HEART disease is Bermuda's number one killer but many people are walking around completely unaware they are of at risk of succumbing to it.

Giving such people the chance to make changes to their lifestyle and avert a potential early death is one of the aims of a campaign over the next few months to detect the danger signs within all of us.

Blood pressure and cholesterol levels are two indicators of the risk of imminent malfunction of the blood-pumping organ and those are what the Department of Health's community nurses will be testing for at local pharmacies.

LAST time a series of health checks were held in local pharmacies, it opened up something of a Pandora's Box of personal disasters waiting to happen.

Based on the findings of tests carried out between August and November last year, it seemed that almost 50 per cent of the population could be at risk of heart disease.

Of those screened, 47 per cent had high blood pressure and 43 per cent had borderline to high cholesterol.

Dozens of those tested went away shocked by their own results, but at least taking the tests had given them the knowledge that something was wrong and the opportunity to do something about it before permanent damage had been done.

Taking a few moments to go through the simple testing procedure could result in years of extra life - but only if those with worrying results were willing to make lifestyle changes to control blood pressure and cholesterol levels.

For the next four Wednesdays, the Department of Health's community nurses will be at the Phoenix Centre in Hamilton between 10 a.m. and noon to offer not only free-of-charge testing of blood pressure and cholesterol, but also nutritional counselling.

That will be merely the start of a summer campaign will which also include testing at the Clarendon Pharmacy and the Collector's Hill Apothecary and that will last through until August 16.

Senior medical officer Dr. Brenda Davidson encouraged people to take advantage. "I think these tests are incredibly important in raising people's awareness that they can actually do something to contribute to their own health," she said.

"People really can make a difference to their own health through making just small changes to their lifestyle, by doing things like cutting out smoking, drinking less alcohol, eating an apple a day, taking more exercise.

"In the end whatever advice people are given it's only them who can make the changes to improve their health in this respect."

Dr. Davidson estimated that one in five deaths could be attributed to heart disease and, according to the Government's 1999 Adult Wellness Report, it is Bermuda's number one killer, hence the importance of knowing whether you are at risk.

The disturbing findings of last year's test did not necessarily mean that half the people of Bermuda were at risk of heart disease, said Dr. Davidson, but she stressed that it had been a useful exercise.

"All it means is that half the people who were screened had high blood pressure and cholesterol," she said. "The people who came in for testing were not necessarily from a cross-section of the population.

"They could have been people who got tested because they thought they were at a higher risk of heart disease anyway.

"It would not necessarily reflect the health of the whole population. So yes, the numbers were alarming, but on the basis of those results you couldn't say that 47 per cent of all Bermudians have high blood presure."

High blood pressure, sometimes referred to as the 'silent killer', can do long-term damage to people who have no idea they have a serious health problem.

The Government's chief nursing officer Gaylia Landry said: "People need to keep a close check on high blood blood pressure as it has virtually no noticeable side-effects in its early stage.

"This is why we recommend regular annual checks - even for those with normal blood pressure, or every few months for those high or borderline blood pressure. Sadly, very often the first sign of high blood pressure is a heart attack, stroke or kidney problems and that is what we are trying to avoid."

Blood pressure is the measure of the force of blood pushing against the walls of the blood vessels. When blood pressure is checked, the measurement is given as two separate numbers, for example 110/70.

The top number refers to the pressure in the arteries when the heart is pumping and the bottom number to when the heart is resting.

When blood pressure is too high over a long period of time, arterial walls can become weakened and more prone to a build-up of fatty substances on their walls, a condition which forces the heart to work harder to force the blood through the clogged-up arteries.

High blood pressure is usually defined as a reading greater than 140/90, but Dr. Davidson said those who got such a reading should not immediately fear the worst.

"High blood pressure cannot be diagnosed on one reading," said Dr. Davidson. "Stress or activity, for example, can change the level.

"Someone who gets a high blood pressure reading needs to get it checked again in a controlled environment by a doctor. So, don't be alarmed if it's up on one occasion. But a high reading should be followed up."

Cholesterol is an odourless, fat-like substance used by the body to make cell walls and hormones as well as for other functions. It is not only what a person eats that will determine the level of cholesterol in the blood but also what the body manufactures itself.

A desirable blood cholesterol level for anyone over 20 would be less than 200 mg/dl (milligrammes of cholesterol per decilitre of blood) and people who have this level need to get it checked only once every five years. Borderline high is 200-240 and high is anything over 240 and it is recommended that people in these categories should get their cholesterol tested at least once a year.

Cholesterol readings are not so variable, according to variable factors as blood pressure readings, said Dr. Davidson.

"If you have a cholesterol test and it's high, then it's high - there's no beating around the bush and you do need to get something done," she said. "There is a strong association between high cholesterol and heart disease."

People with high cholesterol can usually bring it down by changing their diet, but medication can speed up the process. After the cholesterol test, which takes a few minutes, those screened can get immediate dietary advice from a nutritionist who will also be at the pharmacy.

"Some cholesterol is essential for all human life," said Dr. Davidson, "but there is 'good' cholesterol and 'bad' cholesterol."

She explained that 'bad' cholesterol was a hard, lard-type substance which tended to glue itself to artery walls, while 'good' cholesterol was more fluid and could be protective to the body.

All animal fats and some vegetable fats contain cholesterol.

Some research has indicated that a little alcohol can help to combat high cholesterol - but Dr. Davidson stressed that too much drink can have precisely the opposite effect. "I think a little alcohol's good but a lot of alcohol can tend to raise cholesterol levels," she said.

Further analysis is recommended for those with high cholesterol. Doctors can do a test following 12 to 14 hours of fasting, which will accurately break down the cholesterol into 'good' high density lipoproteins (HDP) and 'bad' low density lipoproteins (LDP).

Pauline Girling, head of marketing and communications at the Phoenix Stores, said: "As a community pharmacy, we have a responsibility to the people of Bermuda and as heart disease is the number one cause of death in Bermuda we felt it was important to again offer these free checks.

"We welcome both those who haven't been tested recently, as well as the 47 per cent of those screened last year that had elevated blood pressure and the 43 per cent of people with borderline or high cholesterol."

Screening times and venues: The Phoenix Centre, Reid Street, Hamilton, 10 a.m.-12 noon(Weds, May 22; Weds, May 29; Weds, June 5; Weds, June 12), Clarendon Pharmacy, Bermudiana Road, Hamilton, 12 noon-2 p.m. (Fri, June 21; Fri, June 28; Fri, July 5; Fri, July 12), Collector's Hill Apothecary, Collector's Hill, Smith's, 10 a.m.-12 noon (Fri, July 19; Fri, July 26; Fri, August 9, Fri, August 16).