As a former secretary of state for health, Norman Fowler thought he was knowledgeable enough to recognise instantly if he was having a heart attack.
‘I assumed if I had one it would be dramatic, painful and I’d collapse in a heap – but it wasn’t like that at all,’ says Lord Fowler, who spent six years as health secretary in the 1980s during Margaret Thatcher’s premiership.
The tall, lean 86-year-old suffered the heart attack – where the blood supply to the heart is partially or completely blocked as a result of a clot in one of the main coronary arteries – at his West London flat in May.
He recalls slumping into a hallway chair after ‘suddenly feeling pressure on my chest’. His wife Fiona, 78, immediately realised something was amiss.
Ex-health secretary Lord Norman Fowler, 86, and his wife Fiona, 78
Lord Fowler with former prime minister Margaret Thatcher in 1992 at a conference in Brighton
‘He was grey in the face but still conscious – I’d never really seen him looking that way before,’ she recalls.
‘Initially I thought it might be indigestion because he was able to talk to me.’
Although a crushing pain in the middle of the chest, along with nausea and pain down one or both arms, are classic hallmarks of a heart attack, in some older people the signs are less obvious, says Professor Bryan Williams, chief medical officer at British Heart Foundation.
As he explains: ‘It might be that a family member notices they’re a bit off-colour; delirium can also be a symptom of a heart attack in an older person.’
In fact, for some older victims, confusion and weakness are the only tell-tale signs that they are suffering a potentially life-threatening event.
Despite initially not realising the gravity of the situation, Fiona called 111. ‘If I’d known it was a heart attack I’d have called 999 but I didn’t think it was so serious,’ she says.
Two ‘very capable’ paramedics were despatched, gave Lord Fowler an electrocardiogram (an electrical tracing of the heart to look for signs of a heart attack) and assessed him.
‘They didn’t have long faces either, which would have had me thinking “that’s me done for!”,’ he says wryly.
At nearby Charing Cross Hospital, he was given a test to measure levels of troponin, a protein released by the heart when it is starved of oxygen-rich blood. Three hours later, it was confirmed that he had indeed had a heart attack, caused by a partial blockage of an artery.
Later that day he was transferred to the world-class cardiac unit at Hammersmith Hospital, where he was wired up to a monitor and kept under observation ahead of emergency surgery to clear the blocked artery the next day.
‘It’s vital to monitor the heart in the hours after a heart attack; it’s a vulnerable time,’ says Professor Williams. To clear the blockage, surgeons fed a thin, hollow probe – called a catheter – into an artery in Lord Fowler’s groin and fed it up through to the blocked artery.
They then inserted a small mesh-like tube – a stent – through the catheter to open up the artery and restore blood flow to the heart. Every day around 300 people are admitted to hospital with suspected heart attacks. Most attacks are triggered by a furring up of the arteries, caused by a build-up of fatty plaques. This is usually the result of high blood pressure, high cholesterol or type 2 diabetes.
The good news is the number of heart attacks and strokes in the UK has fallen (by about 30 per cent between 2000 and 2019, according to a study in the BMJ). Survival rates have also improved, says Professor Williams.
‘When I started out as an NHS clinician, around seven out of ten people would ultimately die from an acute heart attack. With new drugs and interventions, such as stents, seven out of ten now survive.’
But around 20 per cent of victims will be hospitalised for a second one within five years, according to an American Heart Association report. Survivors are given advice on modifying their lifestyle and diet to prevent another attack.
Doctors were unable to say what had caused Lord Fowler’s heart attack, as he didn’t have high blood pressure, nor was he under any particular stress – it appears to have been age-related.
Indeed Lord Fowler had thought he ate ‘fairly healthily – but my diet is now even more severe and I don’t go in for things like apple crumble any more, which is a source of sadness’, he says.
Instead, the focus is on a Mediterranean diet – lots of salads and vegetables, with the occasional treat. Four months on, he has made a good recovery. But as well as altering his diet he has had to make some fairly big changes to his life.
Doctors have told him to take things easier to avoid putting too much strain on the heart. ‘That’s easier said than done for someone who has been so engaged politically for the last 50 years,’ says Lord Fowler, who was Lord Speaker of the House of Lords from 2016-2021 and recently published a recollection of his time in government, The Best Of Enemies: Diaries 1980-97.
Doctors were unable to say what had caused Lord Fowler’s heart attack – it appears to have been age-related
Lord Fowler outside Number 11 Downing Street in 1993 for a Cabinet meeting
He’s also been instructed to do daily exercises, such as knee and arm raises, leg extensions, toe taps and chest presses – which he says he does religiously – to improve overall fitness. (His House of Lords duties over the past few years meant he took only ‘moderate exercise, mainly gentle walks’.)
And he now takes a ‘daily cocktail of pills’ to help manage his condition, including blood thinners (aspirin and clopidogrel) to reduce the risk of future blockages or clots, statins, ramipril and lansoprazole (a proton pump inhibitor that reduces stomach acid, to counter-effect the impact of the other drugs on the stomach lining).
Professor Williams says this combination of medicines has ‘contributed enormously’ to patients’ improved post-op survival rates. ‘So it’s really important that patients continue to take them,’ he adds.
Having a heart attack has changed Lord Fowler’s lifestyle. ‘It’s the first time I’ve been close to having a condition that could lead to serious consequences, including death,’ he says. ‘It makes you think about your life in a different way and wonder if you’re taking on too much.’
He says he’s now scaling down his parliamentary work, and ‘concentrating on a fewer number of things’, such as completing a second volume of diaries, and campaigning ‘against the continuing stigma attached to Aids in much of the world’.
As health secretary, he oversaw the launch of a hard-hitting advertising campaign to alert the public to the dangers of Aids.
Meanwhile his wife insists she will be keeping an eye on the peer ‘to make sure that he follows doctor’s orders, does his exercises, takes his pills and steers clear of his beloved apple crumble’.
Experts recommend products that really can help
This week: Acupressure mat for muscle tension
‘Acupressure mats are covered in soft nodules or spikes which are designed to stimulate pressure points on the body when you lie on them,’ says Tim Allardyce, a physiotherapist at Surrey Physio in Croydon.
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TRY: Yogi Bare Spikey Acupressure set, £34.95, yogi-bare.co.uk, comes with a spikey neck pillow to help soothe away neck and shoulder tension; or Tectake Acupressure mat, £32.99, robertdyas.co.uk.
