved and an equal number of people would be prevented from suffering heart attacks and strokes.

An ideal blood pressure is one in which the systolic pressure (the upper reading), which records the pressure when the heart is contracting, is under 135 and the lower reading, representing that when the heart is relaxing, should be under 80. Age is no reason to accept higher levels. High blood pressure needs treating whatever the age group. Obesity is a great killer. It leads to high blood pressure and diabetes; the latter is complicated by heart attacks, strokes, kidney failure and blindness. Only one measurement is important in assessing obesity - that is the circumference of the waist measured at its maximum point; a man’s should be, regardless of their height and build, under 40 inches and women’s under 35. If they want to be superfit, a man’s should be under 37 inches and a woman’s under 32.

Exercise is essential and all those who have joints that allow this should take a daily brisk walk of half an hour to forty minutes, twice this if they are already at risk of heart disease because of a high blood pressure, diabetes or raised cholesterol blood levels. There is no need for visits to the gym, jogging in lycra shorts, or even for suicidal bicycling in heavy traffic. The brisk walk should be fast enough to make conversation difficult but not impossible. Those who have a healthy heart but joint problems should swim daily.

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