Pathogenèse, dépistage et prise en charge de l'anévrysme de l'aorte abdominale

RESUME L'anévrysme de l'aorte abdominale est une dilatation permanente et localisée de l'aorte abdominale d'un diamètre transverse supérieur à 30 mm. Il s'agit d'une maladie dégénérative et inflammatoire fréquente de l'aorte, présente chez environ 5% des hommes de 65 à 74 ans de la population générale, et chez 10% des hommes hospitalisés pour une revascularisation coronarienne chirurgicale. En effet, bien que la pathogenèse de l'anévrysme de l'aorte abdominale diffère de celle du processus d'athérosclérose, les deux maladies partagent de nombreux facteurs de risque, en particulier l'âge, l'hypertension artérielle et le tabagisme. L'anévrysme de l'aorte abdominale est une maladie silencieuse, et dans 20% des cas, sa première manifestation clinique est la rupture aiguë avec choc hémorragique. La mortalité totale d'une telle complication dépasse 90% et sa mortalité strictement opératoire est d'environ 50%. Ces chiffres contrastent étonnamment avec une mortalité inférieure à 5% en cas de cure chirurgicale élective de l'anévrysme, justifiant un programme de dépistage systématique de cette maladie par ultrasonographie abdominale. Plusieurs études ont actuellement prouvé l'efficience de tels programmes, tant du point de vue de leur impact sur la mortalité que de leur rapport coût-efficacité. La question d'un dépistage systématique de la population générale ou de celui de souspopulations sélectionnées en fonction de leurs facteurs de risque reste toutefois débattue. La prise en charge de l'anévrysme de l'aorte abdominale est en principe conservatrice pour les anévrysmes de faibles diamètres, la mortalité d'une telle approche étant comparable à celle d'une attitude d'emblée chirurgicale. L'indication opératoire est par contre posée pour les anévrysmes d'un diamètre supérieur à 55 mm en raison du risque inacceptable de rupture, la valeur du diamètre transverse de l'aorte représentant le facteur prédictif de rupture le plus fréquemment utilisé en pratique quotidienne. La cure chirurgicale ouverte est le traitement de référence de l'anévrysme de l'aorte abdominale, mais la cure minimale invasive par endoprothèse, disponible depuis le début des années 1990, représente une alternative attrayante. Le choix de l'approche thérapeutique dépend fortement des caractéristiques anatomiques de l'aorte, ainsi que des comorbidités et de la préférence du patient.

Women and Cancer in Ireland: 1994-2001

Although prevention is the primary aim of cancer control, early diagnosis and effective treatment are also central to reducing disability and death from cancer. Research in Ireland and internationally has shown major differences between women in the stage (extent) of their cancer when first diagnosed, in access to screening, and in the type of treatment received. These factors have also been shown to determine the rate of cure of cancers and the length of survival for those not cured. Many countries, including Ireland, have developed cancer policies in the past decade, with the aim of improving access, and ensuring that all cancer patients have appropriate, and evidence-based, treatment. These changes have major implications for women in Ireland, for example in the provision of breast and cervical screening programmes and in the expansion of specialist treatment centres for breast cancer. This is a publication of the Women’s Health Council. Read the report (PDF, 1.37mb) Read the Summary (PDF, 120kb)

North Down & Ards AMH

AMH, founded in 1963, one of the largest regional voluntary sector organization in NI, has provided a range of services for people with mental health difficulties and learning disabilities. AMH Ards offers a range of person centred activities eg training in IT, administration, catering, literacy and numeracy, crafts etc. They have completed 2 Level 2 applications. This Level 3 application will endeavor to build on the success of the second project, encouraging and building capacity for people to identify their own health needs, enable them to benefit from a range of support services, including pharmacy available to them. In addition, it will continue to educate and involve pharmacists in the road to mental health recovery. 4 programmes (7 weeks long ï¿_ 3 with the pharmacist) will be delivered each year (2 at each of the centers in Ards and Bangor). This more formal programme will be supplemented by ongoing support, staff training (2 sessions) and 4 informal drop in sessions and more general health events. At all of these sessions, the pharmacists will either lead on or attend.

