BCPA Journalbcpa.uk/pdf/journal/BCPA_Journal_218.pdf · BCPA Annual General Meeting The 36th Annual General Meeting of The British Cardiac Patients Association will be held on Saturday

BRITISH CARDIAC PATIENTS ASSOCIATION

Issue 218May 2018

THE PATIENT

AND CARERSINDEPENDENT

[email protected]

JournalBCPA

2

BCPA Journal Issue 218 www.BCPA.eu

Co-ordinatorsCambridge: Tony Ward 01223 860329Halton: Betty Rogers 07710 485727Lincoln: Bill Lawton, Chairman & acting Co-ordinator 01522 703026South East London & Kent: Chris Howell 01689 821413Staffordshire: Eddie Coxon 01782 416143Warrington: Dennis Atkinson 01925 824856Wirral: Barrie Harding 0151 608 6212Wrexham: Gerald Hughes 01978 758335ContactsBedford: contact BCPA Head Office 01949 837070Belfast: John Hamill 028 9081 3649Cannock Area: Brian Nicholls 01922 412753Chester: contact BCPA Head Office 01949 837070Cornwall: John Genower 01209 215220East Suffolk: contact BCPA Head Office 01949 837070Hull & East Riding: Stephen Hackett 01482 561710Huntingdon: Mike Simpson 07840 755513Llandudno: Joan Owen 01492 876926North Staffordshire Implantable Cardioverter Defibrillator ICD Group: James Lyons 01782 852509Oxfordshire: Chris Gould 01491 872454Peterborough: Gordon Wakefield 01733 577629Swindon: Jim Harris 01793 534130Worthing and the Martlets: George Beer 01903 824373West Suffolk & South West Norfolk: contact BCPA Head Office 01949 837070Affiliated GroupsChelmsford & District Cardiac Support: Malcolm Gibson 01621 893064Chester Heart Support: Peter Diamond 01244 851441Croydon Heart Support: Ken Morcombe 020 8657 2511King of Hearts, Redbridge, Essex: Tony Roth 020 8252 0877Southend Take Heart: George Turner 01702 421522Wolverhampton Coronary Aftercare Support: Ken Timmis 01902 755695

The Journal is the bimonthly magazine of theBRITISH CARDIAC PATIENTS ASSOCIATION

also known as BCPA. Registered Charity 289190

President: Professor John Wallwork CBE DL FMedSci;

Vice-Presidents: Alan Bowcher DMS FFA, Derek Holley OBE, FCA

Executive OfficersChairman: & Journal Editor: Keith JacksonVice-Chairman: Dr Richard Maddison Tel:

01234 212293 Treasurer: Derek Holley

BCPA Head Office: 15 Abbey Road, Bingham, Notts NG13 8EE Tel: 01949 837070

Email: [email protected] Website: www.BCPA.eu

Opinions expressed in the Journal are not necessarily those of the Editor or the BCPA.

No item may be reproduced without consent.Advertisements must conform to the British

Code of Advertising Practice. Publication does not indicate endorsement by the BCPA. © Copyright 2016 BCPA and/or the authors

Designed, printed and mailed by Core Publications Limited - [email protected]

Cover Picture: The Rhodedendron trail at The Petwood Hotel, Woodhall Spa, Lincolnshire

ContentsPage

2. Co-Ordinators, Contacts and Affiliated Groups3. From Me to You - Keith Jackson4. The BCPA - The way forward5. BCPA AGM Weekend6. Ricky’s Quickies - Dr Richard Maddison11. Cryptic Crossword11. Recipes 12. My Wainwright Challenge - Three rounds of the 214 - John Gore14. Corey Beecher - Bedford Heartbeat Making the dream a reality15. “So Much for Education” ..... 16. News from around your areas18 Crossword Solution19. Dates for your diaries

3


FROM ME TO YOUKeith Jackson-National Chairman

Annual General Meeting Weekend 11-13 May 2018Details of the AGM weekend have been given in full in the previous two journals. In this issue you will find the formal notice convening the meeting. You still have time to book accommodation for the weekend. Please contact me for a booking form (Keith) on 01949 8367070 or 10949 836430. It would be great to have you join us for the weekend.Of course it is not necessary to book to attend the AGM. We shall be delighted to see you at the Ettington Chase Hotel. Membership and SubscriptionsAnnual membership subscriptions became due on the 31st March 2017. Many members have already taken the opportunity to use the renewal form included with the February/March Journal and I thank them for having done so. To those who have yet to forward their renewal please do so either by using the form in the last issue or by taking the form from the back of this issue.You may no longer feel in need of our support, but please remember, it is only by giving your support to the Association that the Association in turn is able to help others.Subscription rates continue to be:

• Annual single subscription £10.00• Annual joint subscription £15.00

Growing the AssociationAs a valued member of the Association it is likely that you are aware of someone who may benefit from also becoming a member. The initial reaction to my suggestion may seem a strange one but might it be that when you are considering purchasing Christmas presents you may consider membership as that present.

If so then please contact the office so that we can get the new member details back to you in time for you to gift wrap with a personal note.Membership applications Are you reading this Journal as someone who is not a member of the Association? If so we are pleased to count you as a valuable part of our readership.However, might you take a few moments to consider making use of the application form to join the Association. Maybe you are a heart patient, a relative or carer of someone with a heart condition, or indeed someone taking a general interest in the Association and the support we are able to offer. Whatever your interest it may be that becoming a member is something you have never considered. May we invite you to consider it now. We would be delighted to hear from you. Please see the inside back page.What do you do with your past copies of the Journal?Some readers retain Journals enabling them to refer back to any items of particular interest.Many copies are destined for the bin once they are finished with after the initial reading.To those of you who do not retain copies please consider whether your copy could be of use to others. Perhaps it could be useful reading in a doctor’s waiting room rather than some of the old and perhaps tatty copies of the regular reading matter usually available.

DonationsDonations received from February to date in support of the Association amount to of £915 Almost all of these are as a result of the February newsletter report “The Way Forward”.

