There are some alarming statistics regarding men’s health. More than 40% of Australian men over 40 suffer a serious health problem. Men under 75 years of age are almost three times more likely to die from heart disease, stroke or blood vessel disease than women in the same age group; and in men alcohol misuse results in about 3,000 deaths and 65,000 hospitalisations every year.

This year the theme of IMHW in Australia is Kick a Goal for Men’s Health – especially appropriate at the time of the Football World Cup.

Associate Professor Gary Wittert from the University of Adelaide’s Department of Medicine, writing in the Men’s Health Australia website, tells us: “Compared with women, Australian men of all ages are less healthy and, therefore, do not enjoy as good a quality of life as they should. All chronic conditions such as obesity, cancer, diabetes and cardiovascular disease occur more frequently in men and their life expectancy is five years less than that of women.”

The Australian male mortality rate (the number of deaths from all causes) is almost one and half times the female mortality rate. Overall for every two women who die, three men die. More men die at every age group than women, except for the over-65 age group.

According to Professor Wittert, it’s important that we identify the reasons for men’s poorer physical and mental health. Measures could then be developed and implemented to promote a healthy and active lifestyle and eventually prevent diseases.

It probably comes as no surprise to learn that men generally indulge in more risky behaviour than do women; and this behaviour pattern has been the case for many centuries.

Perhaps this is one reason why men don’t last quite as long as women. Compared with women, men are much more likely to die in accidents – traffic or work-related accidents – and be the victims of homicide or suicide. But the fact that some men occasionally behave quite badly is not the only reason that in Australia women live longer than men. This five year gap is quite common in other parts of the world as well; but the reason differs from country to country.

So, when young Australian men survive their aggressive adolescence, they are still more likely to indulge in dangerous lifestyle pursuits – smoking, eating and drinking to excess and exercising too little.

It’s fair to say that women appear to have biological advantage over men; women seem to have a stronger immune system; and the hormone oestrogen protects against heart disease and stroke – at least until after the menopause.

However, men are less inclined to visit the doctor, whether that be when they are ill, or just to have a regular check-up. They’re very much aware of the need for motor vehicle or other machinery maintenance, but ignore the need to protect their bodies from abuse, misuse or age-related deterioration.

In preparing to kick those men’s health goals and closing that five year gap, all men, and women who care about them, could check out the series of men’s health fact cards. They’re available from all pharmacies around Australia providing the Self Care health information. Call the Pharmaceutical Society (PSA) on 1 300 369 772 or log on to the PSA website at www.psa.org.au for the nearest location.

©2010 Pharmaceutical Society of Australia

There would hardly be a man, woman or even child in Australia who doesn’t know about the dangers of smoking.

And this awareness has led to a slow but steady reduction in prevalence rates for smoking. The latest figures available show that around 17% of all Australians now smoke – down only a couple of percentage points in the last few years, but down almost 7% since the early 1990’s.

In Australia, there are still more male smokers than female, however, amongst teenagers, more girls smoke than boys. This, sadly, seems to be a worldwide trend. Women now comprise 20% of the world’s one billion smokers. The problem has now reached such proportions that the World Health Organization (WHO) has given overdue recognition to this epidemic of tobacco smoking amongst women with the theme this year for World No Tobacco Day (31 May) “Gender and Tobacco” and an emphasis on the way cigarettes are marketed to women.

Protecting women from a lifetime of dependence on nicotine can stop the increasing prevalence amongst women of crippling and often fatal heart attacks, strokes, cancers and lung diseases.

We know that smoking is most likely the greatest single preventable cause of death and disease in the world. Even passive smoking – inhaling someone else’s second hand smoke – is a major problem. So why would anyone still be a smoker?

Well, there are probably many reasons why people begin to smoke – peer pressure is a particularly relevant factor in young women – and the reality is, once you start smoking it’s mighty hard to stop. Nearly two thirds of smokers would like to stop smoking, but fewer than 1 in 20 people who try to quit will actually remain non-smokers after three months.

Up until recently, it was thought that stopping smoking completely – either cold turkey or with the help of nicotine replacement therapy (NRT) – was the best way to ensure becoming a long term non-smoker. But this “quick stop” method doesn’t suit everyone.

The “cut down then stop” (CDTS) method has now been given the official seal of approval. Evidence has shown that reducing the number of cigarettes smoked with the assistance of NRT, makes it easier for some heavily addicted smokers to ultimately quit completely.