ARC HLC

ARC Healthy Living Centre provides a range of services for a range of groups eg older people, young, unemployed etc. This is their 3rd application and is a Level 3 project. Previous BCPP projects have focussed on for example, peer education programmes for young people, working with Surestart and addiction services. As a result of the project the pharmacist has integrated well into the community. This project will build upon previous work to increase health awareness, promote interagency understanding and deliver a wide range of interactive sessions with groups such as SureStart and alcohol projects. It will also seek to take this out into other areas and encourage other pharmacists to become involved in this way of working.

LLT Community Association

Laurencetown, Lenaderg & Tullylish Community Association (LLT) manage a community centre which serves the surrounding rural areas. Programmes include: parent & toddler, youth group, older peopleï¿_s group (offering 1-1 support) and supports other outlying rural groups. LLT has completed 3 Level 2 projects in the past.The first 3 projects have helped develop better understanding and promoted better access to pharmacy services etc (3 miles away), have raised the profile of LLT and put health on the agenda and has worked well with a range of specific groups including men, older people, pre schoolers etc and is currently seeking to target teenagers and parents. A good working relationship has developed between the pharmacist and LLT. They want to continue a similar approach developed through their Level 2 applications but with an increased focus on pre-school children and young people (teenagers) with their parents. Year 1 includes a health fair, 6 talks to local groups, 10 consultations for older people, 4 sessions for mothers, 4 sessions for fathers and 3 sessions with young people. Most of these, apart from the Health Fair, will be repeated in Year 2 & 3.

YMCA Lisburn

Lisburn YMCA works with at risk young people and adults. Having completed a number of level 2 projects the have now decided to deliver a level three programme. They have built up a good working relationship between themselve and Boots Pharmacy although the pharmacist has changed over the course of the programmes the Pharmacy has a good relationship with the young people of the area and YMCA. The programme will consist of 8 sessions the pharmacist being key to 5 of them. There will be one core group over the course of the three years. Core group two will change, for exampe, in year two they will focus on volunteers, demonstrate how the YMCA is seeking to integrate the work of the pharmacy into all their services an programmes. Fifteen participants will be targeted for each programme. In addition, the pharmacist will take part in ten one stop shop sessions each year and will have the oportunity to sit ona multi agency steering group.

PHA supports World No Tobacco Day

The Public Health Agency is taking the opportunity to highlight this year's World No Tobacco Day which takes place on Tuesday 31 May.In Northern Ireland, around 340,000 people aged 16 and over smoke. Smoking contributes not only to many cancers, heart disease, bronchitis and asthma, but to other illnesses, including stroke. In fact, smoking causes around 2,700 deaths per year here, all of them avoidable.The PHA is committed to saving lives by reducing the percentage of people who smoke. The PHA:works with councils to ensure smoking-related laws are enforced; funds a range of support to smokers who want to quit; educates young people to not start smoking, through programmes like 'Teenage Kicks' and 'Smokebusters'. In January this year, the PHA also launched its smoking campaign 'Things to do before you die' to encourage smokers, particularly those aged 20-49, to stop smoking.Health Minister Edwin Poots said:"Smoking is the greatest cause of preventable illness and premature death in Northern Ireland. While good progress has been made in the last number of years to reduce the number of people who smoke, more needs to be done."I would appeal to all smokers to use the wide range of support services available to make every effort to stop smoking - it is the single best step you can take to improve your health and quality of life."Mark Mc Bride, Health Improvement Manager, PHA, said "Smoking is the single greatest preventable cause of death in the world today. Across Northern Ireland there are over 600 support services for people who wish to stop smoking. These are based in GP surgeries, community pharmacies, hospitals, community centres and workplaces."From April 2010 to end March 2011 more than 1 in 10 of all adult smokers sought help from the support services and approximately half had quit after four weeks. This is a substantial - roughly 50% increase - on previous years and shows the benefit of the PHA campaigns and the dedication of the many specialists who help smokers quit."I would encourage everyone who is either thinking about quitting or ready to log on to our Want 2 Stop website www.want2stop.info or to contacting the Smokers' Helpline on 0808 812 8008 a Quit Kit free of charge."