4


Thank you to those of you that have returned the questionnaire from the February journal; some 330 to date. To those of you not yet having returned the form please do so. It is only in this way that we can determine how you, the members wish to see the future of the Association. Repeated below is the statement form the February Journal. It is regrettable, but the statement made in the February posting was.

• Only by completing the questionnaire will we know your intentions.• A nil response regrettably, will have to be taken that you no longer wish to remain in

membership• Regrettably, if a response has not been recieved by the end of March this will be the final

communication.• Due to the low response to date, the May issue is being sent to those who have not yet

responded.• With the huge support to continue contained in the received forms is seems inconceivable

that lack of response equals a lack of interest. Annual Members To date 135. Annual Members have returned the membership renewal but chose to assume that the questionnaire did not apply to them. It is equally important to annual members that you make yourviews known. By renewing your membership it is clear that you wish the Association to continue, however, questions 2,3 & 4 on the form apply equally to you. They determine how YOUR Association looks going forward. Particularly important is the question ‘Are you willing to receive your Journal via email?’. Of those responding almost one third said YES to this.

The British Cardiac Patients AssociationThe Way Forward

Yes NoDo you wish the Association to continue

Do you wish to remain a member and receive the journal

Do you wish to remain in membership without the journal

Are you willing to receive the journal by emailIf so please include your email address below

First name Joint member’s name

Surname

Address

Post Code

Email Address

Member details

5


BPCA ANNUAL GENERAL MEETING WEEKEND 11-13TH MAY 2018

BCPA Annual General MeetingThe 36th Annual General Meeting of The British Cardiac Patients Association will be held on Saturday 12th May 2018 commencing at 3.30pm at the Woodland Grange Hotel, Leamington Spa Warwickshire. Prior to the formal meeting our speaker will be Mr Wil Woan CCEO of Heart Valve Voice. He will speak on the need for the HVV charity and what it is doing to improve the diagnosis and treatment of heart valve disease. The afternoons proceedings will commence at 2.45pm.AGM AgendaNotice of the MeetingMinutes of the 35th Annual General MeetingChairman’s ReportTreasurer’s Financial Statement and Statement of Financial ActivitiesAuditor’s ReportElection of AuditorElection of Officers and Executive MembersDiscussion to determine the future of the AssociationAnnouncement of the ballot results for the appointment of:

• Association Vice-Chairman–See note below • Executive Committee Members –See note

below.Open MeetingAn open meeting will follow immediately after the completion of the formal business of the AGM. Members are invited to submit any questions that may require prior research to Head Office by the 4th May.The Executive Committee reserves the right to impose a time limit on items for discussion in the Open meeting.Note The nominations received by the closing date were as follows.

• For Vice-Chairman Dr Richard Maddison. So Richard Maddison is declared elected for three years from the close of the 2018 AGM.

• Executive Committee Members. Two nominations (Mrs M Lyth and Mrs B Rogers) and are declared elected for three years from the close of the 2018 AGM..

Signed: Keith Jackson, Chairman

6


Ricky’s Quickies Dr Richard Maddison

Anti-inflammatory therapy with canakinumab for atherosclerosis

Coronary artery disease (CAD) is a condition which affects the arteries that supply the heart with blood. It is usually caused by atherosclerosis, which is a build-up of plaque inside the artery walls. This build-up causes the inside of the arteries to become narrower and slows down the flow of blood.3

Atherothrombosis is the formation of a blood clot within an artery as a result of atherosclerosis. This is the major cause of acute coronary syndromes (ACS) and cardiovascular death. It is the leading cause of mortality in the industrialised world.4

Experimental and clinical data suggest that reducing inflammation without affecting lipid [fat soluble in water] levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved.2

A research team conducted a trial of canakinumab.2 It was a randomised controlled trial (RCT), double-blind [so neither patients nor medics know which treatment or placebo a patient has been randomly allocated to1]. Canakinumab is a therapeutic monoclonal [cells coming from a single clone] antibody-targeting interleukin-1β.2 [Interleukins are types of proteins that regulate immune responses.]

The trial involved 10,061 patients with previous myocardial infarction [damage to heart muscle(s)] and a high-sensitivity C-reactive protein level of 2 mg or more per litre. [A C-reactive protein is a blood test marker that can detect if there is inflammation in your body; it is produced in the liver, and measured in a blood test.1]

The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously [by injection through the skin] every 3 months) with placebo.2

The primary efficacy end point [what was primarily being watched for] was nonfatal

myocardial infarction, nonfatal stroke, or cardiovascular death.2

They found that at 48 months the median reduction from baseline in the high-sensitivity C-reactive protein level as compared with the placebo group was:2

• 26 percentage points greater in the group that received the 50-mg dose of canakinumab

• 37 percentage points greater in the 150-mg group

• 41 percentage points greater in the 300-mg group.

They also found that canakinumab did not reduce lipid levels from baseline.2

At a median follow-up of 3.7 years, the incidence rate for the primary end point was:2

• 4.50 events per 100 person-years in the placebo group,

• 4.11 events per 100 person-years in the 50-mg group, p=0.30, not statistically significantly different,

• 3.86 events per 100 person-years in the 150-mg group, p=0.021, also not statistically significant, and

• 3.90 events per 100 person-years in the 300-mg group, p=0.031, also not statistically significant.

