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more difficult. Local health authorities should undertake their
customary epidemiological role and ascertain the extent of the
problem and, by concentrating on the "at risk" groups, break the
sequence of events leading to addiction. Regrettably, adherence
to "confidentiality" proves somewhat of an obstacle in the fight
for prevention.
Heart Disease
My previous reports have extensively covered congenital and
acquired heart disease as well as aspects concerning causes and the
modern methods adopted to prevent or ameliorate those various
conditions. Certainly acquired heart disability is a serious national
problem in that it is claiming an ever increasing proportion of our
first-class middle-aged men who have so much to contribute to the
life of the community. We can ill afford their loss.
Our inability to understand completely the aetiology of heart
disease is a restricting factor but we are aware that cigarette
smoking stimulates the production of adrenalin. This causes the
heart to work harder and demand more oxygen but at the same
time the lumen of the coronary arteries is narrowed resulting in a
reduction of oxygen to the heart muscle. Persistence of such
conditions over a number of years can hardly be beneficial.
Diet would seem to have some effect on heart disease but its
importance and place in prevention and treatment remains obscure.
Recent research has found magnesium ions to be essential for
the maintenance of normal myocardial structure and function and
that acutely infarcted hearts are deficient in magnesium content to
the extent of 42% when compared with those from persons dying
from sudden traumatic causes. Moreover, it is now thought that
magnesium depletion predisposes to arrythmias, infarcts and
myocardial necrosis. As magnesium in the body is a trace element,
is its absence a matter for the dietitian or physiologist?
It is known that men in sedentary occupations are more prone to
heart attacks than those actively engaged—clearly an indication
that exercise is a preventive measure of major significance.
Whilst raising physical tone after an attack there is a great need
to sustain morale and mental condition by employing a patient
to his full capacity as early as possible and to return him to a
normal social environment thus avoiding a relapse into "cardiac
neurosis", a most devastating complication.
Congenital heart disease falls into a different category. It seems
a paradox but we should not be surprised to learn that our
successful efforts, nationally, to reduce infant mortality is giving
rise to an increase in notified congenital malformations. Those