PHA advises 'breast is best'!

The Public Health Agency is using National Breastfeeding Awareness Week (NBAW) to emphasise the message that breastfeeding is the healthiest option for both you and your baby and that by deciding to breastfeed, you will be giving your child the best possible start in life. NBAW runs from 19-25 June and highlights the fact that any period of breastfeeding, however short, will benefit your baby.Breast milk is different to formula milk as it contains antibodies that cannot be manufactured in formula. Antibodies help protect babies from infection and stimulate their immune system.Northern Ireland has the lowest breastfeeding rate in the UK, with an average of 63% of women breastfeeding their baby at birth. Janet Calvert, Regional Breastfeeding Coordinator at the PHA, said: "This is an issue that clearly needs addressed, as breastfeeding has many important health benefits for both mother and baby. These include a reduced risk of ear, chest, kidney and stomach infections and less risk of childhood diabetes and obesity."Breastfeeding can also significantly reduce the risk of hospital admission of children for gastroenteritis and chest infections. The health benefits for mothers who choose to breastfeed include a reduced risk of developing illnesses such as breast cancer, ovarian cancer and osteoporosis."There are other benefits as well as those to your health. Breastfeeding is free - you don't have to buy formula, bottles, teats, sterilising equipment etc. Breast milk is always available, with the right ingredients, at the right temperature, so it's easier to feed at night or on the go.The PHA recognises the importance of breastfeeding to health and the need to ensure that mothers get off to a good start with breastfeeding. It is vital that mothers get the right support and encouragement from their family and friends should they decide to breastfeed. Breastfeeding can be difficult at the start and mothers need reassurance while they learn."There are many local initiatives in the community to improve breastfeeding support. These include improving support in the health service and through Sure Start programmes, which work in areas of need to help ensure children get the best start in life," Janet added."Mother to mother peer support programmes are in place in many areas and are working with expectant and new mothers to help them breastfeed for longer. There are also 70 breastfeeding support groups, which provide ongoing support for breastfeeding mothers throughout Northern Ireland. "The PHA is also working to improve attitudes to breastfeeding in public through the Breastfeeding Welcome Here scheme, which began in 2005 and now has over 200 businesses and public facilities signed up to support and welcome breastfeeding families. All these initiatives, along with support from partners and family, are vital to help expectant and new mothers stay with breastfeeding."Health Minister Edwin Poots said: "There is clear evidence that breastfeeding offers health benefits for both babies and mothers. We know that breast milk gives baby the best start in life by providing all the nutrients and protection a baby needs for the first six months of life. That is why my Department is committed to promoting and supporting breastfeeding".For further information on breastfeeding visit www.breastfedbabies.org.uk