The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization [bypass surgery] P=0.005.2

Canakinumab was associated with a higher incidence of fatal infection than was placebo.2 There was no significant difference in all-cause mortality.2 Canakinumab significantly reduced high-sensitivity C-reactive protein levels from baseline, as compared with placebo, without reducing the LDL cholesterol level; and the 150-mg dose resulted in a significantly lower incidence of recurrent cardiovascular events than placebo.2

7


The effect of physical activity on mortality and cardiovascular disease in various countries

Physical activity has a protective effect against cardiovascular disease (CVD) in high-income countries, where physical activity is mainly recreational. But it is not known if this is also observed in lower-income countries, where physical activity is mainly non-recreational.5 CVD includes coronary heart disease, stroke, and peripheral vascular conditions. There can be a narrowing of arteries both in the heart and throughout the body from a build-up of fatty acids that form plaques – ie atherosclerosis.1

The researchers examined whether different amounts and types of physical activity are associated with lower mortality and CVD in 17 countries at different economic levels (Canada, Sweden, United Arab Emirates, Argentina, Brazil, Chile, Poland, Turkey, Malaysia, South Africa, China, Colombia, Iran, Bangladesh, India, Pakistan, and Zimbabwe).5

Within each country, urban and rural areas in and around selected cities and towns were identified to reflect the geographical diversity. Within these communities, they invited individuals aged between 35 and 70 years who intended to live at their current address for at least another 4 years. They assessed total physical activity using the International Physical Activity Questionnaire (IPQA). Participants with pre-existing CVD were excluded from the analyses.5

Mortality and CVD were recorded during a mean of 6.9 years of follow-up. Primary clinical outcomes during follow-up were mortality plus major CVD (CVD mortality, incident myocardial infarction, stroke, or heart failure), either as a composite or separately. The effects of physical activity on mortality and CVD were adjusted for sociodemographic factors and other risk factors taking into account household, community, and country clustering.5

Between 2003 and 2010, they enrolled 168,916 participants, of whom 141,945 completed the IPAQ. They limited it to the 130,843 participants without pre-existing CVD.5

They compared:• low physical activity (less than 600

metabolic equivalents [MET] × minutes per week or less than 150 minutes per week of moderate intensity physical activity)6.

[The Metabolic Equivalent of Task (MET), or simply metabolic equivalent, is a physiological measure expressing the energy cost of physical activities.]

• moderate (600–3000 MET × minutes or 150–750 minutes per week); and

• high physical activity (over 3000 MET × minutes or over 750 minutes per week).

They found that:5

• these were associated with graded reduction in mortality (P<0.0001 for trend), and major CVD (p<0.001 for trend).

• Higher physical activity was associated with lower risk of CVD and mortality in high-income, middle-income, and low-income countries.

• The adjusted population attributable fraction for not meeting the physical activity guidelines was 8.0% for mortality and 4.6% for major CVD, and for not meeting high physical activity was 13.0% for mortality and 9.5% for major CVD.

• Both recreational and non-recreational physical activity were associated with benefits.

So higher recreational and non-recreational physical activity was associated with a lower risk of mortality and CVD events in individuals from low-income, middle-income, and high-income countries. Increasing physical activity is a simple, widely applicable, low cost global strategy that could reduce deaths and CVD in middle age.5

Proton-pump inhibitors to over-75s on daily aspirin

Proton pump inhibitors (PPIs) reduce the production of acid by the stomach. They do this by irreversibly blocking the actions of an enzyme responsible for acid production, H+/K+ ATPase, that is located in the parietal cells in the stomach wall.9

This allows any ulcers present in the oesophagus, stomach, and duodenum to heal and helps prevent new ulcers from forming. PPIs are also used to treat other gastrointestinal disorders characterized by excessive acid secretion.9

GPs should prescribe PPIs to over-75s who are on a daily dose of aspirin, to prevent serious gastrointestinal bleeds, a study has concluded.8

Continues on Page 8

8


Researchers from Oxford University studied more than 3,000 patients on antiplatelets (mainly aspirin) over a 10-year period, more than 300 of whom were taken to hospital for bleeding.8

They concluded that among patients aged 75 or older, the overall risk of developing serious bleeding was 10 times higher – which the authors concluded was ‘at least as likely to be disabling or fatal’ as another stroke.8

As half of the major bleeds recorded in the over-75s were upper gastrointestinal (GI), the study also looked at the effect of PPIs, which can reduce upper GI bleeding by up to 90% in patients on long-term antiplatelet therapy.8

They estimated that for every 25 people aged 85 or above treated with PPIs, one patient could be saved from a serious upper-GI bleed.

Current National Institute for Health and Clinical Excellence (NICE) guidance on prescribing NSAIDs (Non-steroidal anti-inflammatory drugs) already recommends co-prescription of PPIs in patients at increased risk of adverse GI effects, which includes those aged 65 or above.8 Despite this, such treatment is not routine and among the study participants just one-third of patients were prescribed a PPI.8

Experts are now calling for the guidance to be updated so that patients aged 75 or above on long-term antiplatelet therapy are routinely co-prescribed a PPI.8

Cost-effectiveness of intensive versus standard blood-pressure control

In the Systolic Blood Pressure Intervention Trial (SPRINT), adults at high risk for cardiovascular disease who received intensive systolic blood-pressure control (target less than 120 mm Hg) had significantly lower rates of death and cardiovascular disease events than did those who received standard control (target less than 140 mm Hg).10

On the basis of these data, the researchers wanted to determine the lifetime health benefits and health care costs associated with intensive control versus standard control.10

They used a microsimulation model to apply SPRINT treatment effects and health care costs from national sources to a hypothetical cohort of SPRINT-eligible adults. The model projected lifetime costs of treatment and monitoring in patients with hypertension, cardiovascular disease events and subsequent treatment costs,

treatment-related risks of serious adverse events and subsequent costs, and quality-adjusted life-years (QALYs) for intensive control versus standard control of systolic blood pressure.10

They determined that the mean number of QALYs would be 0.27 higher among patients who received intensive control than among those who received standard control and would cost approximately $US47,000 more per QALY gained if there were a reduction in adherence and treatment effects after 5 years; the cost would be approximately $US28,000 more per QALY gained if the treatment effects persisted for the remaining lifetime of the patient. Most simulation results indicated that intensive treatment would be cost-effective (51 to 79% below the willingness-to-pay threshold of $US50,000 per QALY and 76 to 93% below the threshold of $US100,000 per QALY), regardless of whether treatment effects were reduced after 5 years or persisted for the remaining lifetime.10

In this simulation study, intensive systolic blood-pressure control prevented cardiovascular disease events, and prolonged life, and did so at levels below US common willingness-to-pay thresholds per QALY, regardless of whether benefits were reduced after 5 years or persisted for the patient’s remaining lifetime.10

Blood-thinning drugs may reduce dementia risk in people with irregular heartbeats

Several misleading headlines have been published, including these and others given later.

