How could a fit 51-year-old have a 25pc chance of a massive heart attack within a year?

Calcification of the arteries is more dangerous than all the 'traditional' factors put together

WHEN you train five days a week, are a non-smoker and have eaten healthily your whole life, it's quite likely that a battle with heart disease is fairly far from your mind. Yet at the age of 51, David Bobbett suddenly found himself on the frontlines and squaring up to the possibility of heart attack after a routine health check in 2009.

"I always had great blood pressure and did an annual stress test from an insurance perspective and there was never an issue in relation to it," he explains. "There wasn't even a thought in my mind that I could be impacted by something like a heart issue. That was something that happened to someone else."

After a friend did a full medical test in a US clinic and was found to have a severe form of cancer, Bobbett decided to go for a similar round of health screening test Stateside. A relatively new heart test -- a calcification test, showing calcification in the arteries -- showed that he had a score of 806. He was in the worst 1pc for his age group, and had the arteries of an 87-year-old. A further angiogram revealed that one of his arteries was fully blocked, while the others were 70pc blocked. His doctors gave him a one-in-four chance of having a massive heart attack within the next 12 months.

"I'd never been feeling unwell," says Bobbett. "I'd never even heard of a calcification test, but it turned out to be a factor in whether you had heart disease. When I had a CT scan done on my head, the poor radiologist couldn't read the scan as there was so much heart disease.

"It was like a death sentence," he adds. "It wasn't like I felt I could do a lot differently, it's not like I could say that I was going to be fitter or eat better. The only thing they could pinpoint the result on was stress. If I had that kind of score doing the healthy things I did in my lifestyle, I recognised I was in serious difficulty."

Duly alarmed, Bobbett set about extensively researching his newly discovered condition, and looked for ways to beat his grim prognosis. For six months, he gave up work and set about reading everything he could on heart disease analysis.

Amid his myriad findings, Bobbett realised that 10 people a day in Ireland have a heart attack without warning. Cardiovascular disease is a progressive disease, yet causes more deaths than all cancers combined. Around 20pc of all people who die do so from either a heart attack or stroke. Many of these have little or no sign of heart disease.

Of the three categories of people at risk -- high-risk, middle-risk and low-risk -- most heart attacks happen to people in the middle-risk category. High-risk people were sufficiently monitored by their doctors, while middle risk people went under the radar, only to be treated in the event of a heart attack.

And in many cases, these attacks aren't necessarily caused by high cholesterol as is widely believed, but rather by a build-up of calcified plaque in the arteries. A simple scan, which shows how much calcification one has in their blood vessels, could provide an early indicator to this condition and provide an even more accurate reading than a cholesterol reading.

"To my mind, the reading is a better indicator of heart disease than all the other indicators combined," says Bobbett.

"Calcification of the arteries is more dangerous than all the 'traditional' factors put together," he explains. "It's more powerful than cholesterol, blood pressure, family history of heart disease and smoking. What's more, people who have low cholesterol can have heart disease. I came out from my consultation thinking, how many people have died [who] didn't have the information that I have?

"The wonderful thing about this calcification test is that while heart disease is very complicated, the test simply gives you the overall end score. It formulates a complicated issue into an easy-to-read scenario."

Though a relatively new procedure, the calcification test has yet to be widely recognised in Ireland as an effective screening method for heart disease. GPs, for instance, are yet to offer the test as part of a routine health check.

Eight centres currently offer the screening across the country -- among them Dublin's Hermitage Clinic; Mater Private Hospital; Blackrock Clinic; UPMC Beacon Hospital; Bon Secours Hospital; Kildare's Vista Primary Care; Cork University Hospital; and Merlin Park University Hospital, in Galway.

Bobbett -- now the founder of Irish Heart Disease Awareness -- is frustrated that the service isn't available outside the private healthcare system in Ireland.

After all, without having had the test, the full extent of his heart disease would still not be known. In the US, the screening can be done at a cost of $99 at walk-in facilities. In Ireland, the test costs between €325 and €400, and one has to be referred to one of these centres by a cardiologist or GP. Still, he is hopeful that in years to come, the process will become more widespread in Ireland.

"I hadn't heard about the calcification screening apart from that lucky test I took in the US," says Bobbett. "Instead, resources in this field focus on treatment after a heart attack. It's a disease that can be measured and then managed. It's really strange to me that no one is openly saying that millions of people around the world are dying of a disease that can be managed."

'The test only has to be done once," he continues. "The test has the same amount of radiation involved as a mammogram, and mammograms have to be undertaken regularly. Seven times more women die from heart disease in Ireland than breast cancer."

While a score on the calcification test cannot be lowered, it's possible to manage the disease effectively and dramatically slow down its progress.

'Because it's an inflammation disease, statins (cholesterol-lowering drugs) is the strongest management for heart disease," says Bobbett. "Statins reduce heart attack rates by 30pc, and beta blockers can be incorporated into a regime to reduce risk."

Bobbett also regulates his condition through diet: "I've stopped eating saturated fats and don't take wheat," he reveals. "I exercise five days a week, just as I have always done. The biggest change is the amount of vitamins I take. Now I take about 15 vitamins and supplements a day from garlic and fish oil to vitamin B (niacin) and Vitamin D. In fact, I had no Vitamin D in my system, and that deficiency is hugely correlated with heart disease.

"Another couple of years and my calcification score would have been so much worse. I hate to think how many people didn't have that opportunity to address the disease. When it comes to taking responsibility for our health, we definitely need a mindset change, not sitting around waiting for the worst to happen."

For more information on calcification screening in Ireland and Irish Heart Disease Awareness, log on to www.ihda.ie or call 01 605 5421.