ASIST suicide prevention training - all-island evaluation report

The findings of a Public Health Agency evaluation report on a suicide prevention training programme were today presented at the North South Ministerial Council Health Sector meeting.ASIST, The Applied Suicide Intervention Skills Training programme, has to date been delivered to more than 20,000 people in the Republic of Ireland and more than 11,000 people in Northern Ireland. This two day course, delivered by a wide range of organisations including those from the voluntary/community sector, for professionals and the public helps individuals provide emergency help to people at risk of suicidal behaviour. It also develops a cooperative network among participants, since often many people have to work together to prevent suicide.Talking about the findings of this work, Dr Eddie Rooney, Chief Executive, PHA, said: "Both the PHA and the National Office for Suicide Prevention (NOSP), based in the Republic of Ireland, are concerned for any loss of life through suicide and we send our condolences to all families who have been bereaved. We know ASIST training brings a positive element to suicide prevention. Those who have been trained said that the two biggest advantages are that they know when, how and have the confidence to help people who are under pressure and that it helps to build positive links between community and voluntary organisations and the health service. I am pleased that this has been borne out in the evaluation and we hope ASIST will continue to be of enormous benefit and will contribute to a reduction in suicidal behaviour and the tragedy that this brings to our community".This evaluation found that within organisations where staff had participated in ASIST training, there were improvements in service development; staff attitudes, confidence and skills in relation to suicide and suicide intervention and in policies and procedures. At a community level, ASIST was found to have contributed to a sense of empowerment through an increased confidence in being able to deal with suicide and suicidal behaviour.The report also shows that the ASIST model offers a common language, helping communication between the community or voluntary organisations and those from a health background. In fact this training helped to cancel out any differences between those with mental health qualifications and those without, in terms of knowledge, skills, attitude and willingness to intervene. The study also confirmed that ASIST training was most relevant to those who were likely to be in contact with a person 'at risk'.In welcoming the publication of the report Geoff Day, Director of the NOSP, said: "This report is an independent evaluation of the ASIST programme, it has allowed us to demonstrate the effectiveness of the programme in increasing community participants confidence and ability to respond to individuals in suicidal crisis.He added: "The fact the evaluation was completed on an all-island basis allows the NOSP and the PHA to avoid duplication of resources, improve coordination of suicide prevention training programmes across both jurisdictions and allows us to learn from different approaches used in suicide prevention across the island of Ireland."He reiterated the Health Service Executive commitment to the continued implementation of quality assured training programmes as part of Reach out: the National Strategy for Action on Suicide Prevention.ASIST training is being rolled out in Northern Ireland as part of the implementation of the 'Protect Life' suicide prevention strategy, which was published by the Department of Health, Social Services and Public Safety in 2006.A copy of the evaluation report can be found below and in the publications section of this website, by clicking here

Consultation launched on Community Development Strategy - your views matter

Issued jointly by the Health and Social Care Board and Public Health AgencyThe Health and Social Care Board and the Public Health Agency have today launched, for public consultation, a new Community Development Strategy.The consultation period will run for 12 weeks from Friday 10 June until Friday 2 September 2011.The Board and Agency want to see strong, resilient communities where everyone has good health and wellbeing, places where people look out for each other and have community pride in where they live.Residents from deprived areas in Northern Ireland experience;lower life expectancy;higher rates of emergency admission to hospital;higher rates of lung cancer;higher rates of suicide; andhigher rates of smoking and alcohol related deaths.The kinds of health and social care issues which can be improved by community development approaches include depression; isolation; falls amongst elderly people; child protection; teenage pregnancy; childhood asthma; postnatal depression; drug and alcohol abuse; and ultimately also long term conditions such as obesity, diabetes and cancer.The Board and Agency seek a number of benefits from implementing this strategy such as; a reduction in health and wellbeing inequalities, which also means addressing the social factors that affect health; strengthening partnership working with service users, the community and voluntary sectors and other organisations; strengthening families and communities; supporting volunteering and making best use of our resources.John Compton, Chief Executive of the Health and Social Care Board said: "Community development is an important way to improving health and wellbeing - driving a message that 'prevention is better than cure' between different groups and communities, and helping to ensure the most effective use of the health and social care budget."Now more than ever we need to work in partnership with families and communities to achieve better health and wellbeing for those living in Northern Ireland.No one organisation can meet this challenge on its own and strong partnerships are needed. "Chief Executive of the Public Health Agency, Eddie Rooney added: "Every health and social care organisation should incorporate a community development approach into their programmes, and this strategy assists them to do so."The Board and Agency have jointly held pre-consultation workshops over the past few months across Northern Ireland on their Community Development Strategy and have engaged widely with the community and voluntary sectors. We are now keen to receive feedback from individuals, families and the wider community as your views are very important to us - they will help shape the future of community development across the province," he said.The draft Community Development Strategy, as well as information on how you can respond, can be found in the attachments below.

