28 August 2018
Professor Martin Cowie, honorary consultant cardiologist at Royal Brompton Hospital, joined an alumni of the world’s most impressive and inspirational speakers when he delivered a TEDx lecture at the Royal Festival Hall in London.
TEDx lectures – which stands for Technology, Entertainment and Design, with the x signifying an independently run event – aim to share ideas around the world. They are known for crystallising complex information into short, accessible and compelling presentations.
Using a mixture of scientific evidence and humour, Professor Cowie explained how simple changes people can make to their lifestyles can prevent coronary heart disease and save lives.
Professor Cowie described how the heart beats “70-times-a-minute, 24-hours-a-day, from many months before we’re born to the second we die… and the arteries, the capillaries, the veins are wondrously designed. If you were to put them together, end to end, they would stretch for 100,000 kilometres – two and a half times round the world.”
Using digital animation, Professor Cowie illustrated how the arteries become clogged with plaques caused by cholesterol, blocking the arteries and causing heart attacks and strokes. Heart disease, the audience was told, causes 18 million deaths a year around the world – one every two seconds.
“Most of you are furring up,” Professor Cowie warned the audience. “It will have already started in the teenagers here, and some of the older people in the audience – well, your insides are a bit like a kettle!”
He added: “A Scotsman like me considers it a birth right to die of heart disease – that is something we need to change.
“We look at screens more and more. We don’t walk our children to school. These are the factors that are driving the epidemic across the world.
“These are things we can change for ourselves… if you only take one thing away from here, whenever you see a flight of stairs, think of me, keep your weight down, keep your cholesterol down and slow down that furring up process.”
While lifestyle is a large part of the answer to reducing coronary heart disease, drugs, explained Professor Cowie, can also play their role.
“Just recently a very large trial was finished involving 27,000 volunteers in about 60 countries took part. You’ve all heard of aspirin, it’s been around for about 120 years or so, and it’s pretty good at preventing clots forming in your arteries – pretty good, but not perfect.
“Cardiologists have always had a suspicion that, perhaps, if added something on top of the aspirin, we would get a better result. But you can’t just go on hunches, you’ve got to prove it.
“So, we ran a very large clinical trial – half of them getting just aspirin, and half of them getting aspirin and a low dose of a blood thinner. All these people had had a heart attack, stroke, angina, or cardiac bypass operation, so we know they had furred up arteries. The question we were asking was, ‘is aspirin the best treatment or should we be changing this?’
“And what was so good, was that this trial was stopped early – by the ethics committee.
Because the benefit of adding the low dose anticoagulant to the aspirin was so dramatic it was unethical to continue. The aspirin plus the other therapy was so much better at reducing the risk of a heart attack or stroke…. in due course, when all the regulation goes through, it’s likely there’ll be a change in how doctors treat this condition.
“So, we’re doing our bit as cardiologists working with patients to try and get better solutions if you develop the problem; but I’d like you also to realise that you have a responsibility for yourself, children, grandchildren and friends.
“Think of this beautiful system of pipes, the vascular system, think how easy it can be to protect it over a lifetime. Working together, you, me, my profession – let’s beat the world’s biggest killer.”
Watch Professor Martin Cowie’s TedX talk on YouTube.