Also, the simultaneous use of more than one nicotine replacement therapy product used not to be considered appropriate. But experience has shown that some smokers who continue to have cravings with single therapy, or those who have quit in the past and then relapsed, will benefit and become long term quitters by using the patches and gum together.

NRT can be a useful tool for just about everybody to assist with smoking cessation; that is everybody regardless of age, sex or medical history; and using NRT to quit is always safer than continuing to smoke.

There are many myths and misconceptions about the effects of nicotine and NRT. Make sure you get the facts and the right advice on what products will suit you best. Ask for the fact cards on Smoking and Staying a Non-smoker from one of the pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. Phone 1300 369 772 or check out the website at www.psa.org.au for the nearest location.

And if you want some more encouragement to stop smoking, have a look at the posters on the World No Tobacco Day 2010 website. “Being sexy, chic and glamorous is no throat cancer, no mouth cancer and no gangrene; and being tobacco free is a woman’s right”.

©2010 Pharmaceutical Society of Australia

Heart attack warning signs vary from person to person; and they may not always be sudden or severe. Although chest pain or discomfort is the most common symptom, some people will not experience this symptom at all. Jaw, neck, back or shoulder pain can also be a warning sign of a heart attack.

So, pain, pressure, heaviness or lightness in one or more parts of your upper body – sometimes in combination with other symptoms such as nausea, dizziness or shortness of breath – are all causes for concern.

Whatever the symptoms, all heart attacks have one thing in common, that is, the sooner you receive treatment, the less damage will be done.

The heart is a beating muscle that pumps blood continually to the rest of the body. The so-called coronary arteries supply the heart with the oxygen and nutrients that it needs to function.

Red blood cells, white blood cells, and other components of blood flow freely through the arteries to the heart and other parts of the body. In a healthy person, the inner walls of the arteries are smooth and uniform in thickness.

However, arteries can become blocked over time by the build up of fatty deposits of cholesterol called plaque. The greater the build up of plaque, the greater the risk of heart attack. Blockage of the arteries can also occur at the site of a crack in the plaque. When this happens, blood cells and other components can clump together at the site, forming a blood clot, or thrombus. This can grow to completely block blood flow to the heart muscles. If the artery remains blocked, the lack of blood permanently damages the area of heart muscle supplied by the artery.

The extent of damage sustained by the heart during a heart attack depends on the severity and location of the blockage, and the speed at which medical treatment is received. So learning the warning signs is critical. If you think you could be having a heart attack, call 000.

Along with early recognition of heart attack, prevention strategies are of paramount importance.

According to the National Heart Foundation, it could be small life-style changes that might make the biggest difference in improving heart health – small changes that we can put into effect ourselves and that are not at all costly and are well within our personal price range. Nevertheless, simple as these changes are, they are often the most difficult to implement, because they involve changes in our sometimes firmly entrenched behaviour.

Weight management is essential. Healthy eating is making sure you still get all the nutrients you need for good health while reducing the amount of energy (kilojoules) you take in. The good news is that many foods that are low in energy are also packed full of essential vitamins, minerals and fibre.

Being physically active is important too and the activity doesn’t have to be over vigorous. Bush walking, cycling or swimming are all fine; whatever takes your fancy. Aim for about 30 minutes of moderate intensity on most days of the week; and this can be accumulated in bouts of 10 minutes or so if this is more convenient.

You can get more healthy heart tips from the “Heartsite” at www.heartfoundation.org.au or visit your nearest Self Care pharmacy – pharmacies providing the Pharmaceutical Society’s health information. There are fact cards on Exercise and the Heart, Weight and Health, Fat and cholesterol and High Blood Pressure. Call 1300 369 772 for more information, or check out the Pharmaceutical society website at www.psa.org.au and click on Self Care pharmacy finder.

©2010 Pharmaceutical Society of Australia

While it has been well recognised for many years now that being overweight and obese is a short cut to a life of ill health and premature death, the comparatively long living indigenous peoples of Alaska, Canada and Greenland posed a medical dilemma – both the food they ate and their general appearance was more fat than lean.

It was in the 1970s researchers discovered that the copious serves of fat mainly from the oily fish they consumed, rather than pre-disposing towards heart disease, was actually serving to prevent it. The so-called omega-3 fatty acids contained in the fish oil were providing the benefit.

Omega-3 fatty acids and omega-6 fatty acids are together known as polyunsaturated fatty acids – they are essential building blocks for a number of chemicals involved in important reactions in the body. They’re the good fats.

The bad fats are the saturated fats. Foods containing a high proportion of saturated fats include dairy products (especially cream and cheese), animal fats, fatty meat, chocolate and some processed foods.