‘Common blood thinning drugs halve the risk of dementia for patients who have an irregular heartbeat,’ reported the Mail Online on 25 October 2017.11

‘Blood thinners halve risk of dementia for heart patients’ was the corresponding headline in the Daily Mail the same day.12

In my opinion these are misleading as explained below.

The NHS published a better explanation13 of the research article14 and their conclusions13. The heading above and the text below is based on the NHS version.

Researchers in Sweden used the country’s health registry data to assess whether people with atrial fibrillation were less likely to get dementia if they took drugs like warfarin.13 The association between atrial fibrillation (AF) and

Continued from Page 7

9


dementia is well documented, but it is not clear if oral anticoagulant treatment offers protection. The aim of the study was therefore to compare the incidence of new dementia in patients with AF with and without oral anticoagulants, and to explore if there is a difference between novel anticoagulants and warfarin in this respect.14

Atrial fibrillation (AF) is a heart condition that causes an irregular and often abnormally fast heartbeat. This can make the blood more likely to clot, which can lead to a stroke.

Most people with AF are prescribed anticoagulant drugs, which reduce the blood’s ability to clot. Anticoagulants are often referred to as ‘blood-thinning drugs’, but this is technically incorrect as they don’t affect the density of blood.13

People with AF are also at more risk of dementia, probably because of a build-up of tiny clots in the small blood vessels of the brain.13

The research study, which included all patients diagnosed with AF in Sweden from 2006 to 2014, excluding those who already had dementia13, 14, showed that:

1. 26,210 of the 444,106 people in the study group got dementia – a rate of 1.73 dementia cases per 100 people each year.13, 14

2. people with AF who were prescribed anticoagulants within a month of diagnosis had a 29% lower risk of getting dementia, compared with those not given the prescription.13, 14 But because of the type of study, the researchers can’t prove that anticoagulants are the reason for the reduced risk.13

3. there was no difference between rates of dementia when directly comparing older anticoagulants like warfarin with newer types such as clopidogrel.13, 14

4. people who had anticoagulant prescriptions 80% of the time were 48% less likely to get dementia than people who never had anticoagulant prescriptions.13, 14

Still, as the researchers point out, the possible reduction in dementia risk is another reason to keep taking anticoagulant drugs if you’re prescribed them.13

You shouldn’t take anticoagulants if you’re not at risk of blood clots as they can increase your risk of bleeding.13

Where did the story come from?The study was carried out by researchers at

Danderyds University Hospital in Stockholm, Sweden.14

The Sun’s headline described anticoagulant treatment as a ‘2p Alzheimer’s buster’, which is unfortunate – the type of dementia likely to be most affected by blood clots is not Alzheimer’s disease, but vascular dementia.13 The Sun said:

‘2P ALZHEIMER’S BUSTER Giving Brits 2p-a-day blood-thinning drugs could SLASH dementia risk by up to 50 per cent, study reveals’ 15

All the media used the more impressive 48% risk reduction figure from the study, which came from looking at people who took the drugs for most of the time, compared with people who never took them. The more usual scientific standard is to use an intention to treat analysis of the figures, which gives a risk reduction of 29%. Finally, The Guardian’s headline15 “Blood-thinning drugs ‘can reduce risk of dementia by up to 48%’ ” could have made it clearer that any reported dementia risk reduction only applied to people diagnosed with atrial fibrillation and not to the population at large.13

This retrospective cohort study used data from Swedish health registries. This type of study can help researchers spot patterns and links between factors (in this case anticoagulant drugs and dementia) but can’t prove that one thing (the drugs) causes another (the lower dementia risk). That’s because researchers can’t rule out the effect of confounding factors that may influence the results.13

ConclusionIf you’ve been diagnosed with AF and

prescribed anticoagulant treatments such as warfarin or clopidogrel, we already know they protect you against having a stroke. This study suggests they may also help protect you against dementia.13

The risk of dementia is higher without oral anticoagulant treatment in patients with AF. This suggests that early initiation of anticoagulant treatment in patients with AF could be of value in order to preserve cognitive function.14

Cutting the risk of dementia for people who have a raised risk from AF would be an exciting step forward.13

Unfortunately, we can’t tell from this study whether the protection against dementia was

Continues on Page 10

10


down to the anticoagulants because of the possible effect of unmeasured confounding factors.13

Usually, we would want to see a randomised controlled trial (RCT), to follow this study to find out if anticoagulant drugs really do have that effect. In an RCT patients are randomly assigned to the possible treatments or placebo and they and the medics don’t know who has been assigned to what. But because people with AF are usually prescribed anticoagulants to reduce their risk of stroke, it wouldn’t be ethical to do an RCT, as it would leave people unprotected against stroke when a known preventative treatment is available.13

Because of the difficulties of carrying out a proper trial, the researchers say we’ll need to see more studies of the kind done here, in different populations, to see whether the results hold true.13 It would be useful if future studies have clearer information about which confounding factors are being taken into account.13

There are a few things we don’t know from this study.13

• The researchers were unable to differentiate between types of AF. Some people have just one episode of AF that doesn’t return or goes away with treatment, while others have persistent AF that happens all the time. The type of AF may affect both dementia risk and whether you’re prescribed anticoagulants.

• We also don’t know which types of dementia people were diagnosed with. AF may be more strongly linked to vascular dementia than Alzheimer’s disease. But we don’t know for sure which type of dementia might be helped by taking anticoagulants.

