It has not been a good week for big public health. In a massive backdown, the Australian Heart Foundation has pulled a series of advertisements which suggests that people who don’t get a “heart check” don’t love their families. I did not see the TV version but heard them on the radio.

One has a plaintiff sounding woman claim that her late husband didn’t really love her because he had a heart attack. Another had a mother telling her son “every time I said I loved you I was lying”. In a third, a young girl sitting on her mother’s hospital bed, tells her mum: “It’s not just your heart you didn’t care about. It’s all of ours, and now we are going to have to live with the consequences.”

The implication is that having a “heart check” would have prevented this. It upset many who had lost love ones. Initially the foundation held firm claiming that shock tactics were needed.

Dr Sue Walker, a Melbourne obstetrician described the ads as heartless. A few days after digging in, Chris Leptos the chairman on the National Heart Foundation board said “To all the people who have been offended by our campaign, we apologise, and to all those who provided their feedback, we have listened.”

Three days earlier they were congratulating themselves on their “bold approach” to get Australians to understand their risks of heart disease. It took a few days but they relented and pulled the ads whilst issuing an apology. Heart check became heart checkmate.

Regular readers will know my view on free speech and if the Heart Foundation wants to run tasteless ads then it should be their right to do so in a free country. I would not seek to ban them. However, public opinion won out.

The key to this is that the “heart health check” which is a new Medicare item has no validity. There is no way of predicting who may have a heart attack at a point in time. There are risk factors such as smoking, high blood pressure, diabetes and genetics, but none of these needs be present. Equally some with multiple risk factors do not suffer a heart attack. Furthermore, the new “check” is not new as it does not cover anything which has not previously been done by doctors.

Even more pointedly, the Cochrane Collaboration did a review on these “heart checks” and found they achieved no change in mortality or cardiovascular events but did lead to increased prescribing of medications – “There is uncertainty whether current strategies for providing CVD risk scores affect CVD events. Providing CVD risk scores may slightly reduce CVD risk factor levels and may increase preventive medication prescribing in higher‐risk people without evidence of harm”.

Essentially more people taking more tablets without any health improvement, other than in proxy measures such as cholesterol levels. The Heart Foundation (HF) receives grants from makers of pharmaceuticals.

In the same week we saw the first Aussie vape day letting smokers know that if they cannot quit cigarettes, switching to vaping is at least 95% less harmful. Despite smoking combustible tobacco being the biggest contributor to heart disease, is there any support from the HF for smokers wanting to reduce their chances of heart disease through vaping? Of course not.

The HF also continues to promote the discredited low fat diet despite clear evidence that it has contributed to many health problems including obesity, type two diabetes and heart disease.

If the HF were in an apologising mood, then an apology to the general public and to smokers would be appropriate. Don’t hold your breath.

To be fair, the HF is not the only arm of big public health to display arrogance and a “we know best even when we are wrong” attitude. The tin ear shown to those genuinely upset by their ads is not surprising.

Awareness advertisements telling people to go to doctors where the end result will be more tablets without any health benefit serve no purpose.

Real improvements in heart health can come from not smoking (via whatever method works for the individual), doing regular exercise, getting adequate sleep, reducing processed food intake regardless of how many stars or elephant stamps it gets and eating real food.

The public backlash against this ad is the first time that any arm of big public health has had to back down. Bravo to those who stood up. Whilst a small start, it sets a precedent for more push back and eventually some accountability for those who seek to use the power of the nanny state to push their, often discredited, agendas.

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