While the National Heart Foundation recommends that our total fat intake should make up 20–35% of our energy requirements, it recommends that saturated fat should be less then 7%.

Furthermore, just when we think our brain is saturated with information about fats, we learn that trans fatty acids – a different form of unsaturated fats – seem to have an even greater adverse effect on the risk of heart and blood vessel disease than even the saturated fats. They increase the level of LDL cholesterol (the bad one) and decrease the level of the good HDL cholesterol.

We need both omega-3 and omega-6 polyunsaturated fatty acids, but over the past century or so, our diet has changed from predominantly fish, plants and wild game to a diet of farmed meats and processed foods and the ratio between the omega-3 fats and the omega-6 fats has become unbalanced (too much 6 not enough 3).

Chemicals with the abbreviated names of EPA and DHA are the two of the major forms of omega-3 fatty acids which seem to be responsible for their beneficial effects. They help protect us from heart and blood vessel disease and have an anti-inflammatory effect; and some studies have shown EPA/DHA supplementation is able to protect against the progression of macular degeneration and also to enhance concentration and learning in children.

So there is good evidence for dietary supplementation with fish oil. However, even with naturally occurring substances, if there’s a benefit, there’s also always a risk.

Fish oil capsules are generally well tolerated, but gastro-intestinal side effects are not uncommon – a ‘fishy’ aftertaste or heartburn and indigestion may be experienced. And people who are allergic to fish may also be allergic to fish oil supplements. Also, there can be interactions between fish oil and some prescription medicines, so check first with your pharmacist before starting treatment. On the plus side while mercury toxicity is a concern with some fish, in Australia the mercury content of fish oil capsules is required to be extremely low.

And remember, ‘oils ain’t oils’. There is a difference between fish oil supplements and cold liver oil capsules. Large quantities of the latter may provide toxic doses of vitamins A and D. You can get more of the good oil about fish oil from pharmacists providing the Pharmaceutical Society’s Self Care health information. Log on to the Pharmaceutical Society website at www.psa.org.au and click on Self Care pharmacy finder for the nearest location.

©2009 Pharmaceutical Society of Australia

But too much blood pressure can result in a catastrophic outcome – just like a pressure cooker on high heat without an escape valve.

Hypertension (the medical term for abnormally high blood pressure) is considered by the World Health Organization (WHO) as one of the most serious risk factors for death worldwide. It is estimated that about 30% of Australian adults have hypertension; and most of these people are receiving no treatment.

What makes hypertension so serious is that, well before the explosive heart attack or stroke occurs, there is underlying, sometimes irreparable damage done to the cardiovascular system, the kidneys and the brain. Also, hypertension, especially when combined with diabetes, significantly increases the risk of blindness.

In most cases the actual cause of high blood pressure can’t be identified, but we do know what groups of people are most at risk of developing hypertension; and we do know ways whereby we can reduce the risk.

There are usually no symptoms of hypertension; at least generally not until the blood pressure reaches a sustained dangerous level. So, if there is a history in the family of heart disease, kidney disease or diabetes, a regular – at least yearly – check up with your GP is essential.

For most of us, lifestyle behaviour changes will help prevent high blood pressure problems occurring and certainly help control high blood pressure if it does occur. This involves effective weight management strategies (being over weight or obese is a major risk factor), adequate exercise, moderation in alcohol consumption and becoming (if not already) a non-smoker.

If we do have hypertension, regular and long term treatment with medication will most likely be a necessity. Understanding how these blood pressure medicines work is helpful; and your pharmacist can provide you with so-called Consumer Medicines Information (CMI) which explains the benefits and the occasional problems you may encounter. Uncomfortable side effects with anti-hypertensive therapy can sometimes be experienced, especially in the early stages of treatment, so it’s nice to know what to expect.

For more information about hypertension ask for the Blood Pressure fact card at one of the 2,000 pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. There are also cards on Weight and Health, Exercise and the Heart, and Staying a Non-Smoker.

Taking ownership of a medical condition will often help improve outcomes. With hypertension this can sometimes be achieved by the use of home blood pressure measuring devices. The modern machines are simple and easy to use. Check with your doctor whether one of these could be an advantage. And if you have trouble remembering to take your blood pressure tablets, a ‘dose administration aid’ or medication blister pack could help.

It’s as well to remember that there are some medicines – both prescription and non-prescription medicines – which can cause or worsen hypertension. This includes some pain relievers, anti-depressants oral contraceptives, cough and cold products and various herbal preparations. If you have high blood pressure, always check first with your pharmacist before self selecting another medicine.