You can reduce your risk of vascular dementia by avoiding conditions such as type 2 diabetes and high blood pressure, which can be triggered by smoking and obesity.13

Sources1. BCPA Glossary. www.bcpa.eu/glossary.htm; or www.bcpa.eu; on the blue ribbon click on Glossary; and navigate to the term you want.2. N Engl J Med 2017; 377:1119-1131 Sept 21, 2017 DOI: 10.1056/NEJMoa17079143. https://www.ottawaheart.ca/heart-condition/coronary-artery-disease-atherosclerosis

4. https://www.google.co.uk/search?q=ath-erothrombosis+definition &oq=atherothrom-bosis&aqs=chrome.1.69i57j0l5.3949j0j7 &sourceid=chrome&ie=UTF-85. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31634-3/fulltext?els-ca1=tlpr 29 Aug 20176. https://en.wikipedia.org/wiki/Metabolic_equivalent8. http://www.pulsetoday.co.uk/clinical/cardiovascular/gps-should-co-prescribe-ppis-to-elderly-taking-aspirin-say-researchers/20034595.article 14 June 20179. https://www.drugs.com/drug-class/proton-pump-inhibitors.html10. N Engl J Med 2017; 377:745-755 August 24, 2017 DOI: 10.1056/NEJMsa161603511. Mail online 25 Oct 2017. http://www.dailymail.co.uk/health/article-5014135/Blood-thinners-cut-dementia-risk-heart-patients.html12. Daily Mail 25 Oct 201713. https://www.nhs.uk/news/2017/10October/Pages/Blood-thinning-drugs%20may-reduce-dementia-risk-in-people-with-irregular-heartbeat.aspx. Wed 25 Oct 201714. European Heart Journal, ehx579, https://doi.org/10.1093/eurheartj/ehx579. Also https://academic.oup.com/eurheartj/article/doi/10.1093/ eurheartj/ehx579/4560111/Less-dementia-with-oral-anticoagulation-in-atrial15. https://www.thesun.co.uk/news/4760209/cheap-heart-drugs-slash-dementia-risk/16. https://www.theguardian.com/science/2017/oct/25/blood-thinning-pills-irregular-heartbeat-patients-dementia-stroke

Continued from Page 9

National Helpline 01223 846845

Do you have concerns or worries that you would like to talk to someone about?Our telephone helpline, as part of our national support services, normally operates 9.00am to 7.00pm Monday to Saturday. If you get no reply please leave your name and number, and we shall attend to your call as soon as possible.All the people who answer our helplines have been patients or carers so are likely to understand your concerns because they have been there.

11


Across1. Phone a restaurant, closest essential (7)5. Surrounded by water in this lea (4)10. Food in macabre advert (5)11. Scam elements, involves desert mammal (5)12. Sounds like individual borrowings (5)13. Dog rescued, discovered monsters (5)14. Finally, endless map collection (5)16. Husks in mulch affected (5)21. Instrument used in suburban jobs (5)23. Notions or self direction last removed (5)25. Weight of gem in replica ratified (5)26. Mysterious guru inspects ancient buildings (5)27. Expensive sounding ruminant (4)28. Make a gift of writhing serpent (7)

Down2. Graceful, a gentle refinement (7)3. Extra diode contained communication medium (5)4. Dismissed, it's in the bag (6)6. Essentially also largely sun related (5)7. Firstborn in yield estimate (6)8. A ray of light across a ship? (5)9. Oh most silky, when unwrinkled (6)15. Sounds like a plank on a boat (6)17. Change if has no style (7)18. Discovered drab roads overseas (6)19. Found Darwin terrific for the time of year (6)20. Uncovered extra shed rubbish (5)22. Recess revealed mini chest (5)24. Brings in money from large vases, reportedly (5)

Cryptic Crossword

Solution on page 18

A senior citizen said to his eighty-year old friend: 'So I hear you're getting married?' 'Yep!' 'Do I know her?' 'Nope!' 'This woman, is she good looking?' 'Not really.' 'Is she a good cook?' 'No, she can't cook too well.' 'Does she have lots of money?' 'Nope! Poor as a church mouse.' 'Well, then, is she good in bed?' 'I don't know.' 'Why in the world do you want to marry her then?' 'Because she can still drive!'

12


My name is John Gore and I was born in Roby Mill, a small Lancashire village near Wigan, in 1943. My early days were happy and I recall annual holidays to Colwyn Bay and outings into Snowdonia. Equally memorable were Sunday School trips to the Lake District when I climbed many of the popular mountains such as Helvellyn, Crinkle Crags and Bowfell. Appreciation of this beautiful part of England certainly began in my teenage years and my time at university gave me opportunities for more visits.Soon after this, I married and started my teaching career in North Yorkshire. My wife Margaret and I lived in the village of Marton Cum Grafton, near Boroughbridge, and our three sons were born in the 1970s. We had many holidays in north Wales and the Lakes but, as time went by, it was the Lake District that we explored more extensively, and it was mainly here where we exercised our passion for walking and climbing. Having led a very active life, it was a big shock when, at the age of 56, I experienced a rapid deterioration in my physical capabilities. The outcome was that in June, 1999, I had major heart surgery at the Yorkshire Heart Centre in Leeds, where I was fitted with mechanical aortic and mitral valves. After the operation, I built up my exercise schedule steadily and was soon

climbing in the Lake District again. Indeed, my first significant achievement came just nine weeks after my operation, when I climbed some 1800 feet to the summit of Sheffield Pike, a peak above Glenridding at the southern end of Ullswater. It certainly gave me a feel-good factor because there had certainly been many occasions in previous months when I wondered whether I would ever be able to go hill-climbing again. Soon after this, we had a holiday in Snowdonia when I climbed Tryfan with Margaret and one of my sons. I continued to improve my level of fitness with plenty of exercise and sensible eating, and when convenient I headed for the hills. This gave me tremendous encouragement and pleasure – the discipline and sacrifice needed were certainly worthwhile.Margaret and I moved to Morland, a Cumbrian village in the Eden valley, in autumn 2000. Soon afterwards, having at that stage climbed 27 of the 214 Wainwrights, I set myself the target of completing the round by the beginning of June, 2004, this being five years after my operation. I enjoyed many challenging and noteworthy outings during this period. They included the well known Kentmere round

