Doctor Blames Irish Breakfasts, Stress for Record Rate of Heart Disease in Ulster

The highest rate of coronary heart disease in the world is found in Northern Ireland, and the average breakfast may be one of the causes.

The typical breakfast here, often called “heart attack on the plate,” has enough cholesterol in it to clog the strongest arteries. For many Belfast residents, there is no finer start to the day than a plate of fried eggs, bacon, sausages, tomatoes, soda bread, potatoes and mushrooms.

According to the latest statistics from the World Health Organization (WHO), heart disease kills 559 per 100,000 of the province’s population. The next highest rates in the world are in Scotland and Finland.

The United States has reduced its heart disease death rate to 320 per 100,000, and Japan is proudly at the bottom of the table with just 51 deaths per 100,000.

How do you get the people of Northern Ireland to change a habit of a lifetime and switch from a diet that can put them in an early grave?

“It is a mountain for us to climb. I am not quite sure how you do it,” Dr. Alun Evans, a heart specialist, said.

Evans, of Belfast’s Royal Victoria Hospital, heads Northern Ireland’s branch of a 10-year WHO project to monitor heart disease worldwide.

Health authorities have embarked on a “Change of Heart” campaign to educate workers through seminars on the factory floor. Staff cafeterias are being urged to cut down on fried foods.

“Heart disease is fundamentally diet-related,” Evans said. “Countries with a high intake of saturated fats from milk and meat have high death rates.”

“There is no fat in the traditional Japanese meal,” he noted.

He complained about entrenched interests of the food industry. “The Milk Marketing Board seems reluctant to sell low-fat dairy products,” he said.

Diet alone does not kill, however. Evans cited smoking as a big factor in a province where one in three adults smokes and children start early.

“Nurses as a group have an awful history of smoking,” he said.

Stress obviously plays a part in Northern Ireland, where nearly 3,000 people have died and thousands have been injured in the 20-year fight by Irish Republican Army guerrillas to oust Britain from the province.

“Longtime reviews of a changing life style seem somehow irrelevant if bombs are going off and you feel your life may not be extended anyway,” he said.

Trouble starts early. A recent survey of 100 children in one school showed that 50% of them had elevated cholesterol levels and that 10% of the 12-year-olds smoked.

Doctors plan a two-year survey of 1,000 children that will examine their blood pressure, exercise patterns and general life style.

Evans recited almost longingly the statistics from other countries.

“The Americans have reduced heart disease by 40% in the last 20 years. They have added three years to the American life span. That is an enormous chunk,” he said. “Australia has halved its coronary heart disease level in the last quarter of a century.”

Evans highlighted an irony: Northern Ireland ranks as one of the safest places in the world to have a heart attack.

In the 1960s, Belfast’s Royal Victoria Hospital pioneered the introduction of cardiac ambulances--mobile coronary-care units that can act with life-saving speed.

“Northern Ireland has a dozen of these units compared to 300 for the whole of the United States,” Evans said.

Northern Ireland also developed the portable defibrillator, a battery-operated apparatus that administers a carefully monitored electric shock to restart a stopped heart.