Meanwhile, for the location of the nearest pharmacy where you can pick up those Self Care fact cards, phone the Pharmaceutical Society on 1 300 369 772 or log on to the website at www.psa.org.au and click on Self Care Pharmacy Finder.

©2009 Pharmaceutical Society of Australia

Uncontrolled diabetes poses a serious risk to our health. Complications can include blindness, kidney failure and increased risk of heart disease and stroke.

Diabetes is the name given to the condition where our body is unable to use glucose properly – and glucose is our major energy source; the fuel which keeps our body functioning effectively.

There are two major forms of diabetes – type 1 and type 2. Type 1 diabetes usually occurs in childhood or young adulthood – possibly because the body’s immune system runs a bit wild and attacks and destroys the insulin-producing cells in the pancreas gland. Because the body stops making insulin, people with this form of diabetes need daily doses of insulin.

However, type 2 diabetes is the form of diabetes likely to affect most Australians (in type 2, insulin is produced, but we just can’t use it effectively). It accounts for 85-90% of the more than a million Australians with the condition – a number that could double over the next 10 years or so, if control strategies are not put in place.

Type 2 diabetes usually occurs in older adults – it used to be called maturity onset diabetes – but increasingly the condition is affecting younger people. Family history is one reason.

Of course our parents are not totally to blame. Family history is just one risk factor. Lifestyle issues are also highly significant. Overweight and obese adults are two to four times more likely to suffer from diabetes.

We now know that high blood pressure is another major risk factor for diabetes; a factor which is apparently not widely understood. According to Dr Neville Howard, President of Diabetes Australia – NSW, “there is a staggering lack of awareness about the link between high blood pressure and developing diabetes and its serious complications.” “While most people are aware that family history and being overweight can put them at risk,” he said, “a Diabetes Australia Study conducted last year has shown that 90% of people surveyed did not know that high blood pressure was a risk factor.”

When blood pressure is measured, two reading are taken; and it is usually expressed as one larger number over another. The top reading (so-called systolic blood pressure) is a measure of the force of the heartbeat. The lower reading (diastolic) is a measure of the blood pressure when the heart is at rest between beats.

There is no “ideal” blood pressure – it will vary from person to person; but as a guide the target blood pressure is less than or equal to 130/80.

Lifestyle changes are the key to reducing the risks of and treating high blood pressure, said Dr Howard. This should involve healthy eating, regular exercise, drinking lots of water, reduced salt intake, alcohol in moderation (no more than two standard drinks per day) and no smoking. Most of us will also need to lose some weight around our waist line. The aim should be a waist circumference of less than 80cm for women and 94cm for men.

And every time we visit the doctor we should get our blood pressure checked. If we seem otherwise healthy, we should make sure we have at least a yearly check up, especially if we’re over 40.

You can get more information about diabetes from the Diabetes Australia website or pick up a Fact Card from one of the 1,650 pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. Phone 1300 369 772 for the nearest location or go to the Pharmaceutical Society’s website at www.psa.org.au and click on “Self Care Pharmacy Finder”.

©2009 Pharmaceutical Society of Australia

While our current test players are preparing for a challenging test in Perth, one of our former test cricket legends is taking on a challenge of a different kind.

Michael Slater opened the batting for Australia between 1993 and 2001, so successfully that he kept the run scoring machine, Matthew Hayden, on the sidelines. Michael’s aggressive attitude changed forever what we expect from an opening batsman.

Now Michael Slater is using the same enthusiasm to promote heart health. He is the face of a new national education program to urge Australians at risk of heart disease to take action against atherosclerosis.

Atherosclerosis, also known as atheroma, is the leading cause of cardiovascular (heart and blood vessel) disease; and cardiovascular disease is the number one killer in Australia.

In fact, cardiovascular disease accounts for nearly 17 million deaths worldwide every year – making it the greatest risk for life for most adults.

The condition known as atherosclerosis occurs when so-called plaque, made up of liquid and semi-solid substances including cholesterol and calcium, builds up on the inside walls of the arteries – the blood vessels carrying blood from the heart.

Yet a recent Newspoll survey revealed that seven out of 10 Australians had never heard of atherosclerosis, let alone realised that it can lead to an increased risk of heart attack.

The President of the Australian Atherosclerosis Society, Associate Professor David Sullivan, expressed concern about this lack of awareness of the cause of “premature ageing of the arteries” which leads to heart attack and stroke. And Society spokesperson, Associate Professor Richard O’Brien from the University of Melbourne, said we need to know how the risk factors – high cholesterol levels, high blood pressure, diabetes and smoking – can damage the arteries.