which took in seven Wainwrights, and an epic excursion of seventeen miles and some 6,000 feet of ascent when claiming nine peaks in

my wainwright challenge ...... three rounds of the 214

Continuing on from “Put Your best Foot forward” BCPA Journal 213: April/May 2017

Summit of Great End June 2004

Summit of Scafell October 2007

Summit of Tarn Crag April 2017

Summit of Bowfell Autumn 2016

13


the High Street area. Pleasingly, on June 5th, 2004, I realised my ambition of completing the Wainwright round by scaling the aptly named “Great End”. Margaret often accompanied me during this 5 year period and at the end of it she had 56 of the Wainwrights left to climb. It was at this stage that we agreed two new objectives. I set myself the target of climbing the 214 peaks again, by different routes where possible, before my 65th birthday in February 2008, while Margaret’s aim was to complete her round before her 60th birthday in December 2005.Both of these were successfully accomplished, Margaret finishing her challenge on the summit of Tarn Crag near Grasmere in December 2005, and me completing my second round on Scafell in October 2007.Our love of the fells and the health benefits we derive from walking have never diminished and since reaching those milestones we have continued to climb the Lake District peaks. In fact, it became clear as time went by that the objective of completing a third 214 round was attainable for me. By the beginning of 2017, only four summits had to be reached for this: Scafell Pike, Lingmell, Great End and Tarn Crag. I climbed the first three in early April and the fourth, accompanied by various family members, on 29 April. This was celebrated at a family get-together in Grasmere. Throughout my Wainwright challenges I have kept a full record of my walks, the 642 ascents having been completed in 294 excursions entailing nearly 2,000 miles of walking and 690,000 feet of ascent.At the beginning of 2017, I was encouraged by many people to set up a fundraising venture. I saw it as a way of saying a big thank you to so many folk who have made my successes possible. I raised money for three charities: The British Heart Foundation, Take Heart (a charity which helps to fund the Yorkshire Heart Centre in Leeds where I had my operation) and The Lake District Search and Mountain Rescue Association. Obviously, I owe a huge personal debt of gratitude to the first two organisations. Fortunately, I have never needed the help of the third, but I know what an amazing job they do.

My initial target of £3000 was very soon passed and I was thrilled in the end to be able to give £1700 to each of my three charities. The support and generosity of my family and many other people was truly remarkable.An important reason for me to write my story was that it might give encouragement and hope to others who, like me, have had to face significant health issues.

Morris, an 82 year-old man, went to the doctor to get a physical. A few days later, the doctor saw Morris walking down the street with a gorgeous young woman on his arm. A couple of days later, the doctor spoke to Morris and said, 'You're really doing great, aren't you?' Morris replied, 'Just doing what you said, Doc: 'Get a hot mamma and be cheerful.'' The doctor said, 'I didn't say that.. I said, 'You've got a heart murmur; be careful.'

14


COREY BEECHER

2018 is a very big year for Bedford

Heartbeat – the team that delivers the Cardiac Recovery Programme for Bedford Hospital NHS Trust. January has seen the launch of their Home Exercise DVD at a special Black Tie event. This project, the brainchild of fitness specialist Corey Beecher, fulfils a long-held ambition to produce a DVD of his very successful Cardiac Recovery exercise plan that can be safely practised at home. Twenty years ago when Corey’s father Derek underwent heart surgery he received expert care in hospital. However, it was soon clear that following discharge there was no cohesive plan in place for recovery or prevention of further cardiac problems in the future.Drawing on his background as a Personal Trainer Corey set about designing a programme of exercise that would enable cardiac patients not only top recover but to maintain a high level of personal fitness. Derek continues to follow the plan and is absolute proof that it works! It is now widely accepted that the key to recover from a cardiac event is attendance at a cardiac recovery course which includes a programme of exercise. Despite this, the take-up of such courses is often disappointingly low. One of the main reasons is the difficulty in accessing transport to the sessions for patients, especially those in rural areas. A cardiac event is a life-changing experience for everyone involved and the aim of this DVD is to help those who attend the recovery programme practise what they have learned and offer support to those unable to travel to the sessions. Our home exercise DVD enables all of the benefits of regular exercise such as lowering resting blood pressure, resting heart rate, increasing the happy hormones that control our mood. Working with household items instead of the formal equipment also breaks down the barriers to exercise some people face. Also using our own homes can make us more motivated to exercise as we have all we need available to us to change and refresh after a workout without the need to travel, park and

undress in poor conditions. The idea of the home exercise DVD is not new but what makes this project unique is that it is a collaboration between the amazing Bedford Hospital NHS Trust Cardiac Recovery Team (Bedford Heartbeat) and a group of former patients lucky enough to have benefitted from their expertise, enthusiasm and encouragement. The production of the DVD has been funded solely by cardiac patients, their friends and relatives who all feel the need to give something back. They have worked tirelessly to raise the funds to bring Corey’s project to fruition without draining precious resources from the hospital. Without their passion and commitment, support for events like race nights, golf days and art exhibitions none of this would have been possible. Corey inspired the group to come together to donate skills they already had and to set about acquiring those that they did not. David brought filmmaking expertise from his day job as a wedding photographer and video maker. Colin had developed film-editing skills when recording his travels around the world on video. Ken’s background in software development meant he could begin to build a website to showcase the project. Barry is a graphic designer and this was a project very dear to his heart – literally! Anyone who has been through the experience of recovery from a cardiac event will tell you of their admiration for the skills of the doctors and nurses who cared for them as a hospital in-patient. However, it is the Cardiac Recovery Team who support you every step of the way on the journey from patient back to person. In these most challenging times for the NHS and Bedford Hospital NHS Trust this is a really exciting venture which will make cardiac fitness and recovery a reality. Working alongside those involved in this enterprise has been a truly inspiring experience and everyone involved is very proud of what has been achieved. The DVD has been used to aid the recovery of 45 additional people through the Cardiac Recovery Programme an increase of some 12%.