Obesity - an acknowledged public health challenge

As we face a difficult economic climate, in which inequalities may worsen, the PHA faces many challenges in its efforts to improve the health of the population. One such challenge is the issue of obesity. Recently, in the Draft Programme for Government and, again today, in anticipation of the publication of the Consultation on the Review of Health and Social Care Services in Northern Ireland, the specific issue of obesity has been highlighted in the media.The PHA is committed to playing a lead role in tackling this major health issue and has been systematically examining the evidence of best practice and effectiveness to ensure that investment and working in partnership will bring clear benefits. A welcome consequence of any success would be a reduction in the impact of the physical, and emotional costs of obesity related ill-health to individuals - and the financial costs to an overstretched healthcare system.A multi-facetted approach to tackling obesity is required for Northern Ireland. This will mean working across government departments, looking at relevant legislation, taxation, food standards and labelling, as well as supporting a raft of programmes within education, workplace, and at the local community level."The prevalence of overweight and obesity has risen dramatically in recent years in Northern Ireland and is now the norm to be overweight, rather than the exception. The Northern Ireland Health and Social Wellbeing Survey (2010-11) indicated that 36% of adults are overweight and a further 23% are obese; this means that approximately 3 in 5 adults in Northern Ireland carry excess weight. A similar proportion of males and females were obese (23%) however males were more likely to be overweight (44%) than females (30%).Data from the Northern Ireland Health and Wellbeing Survey (2010-11) reported that 27% of children aged 2-15 years are obese or overweight. The findings presented here are based on the guidelines put forward by the International Obesity Task Force. Using this approach, 8% of children were assessed as obese, with similar results for boys (8%) and girls (9%). Obesity has serious implications for health and wellbeing and is associated with an increased risk of heart disease and stroke, type 2 diabetes, some cancers, respiratory problems and joint pain.Evidence indicates that being obese can reduce life expectancy by up to 9 years; and it can impact on emotional and psychological well-being and self-esteem, especially among young people.Obesity also impacts on wider society through economic costs, loss of productivity and increased demands on our health and social care system. It is estimated that obesity in Northern Ireland is resulting in 260,000 working days lost each year with a cost to the local economy of £500 million.The good news is that the intentional loss of significant weight (approx 10kg) in overweight and obese adults has been shown to confer significant health benefits, decreased morbidity and may also reduce obesity-related mortality.Key programmes and interventions are undertaken by the PHA in order to prevent and reduce overweight and obesity. The programmes/interventions are supported by significant ongoing work at local level. Examples include:the promotion of breastfeeding; local programmes to increase awareness of good nutrition and develop cooking skills, for example 'Cook It!'; promotion of more active lifestyles, for example, Walking for Health' and 'Teenage Kicks'; development of community allotment schemes; programmes for primary school children, for example Skip2bfit and Eat, Taste and Grow; and sports and other recreation, for example 'Active Belfast'. The PHA's multi media campaign 'It all adds up!' to encourage children to become more active and understand the importance of keeping fit, in a fun and exciting way, ran until October 2011. It encouraged parents and carers to go to the website www.getalifegetactive.com and download the PHA logbook It all adds up! to plan activities as a family. The logbook helped children and parents plan and keep track of their participation in physical activity at school, home and in the community. PHA is currently developing a public information campaign and other supportive work to increase public awareness of obesity as well as to provide advice and support for those who want to make real changes. The campaign development is well underway and is anticipated for launch in late Spring 2012. Like many common health problems, people living in disadvantaged circumstances suffer most and the PHA is committed to tackling this aspect of health inequality. The good news is that even a modest weight loss, of 1-1 Â_ stones, can help to reduce the risk of many of the health problems resulting from being overweight or obese. Information on losing weight through healthier eating and being more active can be found on the PHA websites - www.enjoyhealthyeating.info and www.getalifegetactive.com . These websites provide help and advice for anyone who wants to improve their eating habits and fitness levels, by making small, sustainable, healthy changes to their lifestyle. The PHA leaflet, Small changes, big benefits is also available to download from the PHA website, 'Publications' section.