Of course everybody needs some cholesterol. It’s a building block for a number of essential body chemicals including vitamin D and various hormones. But too much is certainly not a good thing.

The cholesterol travelling around our bodies comes from two sources. We make about 75% ourselves, mostly in the liver. The other 25% comes from the food we eat.

Just to complicate the issue a little more, cholesterol is found in two main forms. There is the good type called HDL (high density lipoprotein) and the bad type LDL (low density lipoprotein). LDL cholesterol is the type that clogs the blood vessels, whereas HDL helps to unclog the blood vessels.

So medicines used to lower cholesterol levels actually aim to lower LDL levels and raise HDL levels. Medicines may be required to regulate cholesterol levels, but attention to diet is the first priority. Eating less saturated fat, exercising more and definitely not smoking are the major lifestyle issues we need to address.

You can get more information about atherosclerosis and heart disease, and most importantly how to protect those arteries from premature ageing, at the website ArteryAge.com.au or call into a Self Care Pharmacy for one of the fact cards: Fat and Cholesterol, High Blood Pressure and Exercise for the Heart.

Phone the Pharmaceutical Society on 1300 369 772 or visit their website www.psa.org.au/pharmacies for the nearest location.

©2008 Pharmaceutical Society of Australia

Worldwide we don’t fare so badly. The highest death rates from these so-called cardiovascular diseases are in Russia, Romania, Poland and Hungary; with the lowest death rates in Japan, France and Canada. Australia is not far behind, but the total burden of heart disease, stroke and blood vessel disease is likely to increase in the coming years due to the growing number of older Australians among whom these diseases are most common.

So National Heart Week, 4-10 May, is focusing on how we can improve our heart health.

This year the theme is all about families. Two out of three families are affected by heart disease; so the Heart Foundation is using Heart Week to urge parents and carers to get active with their children.

Of course we won’t be able to eliminate heart disease completely, however, a little attention to lifestyle issues can certainly reduce our risk.

Being overweight, having high blood cholesterol levels and/or high blood pressure, having diabetes, being a smoker and drinking at harmful levels will all make cardiovascular disease more likely.

If you need medicines to lower your blood pressure, the possibility is that they will need to be taken forever. Sometimes that is difficult to accept; especially when, in all likelihood, there are no noticeable symptoms of the blood pressure being raised. In fact, occasionally the medicines themselves have unwanted effects. They may make you feel drowsy, dizzy or nauseated.

If side effects with your blood pressure medicines do occur, you should tell your doctor and pharmacist. There may be other medicines that suit you better or another way to manage the problem. Nevertheless, the best single piece of advice you could receive, is to take your medicines regularly day after day.

However, we can certainly reduce the need for medicines, or maybe lower the doses needed, by following some simple self help recommendations. These are all outlined in the series of fact cards available from pharmacies providing the Self Care Health Information. Titles include Exercise and the Heart, High Blood Pressure, Fat and Cholesterol, Weight and Health, and Staying a Non-Smoker. Call the Pharmaceutical Society on 1300 369 772 and ask for the location of the Self Care Pharmacy nearest you or visit the website at www.psa.org.au

When it comes to heart health exercise, the Heart Foundation’s Jump Rope for Heart program is a great way to involve kids from an early age in having fun while staying fit.

This year the program celebrates its 25th anniversary with over 400,000 children from more than 2,000 schools expected to participate, using enough rope to stretch from Sydney to Perth. The aim is to skip right into the Guinness Book of Records with the greatest number of simultaneous rope jumpers.

And recent research has confirmed some of the other simple self care strategies we can employ to reduce our risk of heart and blood vessel disease.

For instance just reducing our intake of salt can make a significant difference. A study published last year in the British Medical Journal online showed that a reduction in dietary sodium by about one half could reduce deaths from cardiovascular disease by 20%.

While most of us don’t sprinkle salt onto our meals so liberally these days, there’s still plenty of salt in processed foods. So check out those products on supermarket shelves.

Meanwhile a study of 35,000 deaths caused by heart disease in St Petersburg in Russia between 1993 and 2000 demonstrated that yearly flu vaccines could prevent thousands of deaths. The research team found that the likelihood of dying from a heart attack increased by a third during a flu epidemic.

So there’s a few simple steps to start with: more exercise, less salt, consider the ‘flu vaccine, and check out the Self Care cards.

©2008 Pharmaceutical Society of Australia