BEDFORD HEARTBEAT – making the dream a reality

15


The photo shows Corey explaining to the Mayor of Bedford Dave Hodgson about the exercises contained in the DVD.

The next phase is a collaboration with other NHS Trusts to offer our DVD, support and encouragement to increase the reach of these DVDs to assist other health professionals to promote the great work we all do within this area of recovery. If you wish to take a closer look at what has been produced please visit http://cardiaccorey.com

So Much For EducationThe following questions were set in last

year's UK GED examinationThese are genuine answers (from 16 year

olds) GED is GovernmentEquivalency Diploma.

Q. Name the four seasonsA.. Salt, pepper, mustard and vinegar

Q. How is dew formedA.. The sun shines down on the leaves and makes them perspire

Q. What guarantees may a mortgage company insist onA.. If you are buying a house they will insist that you are well endowed

Q. In a democratic society, how important are electionsA.. Very important. Sex can only happen when a male gets an election

Q. What are steroidsA. Things for keeping carpets still on the stairs (Shoot yourself now, there is little hope)

Q. What does ‘varicose’ mean?A.. Nearby

Q... What happens to your body as you ageA.. When you get old, so do your bowels and you get intercontinental

Q. What happens to a boy when he reaches pubertyA.. He says goodbye to his boyhood and looks forward to his adultery (So true)

Q. Name a major disease associated with cigarettesA.. Premature death

Q. What is artificial inseminationA... When the farmer does it to the bull instead of the cow

Q. How can you delay milk turning sourA.. Keep it in the cow (Simple, but brilliant)

Q. How are the main 20 parts of the body categorized (e.g. The abdomen)A.. The body is consisted into 3 parts - the brainium, the borax and the abdominal cavity. The brainium contains the brain, the borax contains the heart and lungs and the abdominal cavity contains the five bowels: A,E,I,O,U

Q. What is the fibula?A.. A small lie

Q. What is the most common form of birth controlA.. Most people prevent contraception by wearing a condominium. (That would work)

Q. Give the meaning of the term 'Caesarean section'A.. The caesarean section is a district in Rome

Q. What is a seizure?A.. A Roman Emperor. (Julius Seizure, I came, I saw, I had a fit)

Q. What is a terminal illnessA. When you are sick at the airport. (Irrefutable)

Q. What does the word 'benign' mean?A.. Benign is what you will be after you be eight

Q. What is a turbine?A.. Something an Arab or Sheik wears on his head. Once a Arab boy reaches puberty, he removes his diaper and wraps it around his head. God help us. They will be voting in a few years!

16


NEWS FROM AROUND THE AREASLocal news from some of our Groups

Dates for your diary are on page 19 and the list of co-ordinators and contacts is on page 2

Cambridge - Tony Ward 01223 860329Email:[email protected]

Halton - Betty Rogers07710 485727

They say all good things come to an end! It is therefore with regret that I report that on the 12th March 2018 at the

Cambridge Group AGM the group was unable to form a Committee.I confess that it was not through lack of trying. There was considerable understanding displayed, and the retiring committee expressed appreciation for the support that had been given.It was however agreed that the retiring committee members would wind up the affairs and in particular agree with The Royal Papworth Hospital as to how a large donation would be used at the new hospital. It was also hoped that, if possible, at some future date a final get together could be arranged. Perhaps we shall meet up again as members if not as a group.AGW16.3.2018

Halton Group congratulated Maureen and Tommy Newman on their Diamond Wedding Anniversary in February. They were presented with a photograph frame and a card at our Thursday afternoon

session.

They were both delighted and sent a lovely card to thank everyone.

We were pleased to welcome Keith Jackson to our AGM in February. We would also like to thank Rachael Prime, Community Development Officer

with Halton Borough Council, for attending and for her support. There were no other nominations for officers’ positions, so Betty Rogers remains as coordinator, Norman Probert as treasurer and Margaret Rimmer as secretary. The committee remains the same. There were no objections to this. Thank you to all the members who attended and helped to make it such a successful afternoon. We had a lovely buffet provided by Mandy from Macy’s Café and Joe provided us with some line dancing entertainment.

On 1st March we had a tour of Runcorn Town Hall. We were surprised to be greeted by the Mayor and Mayoress of Halton, Councillors Alan and Joan Lowe. Not only did they greet us they took us on the tour, along with a gentleman called Bruce, and stayed with us all afternoon. The members were really pleased that they had taken the time to show us this beautiful building. Another surprise was that we were expecting tea and biscuits and we were Maureen and Terry

Keith and Betty

17


Lincoln - Bill LawtonChairman & acting Co-ordinator 01522 703026

provided with a lovely buffet. The Mayor and Mayoress are great supporters of Halton Zipper Club so it was good to be able to visit them during their term of office.We visited Bridgemere Garden Centre at the beginning of March and had a lovely lunch in the restaurant. We also had free time to look around the garden centre. Everyone said they really enjoyed it.

We were hoping to present the Oximeter we purchased with funds from our bring and buy sale, and also a donation from the BCPA, to the cardiac nurses in March but, unfortunately, the presentation had to be delayed so I will be able to tell you about that in the next journal. We will be visiting Norton Priory in May so I will also be able to tell you about that in the next journal. We have also got a couple of new activities to try so I hope you enjoy them. We meet every Thursday at Grangeway Community Centre from 1pm to 3pm for various activities.

DATES FOR YOUR DIARYTh 10 May 1pm – Norton PrioryEvery Th 1pm-3pm – Grangeway CommunityCentre for various activities

Bridgemere Garden Centre

Our 8 February meeting in The Methodist Chapel, North Hykeham was an opportunity

for members to hear from the committee on the 2018 programme of meetings and trips. Much interest was shown and many suggestions for investigation were made. It was agreed that we should have a change of venue for our Christmas Dinner. We also discussed the way forward by the trustees to put the BCPA on a new programme of reorganisation – especially the bi-monthly Journal. It was thought the proposals were both practical and necessary to assure its future.

