The Mediterranean diet, exercise and optimism are the triad proposed by specialists for a healthy heart until ripe old age, with recent research expressing even more certainty about their role in preventing cardiovascular disease, the leading cause of death in the Western world. Professor of Cardiology at the University of Athens Pavlos Toutouzas, in a roundup of the latest developments, spoke to Kathimerini about the importance of living happily for a sound heart. Mediterranean diet and long life: «Thirty years ago,» Toutouzas pointed out, «the mortality rates of adult Greeks were the lowest in Europe, something that was attributed to their dietary habits.» There is strong evidence, he continued, that the traditional Greek nutrition model prevents cardiovascular disease and certain forms of cancer. «Indeed, a study by Dimitris Trichopoulos announced at the Athens Academy, titled ‘The Health of Greeks: Past and Future,’ shows that adherence to a Greek diet increases longevity considerably.» Mortality rates in Greece are still among the lowest in Europe, but «certain sporadic studies have shown that in the past few years, risk factors have increased.» At the same time, increasing numbers of Greeks are going off the traditional diet. Toutouzas added, «Health policy is oriented toward cure, and the corresponding necessary infrastructure.» But a focus on prevention would surely have more impact on health indices than investment in high technology, he pointed out. Exercise: A leading role in maintaining good health until a ripe old age is physical exercise, which, among other things, feeds and tones muscles and protects against falls, broken bones depression and arthritis. Exercise keeps arteries elastic in old age, as well as boosting levels of glutathione, an anti-oxidant that has a beneficial effect on arteries and keeps blood pressure, sugar and cholesterol levels normal. It strengthens the heart and the brain, while preventing thrombosis and embolisms caused by artery wall debris that accumulates with age. Moreover, it prevents disorders in the regular heartbeat and crises in which the blood flow to the brain is reduced. Exercise does not mean people have to be champion athletes. Toutouzas points out: «In organized sport, one in 200,000 athletes dies of an acute, cardiovascular episode. In most cases, the athletes had not been examined by a cardiologist to see if they suffered from any form of heart disease, or the athletes themselves scorned the diagnosis.» In 30 percent of sudden deaths, the athletes had been given a clean bill of health, a phenomenon known as Commotio cordis. Optimism and calm: Acute anxiety quintuples the danger of sudden death, while anger is an aggravating factor. During the first hour of a bout of anger, the danger of a heart attack doubles, especially when the person has cardiovascular disease. A good psychology and a positive attitude to life despite its difficulties are significant factors in increasing longevity. The results of a Finnish study of a sample of 1,130 elderly patients over the age of 70 are indicative. Scientists observed the elderly individuals for eight years straight, and confirmed that 52 percent of patients who had a pessimistic attitude toward life died before the eight years were up. By contrast, all of those who were optimistic managed to survive. Hypertension: Tackling high blood pressure plays an important part in reducing heart attacks. «With treatment of hypertension,» Toutouzas said, «there is a 40 percent reduction in strokes, a 20-25 percent reduction in cardialgia and heart attacks and a 50 percent reduction in heart failure. Despite the fact that hypertension can be dealt with, the question of a correct diagnosis remains, due to the fluctuation in blood pressure over a 24-hour period.» One in four people visiting a doctor’s surgery develops the «white-coat syndrome» and the doctor finds elevated blood pressure. Then the mistakes begin: Either the individual is incorrectly prescribed treatment for hypertension, or he is not prescribed treatment although they have high blood pressure because it was considered to be a one-off result due to the white-coat syndrome. According to Toutouzas, four or five visits to the doctor over a period of days or even weeks need to be made in order to have checks carried out to find out whether the patient has hypertension or not. Automatic measurements every 20 minutes for a whole day is yet another way to come to a correct diagnosis of high blood pressure. This can be done with a special electronic device which can be worn by the patient for 24 hours (the Holter method). Measurements of blood pressure while the person is both resting and active are thus possible. Blood pressure is calculated by taking the average of all the measurements. Blood pressure is normal if the average is below 13.5/8.5. Heart inflammation: The science of predicting heart attacks has seen major advances, the professor said. A simple blood test for myeloperoxidase (an enzyme produced by leucocytes) informs specialists of the danger a person runs of suffering from a severe cardiovascular episode within the next six months. If the levels of the enzyme in the blood are high, then the arterial plaque is inflamed and torn, leading to thrombosis and sudden arterial blockage. Very high levels of the enzyme mean widespread inflammation. Mobile units: The first minutes of a heart attack are decisive for the progress of the health of the patient. As Toutouzas stresses, if the ambulances were real mobile health units, that is, if they were equipped with defibrillators, electrocardiograms and were able to carry out rapid blood tests to diagnose the patient’s state and start special therapy immediately, then the death rate in the first month would not be over 3 percent.