Cardiovascular disease (CVD) refers to a wide range of conditions that affect the heart and blood vessels. This includes ischaemic heart diseases (like angina and heart attacks), cerebrovascular diseases (like strokes), and heart failure, among others. In 2022, ischaemic heart diseases were the leading cause of death in Australia, and cerebrovascular diseases ranked fourth. The burden of CVD is significant, with many individuals suffering from conditions like heart failure, which particularly affects certain demographics, including Indigenous populations and people living in rural and remote areas.
Active health and exercise professionals play an essential role in the prevention of cardiovascular disease. Through pre-screening, early detection, and exercise programming, you can help your clients reduce their risk of heart disease and other chronic conditions.
Pre-Screening and Its Role in Identifying Potential Heart Health Issues
Pre-screening is a vital step in identifying individuals who may be at risk for cardiovascular issues. Anyone starting an exercise program should undergo a thorough pre-exercise screening using an evidence-based, industry-approved tool. This process helps identify individuals who may have underlying medical conditions that increase the risk of adverse events during physical activity or exercise.
AUSactive strongly recommends that professionals conduct an appropriate pre-screening prior to prescribing exercise or physical activity. AUSactive members can download and utilise the Adult Pre-Exercise Screening Tool or other applicable pre-screening tools, that are considered as standard best-practice for assessing potential health risks before beginning physical activity.
Collaboration Between Active Health and Exercise Professionals and Healthcare Providers
Collaboration between active health, exercise and fitness professionals and healthcare providers is critical for comprehensive cardiovascular care. Active health professionals should work closely with doctors and other healthcare providers to ensure that clients with heart disease risk factors receive the appropriate care and monitoring. In cases where a pre-exercise screening has identified that a person is at a higher risk of experiencing an adverse event, exercise professionals must be prepared to collaborate with and refer individuals to an appropriately qualified allied health or medical expert for further assessment and treatment if necessary.
Prevention is Better Than Cure
In a recent AUSactive webinar, Cardiologist Dr. Warrick Bishop emphasised the importance of prevention when it comes to heart health. Dr. Bishop has dedicated his career to informing, educating, and empowering individuals to take control of their heart health. He believes that the best care is achieved when patients fully understand their health and treatment options. Identifying individuals at high risk for a heart attack can be challenging, as even those who appear and feel healthy may still be at significant risk.
Dr. Bishop discusses coronary artery calcium scoring as a valuable test in assessing risk. As calcium in the arteries increases, the risk of heart attack can also rise. Patients can seem very fit and healthy but may still be at significant risk due to high calcium deposits in their arteries. Calcium buildup in the arteries, known as coronary artery calcification, is a sign of atherosclerosis, a condition where the arteries become narrowed and hardened due to the accumulation of fatty deposits and other substances, including calcium.
What makes calcium in the arteries particularly dangerous is that it often develops silently. Individuals may not experience any symptoms until the calcification has progressed significantly or a cardiovascular event occurs. For this reason, coronary artery calcium scoring is a useful tool for detecting subclinical atherosclerosis—plaque buildup that hasn't yet caused noticeable symptoms. This non-invasive test can help identify individuals at higher risk of heart disease, even if they don't have traditional risk factors like high cholesterol or high blood pressure. It has been shown to improve the accuracy of risk stratification for patients who may appear healthy but have hidden cardiovascular risk factors, potentially allowing for earlier intervention and preventative measures.
Recognising a gap in the healthcare options available in Australia, Dr. Bishop developed a free virtual heart health check as a valuable tool to help assess if someone may be at risk. Dr. Bishop recommends that coronary artery calcium scoring may be appropriate for men around 45 to 50 years of age and women around 55 to 60 years of age, unless there is a compelling reason to conduct the test earlier.
This simple, accessible tool can be shared with clients approaching this age, providing an excellent starting point for identifying heart health risks and encouraging proactive care. Active health and exercise professionals can play a key role in prevention during pre-screening assessments, by measuring blood pressure and discussing health status during onboarding. Identifying red flags early allows professionals to refer clients to healthcare providers for further evaluation, including considering coronary artery calcium scoring if necessary. This proactive approach helps address heart health concerns before they escalate, promoting better long-term cardiovascular care for your clients.
Using Technology to Save Lives
Along with Dr. Bishop’s virtual heart health check, another vital tool to be aware of is the GoodSAM Responder app. This app helps save lives in an emergency by alerting nearby users when someone nearby needs CPR following a cardiac arrest.
For every minute that CPR is delayed, the chances of survival decrease by 10%. However, if a bystander delivers hands-only CPR and uses an automated external defibrillator (AED) before paramedics arrive, survival rates more than double. For active health and exercise professionals, being familiar with and registered on the GoodSAM app can enhance the safety of clients during workouts and classes, ensuring that they are prepared to provide potentially life-saving assistance in the event of a cardiac emergency.
By registering on the GoodSAM app you can make a significant difference in emergency situations and help enhance safety in your community. Find more information at https://www.goodsamapp.org/oz
To learn more from Dr. Warrick Bishop about how to identify individuals at high risk of heart attack and preventative cardiology, don’t miss our new iLearn webinar Preventing Heart Attacks in the Active Health and Exercise Industry.
Authors Michelle Healey & Lucas Dickson (Industry Standards and Development team, AUSactive)
About AUSactive
AUSactive is a not-for-profit industry association and is Australia’s peak body for the exercise and active health sector, and our goal is to activate Australians to move more. AUSactive represents individuals and businesses across modalities ranging from gym classes to yoga, Pilates, aqua and functional fitness.
AUSactive provides industry leading active health, exercise and fitness registration for a broad range of movement and fitness modalities
References
1. Australian Bureau of Statistics (2022). Heart, Stroke and Vascular Disease. https://www.abs.gov.au/statistics/health/health-conditions-and-risks/heart-stroke-and-vascular-disease/latest-release#footnotes
2 – Sahle, B.W., Owen, A.J., Mutowo, M.P., Krum, H & Reid, C.M. (2016). Prevalence of heart failure in Australia: a systematic review. BMC Cardiovasc Disorders 16, 32. https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-016-0208-4
3 – Jennings, G. L. R., Audehm, R., Bishop, W., Chow, C. K., Liaw, S.-T., Liew, D., & Linton, S. M. (2023). National Heart Foundation of Australia: position statement on coronary artery calcium scoring for the primary prevention of cardiovascular disease in Australia. Medical Journal of Australia, 219(7), 328-329. https://onlinelibrary.wiley.com/doi/10.5694/mja2.51039