Members at The Royal OakOn Thursday 22 February 32 members travelled by coach over the Lincolnshire Wolds to the Royal Oak pub, Little Cawthorpe, Louth (known as the Splash) which is accessed through a secluded entrance over a small stream. Lunch was enjoyed in a very olde worlde setting.Leaving the Splash a tour of two hours provided a feast of spectacular views. Passing through Burgh Le Marsh, reported to have one of the oldest saxon barrows in the country then on to Skegness on a cold but bright sunshine day..A very successful day as a short trip. A week later all the roads were shut off for several days by six foot snow drifts.FUTURE EVENTSThursday 3 May 2018 – Proposed visit to North Lincolnshire Wolds – depart pickup point North Hykeham 11am, arrive The Red Lion, Redbourne, Brigg 12.15pm.

Carvery of roast beef and roast ham, seasonal vegetables, choice of desserts and coffee – depart Red Lion 2pm, coach tour of North Lincolnshire Wolds, Brigg, Thornton Abbey, Caistor – a centre of roman history and a district highly contested by the Vikings.

The Red Lion Redbourne

18


Staffordshire - Eddie Coxon 01782 416143

Thursday 7 June – Annual visit to Clumber Park, Nottinghamshire to witness the spectacular display of rhododendrons, wild clematis, and the flowering of the Lime Trees on the 2 mile avenue, we hope to obtain the services of one of the rangers on the coach. Depart Lincoln 11am, arrive at hotel for lunch 12pm, afternoon tour of The Dukeries. Tuesday 4 December Visit to WicksteedPark Spectacular Christmas Variety Show. A cavalcade of Christmas music, dance and laughter, singers from the West End shows Les Miserables, Oklahoma, Miss Saigon and Carousel.

A Thank You. Asda Foundation Customer Services Department, North Hykeham Lincoln By way of the ‘Green Token Scheme’ at Asda, North Hykeham,

the British Cardiac Patients Association Lincoln Group have been awarded a grant of £500.00. The Group were selected as one of the charities for a share of their community funding from October to December 2017 – and luckily were awarded first prize. We are very grateful for this support from such a high profile local business and would like to also thank Paula Robinson, their Community Champion, for her guidance and support throughout the process.

South East London & Kent

Chris Howell 01689 821413

Our AGM and New Year Social was held on Friday 23rd February at the Victory Social Club. It was a pleasure to see Keith Jackson at the meeting who updated us on the Association.Our first meal at the Toby Carvery, Bromley Common was on the 13th March and was well attended.Due to the “Beast from the East” our first social outing of the year had to be moved to the 16th March – but whilst preparing this article “Mini Beast from the East” has arrived and is snowing well.

Five members visited the Charles Dickens Museum which is located at 48 Doughty Street, Bloomsbury, London WC1N 2LX on a sunny and warm day. We started with coffee in the onsite garden café and then toured the house.Charles and his family moved in 1837 and moved out in 1840. The five-storey house was his home and exhibits the family’s personal possessions. There is also a shop on site. After our visit we returned to Piccadilly for lunch and returned to Victoria Station for our journey home, with some delay due to problems at Petts Wood Station.Our next meal at The Toby Carvery, Bromley Common is on the 15th May, the table is booked for 7.30pm. Please let me know if you are coming to the meal.Our next meeting at the Victory Social Club is on 20th July for Strawberries & Cream Evening. Please remember to bring a prize for our raffle.

In April St John’s Ambulance to give us a talk. We are planning Boat Trip with lunch. We have a visit to Gladstone Pottery with

Halton group in July we have a concert with male voice choir. We are also planning a visit to the Black Country Museum.

Crossword Solution

19


Cambridge No meetings plannedContact Tony Ward 01223 860329 for general details and other meeting dates

Chelmsford and District Cardiac Support Group

Fri 18 MayFri 15 JuneFri 20 JulyFri 17 AugustFri 21 Sept

National Gardens Scheme in Essex25th Birthday EntertainmentNew York, New YorkThe History of HarrodsI had a DreamAll 8.00pm at Broomfield Village Hall

Halton Thurs 10 MayOther weeks

Norton Priory Visit. Th 1-3 at the Grangeway Community Centre, Runcorn for Line Dancing and Gentle Tie Chi

Havering Hearties 2nd Thursdays 7.30pm At The Royal British Legion Club premises, Western Road, Romford, Essex

King of Hearts Redbridge, Essex

2nd Wednesdays 7.30pm

The Aldborough Room, Fulwell Cross Library, High Street, Barkingside IG 2EA For details contact Tony Roth 020 8252 0877

Lincoln Thurs 3 MayThurs 7 JuneTues 4 Dec

Visit the North Lincolnshire WoldsOuting to Clumber ParkWicksteed Park Christmas EntertainmentMonthly meetings at the Methodist Chapel,

SE London & Kent Tues 15 MayFri 20 July

Toby Carvery 7:30pmStrawberries and CreamMeetings at the Victory Social Club, Kechill Gardens, Hayes

Staffs & District Check with Eddie Coxon for meetingsMeetings 7.30 for 8.00pm at the Thistleberry Hotel. Contact Eddie Coxon 01782 416143 for further details

Take Heart Southend

2nd Thursdays 8.00pm At Eastwood Community Centre, Western Ap-proaches, Leigh-On-Sea

Warrington Please contact Dennis Atkinson 01925 824856 for meeting details

Wirral Please contact Barrie Harding 0151 6086212

Wrexham Please contact Gerry Hughes 01978 758335

DATES FOR YOUR DIARY

Documents

BCPA Journalbcpa.uk/pdf/journal/BCPA_Journal_218.pdf · BCPA Annual General Meeting The 36th Annual General Meeting of The British Cardiac Patients Association will be held on Saturday