“Greeks, start looking after yourselves now, because your hearts won’t take much more.» That sentence sums up the message expressed last Wednesday by Dimitris Kremastinos, professor of cardiology at Athens University and president of the Greek College of Cardiology and Cardiac Surgery. Kremastinos pointed out that heart attacks have become increasingly common among Greeks aged 35-40 in recent years. The leading cause of heart attacks and of strokes is arteriosclerosis, which develops unnoticed from youth. There are an estimated 20,000 strokes and 25,000 heart attacks and cardialgia episodes a year, Kremastinos told a press conference held in view of International Heart Day this coming Sunday. He attributed the rise in the incidence of heart attacks to smoking and to cocaine use, which has increased in the past five years. «The common factor in the overwhelming majority of episodes,» he said, «is arteriosclerosis, which affects an estimated one in two Greek adults.» Arteriosclerosis upsets the production of vascular dilator and anti-thrombotic substances produced by the inner lining of the arteries. The substances that keep arteries elastic and those that offer protection from so-called «bad» cholesterol also stop being produced, resulting in the formation inside the artery of atheromatic plaque, which can block the artery and cause thrombosis if it ruptures. Damage to arteries from arteriosclerosis is uniform throughout the body, explained Kremastinos, adding that one out of two individuals who have peripheral arteriosclerosis (in their legs, for instance) will suffer a stroke or heart attack without any previous symptoms. «While the complications from arteriosclerosis appear in adults, its cause (apart from genetic predisposition, such as inherited high cholesterol in the blood) is linked to other factors which are present in adolescence,» explained Vassilis Thanopoulos, director of the hub Pediatric Cardiology Department of Aghia Sophia Children’s Hospital, «There are some studies,» he said, «which show that vascular damage is already present in the second decade of life.» The chances of a child growing up to develop arteriosclerosis rise dramatically when other factors are present, such as poor diet, obesity, smoking (active or passive) and a sedentary lifestyle. Spiridonos Moulopoulos, emeritus professor of Athens University and honorary president of the Greek College of Cardiology and Cardiac Surgery, described arteriosclerosis as «the greatest epidemic of the 20th century which is continuing into the 21st.» He noted Greece has achieved a high level of treatment of vascular damage, but it lags behind in treating strokes, developing special treatment clinics and applying interventionary techniques such as thrombolysis and angioplasty of cranial arteries. Moulopoulos also noted the need for National First Aid Center motorcycle squads – especially in Athens and Thessaloniki – that could provide immediate emergency care to people who have suffered heart attacks, given that one out of three people who have had a heart attack dies in the ambulance on the way to hospital. Significantly, the mortality rate from heart attacks is lower in small towns than in large cities, because patients can be taken to hospital more rapidly.