Traveller Focus Week - improving health and wellbeing

Members of the Traveller community and their support organisations joined the Public Health Agency and the Health and Social Care Board at an event in Dungannon to mark Traveller Focus Week (5 - 11 December) by sharing the progress made, and celebrating good practice in meeting the health and wellbeing needs of Travellers.These needs were identified in the 'All Ireland Traveller Health Study' by University College Dublin in June 2010. It estimated that there are 3,905 Travellers living in 1,562 families in Northern Ireland, and the stark findings include that when compared with the life expectancy of the general population, male Travellers lose 15 years of life and females lose 11 years.The report made a number of recommendations, including:prioritising mother and children's health; enhanced preventative work for respiratory and cardiovascular disease, as well as better risk detection and management of the disease; development of primary care interventions which involve Travellers engaging with other Travellers in health improvement;engagement of men and young men in improving health and wellbeing and access to healthcare.Speaking at the event, Mary Black, Assistant Director of Public Health (Health and Social Wellbeing Improvement) PHA, said: "The Public Health Agency works in partnership to promote health and wellbeing and reduce health inequalities."This event with the Travellers Health and Wellbeing Forum was an important opportunity to look at progress against agreed priorities and share good practice across Northen Ireland and the successful work of the Forum. One such example is the recruitment of Travellers into employment as health workers developed by the Belfast Health and Social Care Trust and part-funded by the PHA. Other areas are also considering work placements and all of this developing practice will help inform future partnerships with employers and help break down the real prejudice that can be experienced by Travellers."We also heard about the progress Travellers have made in their own right, and their views about how the Travelling community is fully engaged and participates in the future development of the Forum and programmes that aim to improve health and wellbeing and contribute to a more equal society."Mark Donahue, Equality Officer, An Munia Tober (a Traveller support organisation), added "The event was a great success in terms of highlighting the main health issues for Travellers, which came out of the All Ireland Traveller Health Study. I was heartened to see a great turn out by the Traveller community from all over Northern Ireland and also by the interest and commitment of so many public agencies and other organisations to work together to improve Traveller health."The event, at 'Breakthru' in Dungannon, also brought together representatives from the five health and social care trusts, Cooperation and Working Together (CAWT), Housing and key voluntary sector organisations, all involved in delivering the recommendations from the 'All Ireland Traveller Health Study'.

Cook it! Fun, fast food for less: community nutrition education programme

This training manual was produced to support the Cook it! programme, which was specially developed for use in Northern Ireland. The Cook it! programme is delivered in the community by trained facilitators and can be used with a wide range of groups, including young/single parents, young people leaving residential care, offenders during rehabilitation programmes, older people in sheltered accomodation etc.The manual contains all the information needed to deliver Cook it! programmes in the community, including background information on healthy eating, information about dealing with special dietary requirements, sessions outlines, photocopiable resources and 75 recipes for snacks and meals.This updated version replaces the March 2007 edition.For information on training as a Cook it! facilitator, contact the health promotion service in your local Health and Social Care Trust.

