SCOTLAND, with its love of the deep-fried Mars bar, was once famously labelled the sick man of Europe. Our eating, drinking and smoking habits have helped lower life expectancy in some deprived areas to third-world levels. Our TV screens are full of government-backed adverts painting Scots as unhealthy, drunken slobs.
So it is surprising to see the reality is that levels of coronary heart disease have fallen consistently over the last decade.
The main reason has been the steady decline in smoking. Just 30 per cent of UK men now smoke, with an even smaller propo
rtion of women, in the 1970s it was around half, while in the 1940s it was even higher.
Not only does smoking cause lung cancer, it is also the biggest cause of heart disease – higher than inactivity and obesity, which are both major factors. So are doctors jumping for joy in their surgeries? Sadly not. The steady decline in heart attacks is predicted to slow, level off, and even rise.
The current generation of sport-shy overweight children and heavy-drinking young adults are a ticking timebomb.
Andy Carver, prevention and cure advisor for British Heart Foundation Scotland, said: "There has been a quite dramatic fall in heart disease in the last few years. The problem is with the future generation.
"The risk is the reduction in heart attacks we have experienced in recent years will actually go back up again.
"That will have an impact on individuals' levels of ill health, on increased health service costs and increased disability."
One of the biggest concerns for health chiefs is the gap in lifestyles between deprived areas and more affluent ones.
Children growing up in poorer areas are at risk of picking up bad health habits from their parents and neighbours, have less money for things like gyms and sports and are often slower to take on board healthy-lifestyle messages.
This is a challenge facing NHS Lothian, in particular, as a total of 211 people died in the poorest parts of the Lothians from coronary heart problems between 2004 and 2006, one more than in 2003 to 2005. It was the only area of the country where heart disease death rates in the most impoverished wards did not fall.
However, the health board has been far from complacent and is one of the pioneers of Keep Well, which is aimed at poorer areas of the region, and provides tailored support to help people stay fit and healthy. Dr Ian McKay, chairman of the community health partnership and a GP in Leith, said: "We've definitely seen a drop – less people are having heart attacks and those that do are more likely to survive them.
"But there certainly is this timebomb building up because of obesity and everything else that goes with it, such as not getting a lot of exercise, not eating fast food.
"I doubt it (incidents of heart disease) will get back to the levels it was at when smoking was more common. That was such a major factor and it has definitely tailed off. The smoking ban has helped a lot."
NHS Lothian has also pioneered the Lothian Optimal Reperfusion programme, giving heart attack victims faster and more effective treatment.
What is not clear is how effective the Scottish Government's bombardment of adverts, urging people to drink in moderation, eat healthily and keep fit, is
Ministers and charities run such messages past sample groups to try and avoid giving them impression of preaching to people or playing the role of nanny state.
The latest advert from the BHF, to be screened on August 10, will show a heart failing. They hope this kind of shock treatment will be the wake up call people need to take better care of themselves.
The Scottish Government last week launched a consultation on how best to get healthy messages across to the public to tackle both heart disease and strokes.
The main two targets will be young people and those living in deprived areas.
Minister for Public Health, Shona Robison, said: "Coronary heart disease and stroke remain two of Scotland's biggest killers.
"I welcome the progress that has been made, but there's no doubt that we need a long-term action plan to further drive down rates of CHD and stroke.
"This Government is already taking bold action to cut levels of obesity, smoking and alcohol misuse, which all contribute to CHD and stroke prevalence.
"As well as taking into account preventative measures like encouraging healthy lifestyles, we want to eradicate as far as possible the health inequalities that still exist and ensure that patients receive the best quality of care.
"And through our health action plan, Better Health, Better Care, we're committed to providing patients with the best possible treatment and care.
"This consultation seeks to gather a range of views on how we can further improve services and make them more responsive to patient needs and wishes.
"We will then draw on these to produce an action plan that will form the core of the revised strategy, which we'll publish before the end of this year."
From health boards to Government ministers to charities, there is no doubting people's awareness of the threat of heart disease.
However, these organisations cannot solve the problem alone, and it will be up to ordinary members of the public to change their lifestyles to improve their health.
Whether this happens or not remains to be seen, we can but hope that one day Scotland will be known as the healthy man of Europe.
The full article contains 936 words and appears in Edinburgh Evening News newspaper.
