Figure 7 . Recycle responsibly . |
Figure 8 . Recycle responsibly . |
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and diabetes . Those including higher amounts of less healthy plant foods such as refined grains , potatoes / fries , processed foods , and foods high in added sugar are linked to increased
337 , 338 cardiometabolic risk .
How GPs can help mitigate climate change
Suggestions appear in box 2 . Also see Sainsbury et al 2019 . 339
Take the ‘ 1 tonne challenge ’. 340 If just half of Australian households reduced their annual emissions by 1 tonne , this would be equivalent to 50 million tonnes .
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CASE STUDY
BOB , 61 , retired and with a previous CABG in 2016 lives in rural NSW . During December 2019-January 2020 , his property was surrounded by bushfires and he was helping fight fires . He wore an N95 mask when the air pollution was bad . He felt short of breath during those months , which he felt was due to the significant air pollution and bushfire smoke . He
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had no chest pain .
He presents for routine cardiology review ( later than normal because of COVID-19 ), and mentions shortness of breath on exertion , though not as
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bad as during the fires . All his risk factors are controlled : he has never smoked , his LDL is 1.7mmol / L ( 2.0- 3.4 mmol / L ), his BP is low ( 110 / 70 ) and his random glucose is 4.5mmol / L ( 3.0-7.7 mmol / L ).
His stress echo is abnormal on ECG criteria , which is a new development compared with previous tests . Coronary angiogram shows 50 % distal left main stenosis , an occluded left anterior
descending ( LAD ) artery , severe disease in the circumflex and obtuse marginal ( OM ), and a new 70 % stenosis in the proximal right coronary artery ( RCA ).
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The left internal mammary artery graft to his LAD and the right internal mammary artery to his OM are patent with good anastomosis . The radial artery graft to his posterior descending artery is occluded . Bob undergoes stenting to his proximal RCA with a good result .
Bob was three years post CABG , had arterial grafts ( which last longer than vein grafts ), had good control of
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all his risk factors and attended regular follow-up post-CABG . The heat and air pollution during the bushfires are likely contributors to the progression of his CAD . |
CONCLUSION
THE evidence for climate change and increasing cardiac morbidity and mortality is compelling . CVD is only one of many health impacts of climate change . CVD is a leading cause of mortality in Australia .
While the increased CVD risks associated with climate change may seem small ( although significant ) compared with traditional risk factors
, they are indiscriminate and have a large public health impact . This environmental risk factor is one medical professionals can and need to change , for the health of our patients and for a sustainable future .
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