Shaping the future: applying therapy research to practice

In these challenging financial times the use of research as a basis for effective health and social care cannot be overstated. 'Shaping the Future', a joint Public Health Agency and University of Ulster workshop (27 January) takes a fresh look at research within the Allied Health Professions (AHPs) to improve the care and experiences of people across Northern Ireland.The AHPs provide a wide range of services including physiotherapy, occupational therapy, radiography, podiatry, speech and language therapy and orthoptics.The nature of their work enables AHPs to carry out research that can rapidly benefit patient care and experience. 'Shaping the Future' will look at priorities for new AHP research and consider how existing research can be more effectively shared and used in health and social care development, rather than perhaps being limited to the academic world.Speaking at the event, Professor Bernie Hannigan, Director of Health and Social Care Research and Development (HSC R&D), aDivision of the PHA, said: "A sound base of evidence from research is vital for effective health and social care practice. I welcome this study as an important resource that will help generate new evidence and highlight the potential for existing evidence to be applied in practice. The evidence base points to beneficial innovations that use the most up-to-date knowledge and keep the service user at the centre of care practices. At this event, health and social care policy makers, commissioners, academics and researchers will be able to consider how they can do and use research to ensure our AHP services deliver the best outcomes for patients and are sufficiently cost-effective to be sustained."A recent study funded by HSC R&D was carried out by the University of Ulster working closely with leading AHPs, key stakeholders and service users* from throughout Northern Irealnd. Presenting the results of this study at the 'Shaping the Future' event will help to identify ways to gather evidence and contribute to innovative projects and programmes.Professor Suzanne McDonough, of the Health and Rehabilitation Sciences Research Centre at the University of Ulster, said: "In our study we used the Delphi technique, which is a structured process using a series of questionnaires, to gather information and gain consensus from AHP groups, stakeholders and service users."The results identified seven major priority areas for research. These ranged from: the need for more practice evaluation particularly in the areas of mental health, cancer, obesity; diabetes; chronic disease management (especially stroke and brain injury); the role of AHPs in health promotion; service delivery issues such as access to services and waiting times. This study provides an important road map for AHP research priorities. It is the first step in the process of identifying what research still needs to be undertaken, what research already exists but needs to be translated, and some of the processes that need to be in place to ensure that research is an integral part of the day-to-day practice of AHPs and of service delivery."

Simple steps to a healthy heart

The number of deaths from coronary heart disease in Northern Ireland has dropped significantly, according to recent figures. However, the Public Health Agency is urging everyone to take steps to protect their heart and reduce their chances of developing the disease during National Heart Month (February).Despite the number of deaths dropping significantly in recent years, coronary heart disease is still the number one killer across the country. Over 2,200 people died in Northern Ireland from coronary heart disease in 2010 compared to just over 2,300 people in 2009 - an overall reduction of 100 province-wide. The latest figure reveals the positive downward trend is continuing - in 2008, there were 2,410 deaths, 2,493 in 2007 and 2,554 in 2006, while in 1979 there were nearly 5,000 deaths. Throughout National Heart Month in February, the PHA is calling for people to follow a number of steps in a bid to reduce their chances of developing the disease.Smoking is a major risk factor and, the more cigarettes you smoke, the higher the risk, according to Dr Christine McMaster, Consultant in Public Health Medicine, with responsibility for cardiovascular disease in the PHA."The reduction in smoking over the past number of years through public education, stop smoking programmes and smoke free legislation has had a major impact on reducing deaths from heart disease. However, 24% of the population in Northern Ireland still smoke, putting them at risk of developing the disease."People who suffer from high blood pressure also run an increased risk of developing coronary heart disease. High blood pressure is a silent, but treatable condition. In order to minimise the risk, I would urge everyone over the age of 45 to have their blood pressure measured every five years by their GP," said Dr McMaster.Simple lifestyle changes will also reduce the risk of heart disease, including eating at least five servings of fruit and vegetables a day, avoiding saturated fats, limiting alcohol intake and taking at least 30 minutes of exercise a day, five days a week.Dr McMaster described the reduction in deaths from coronary heart disease over the past few years as "a big success story". "It shows that people can take very positive steps to reduce their risk of heart disease by getting their blood pressure checked and adopting a healthier lifestyle; in particular by not smoking," he added. "The message is clear during National Heart Month - you only have one heart and you can take steps to keep it healthy."