IN the quiet luxury of Government House, winter sunlight streams through the windows and warms the drawing room where Governor Chris Patten and his wife, Lavender, settle into armchairs. It's almost three years since Mr Patten went into surgery for a heart operation. A casual observer would find it difficult to appraise his health but, dressed in a dark suit, the Governor's girth is less expansive and his face is certainly less flushed. It is 11.30am and Mr Patten is to face his half-yearly fitness test with Queen Mary Hospital doctors after a healthy lunch of pureed carrot soup. 'I know I'm overweight at the moment because I can feel my double-chin and see it in the photographs,' he says to his wife. 'But you're definitely less plump than those old photographs,' she replies, reminding him of the 1992 pictures hanging in tea shops everywhere. 'When I see those photographs I see a big difference. But I always tell him, I'm afraid I have very little tact, 'You'd better watch out - you're putting it on again'. It's cruel, isn't it? But it's for his own good.' Mr Patten is one of thousands of Hong Kong people who have felt the twisting chest pain caused by narrowing arteries, and been ordered to change their lifestyle. Every year, about 5,000 Hong Kong people die from heart disease, making it the largest single killer, categorised by diseases, in the territory. Lung cancer runs second. Chief of Cardiology at Hong Kong University Dr Lau Chu-Pak warns that coronary artery disease, where fatty lipids build up inside the arteries and choke the flow of blood to the heart, has recently taken over from rheumatic heart and hypertension as the major cause of heart disease. 'It's because of the change in our way of living: diet and stress,' Dr Lau says. About 25,000 heart patients in Hong Kong had angioplasty operations to force open narrowing arteries last year, and at least 700 had open-heart surgery. The three major indicators for coronary artery disease are a family history of the illness, medical factors such as high cholesterol, high blood pressure and diabetes, and patient-regulated factors such as obesity, smoking and stress. Last year, international scientists awarded Hong Kong the dubious award of being the most stressful city on the planet. This year, psychiatrists have spoken of '1997 syndrome', which they say is responsible for depression and changes in family life. So if doctors were searching for a likely candidate for heart disease, they could look to the man with the most stressful job at the most stressful time in the most stressful city in the world. And they would find Hong Kong's last British Governor, a man with a family history of heart disease, a weight problem and facing a difficult transition. IT was mid-January 1993 when Mr Patten, entering his first winter as Britain's top man in Hong Kong, discovered something was seriously wrong with his heart. There were enormous pressures on the new Governor as he battled to push through constitutional reforms that would offer democracy to the territory. His initial six months in Hong Kong had been a trying time, but then so were his former jobs as Britain's minister for the environment and chairman of the Conservative Party. The Pattens had spent their first Christmas together in the colonial luxury of Government House. Daughters Laura and Kate, then 17 and 19, had returned to England after celebrating the holiday in Hong Kong with their parents and youngest sister, Alice, who was 12. As Cathay Pacific cabin staff launched their bitter 17-day Lunar New Year strike, Mr Patten began to experience an alarming chest pain. Doctors ran tests and discovered two of the Governor's coronary arteries were clogged, severely restricting the flow of blood to his heart. The condition required surgery. Under instructions to ease his stress load, Mr Patten took his wife, Lavender, and Alice to Bali for the Lunar New Year, where they spent a week holidaying and relaxing on sun-drenched beaches. Hong Kong had no inkling of its Governor's health problems. But when the family returned to Hong Kong on Friday, January 29, relations with China again threatened to reach boiling point. Even as the Pattens' beach clothes were being unpacked, the South China Morning Post presses were churning out the headline: 'Triple salvo raises tension; mainland zeros in on airport related projects to be completed before 1997.' That Sunday, Mr Patten phoned longtime friend, Prime Minister John Major, and told him he was scheduled to have a coronary angioplasty to widen his blocked arteries on February 3. The pressure never eased. On the day before the Governor placed himself in the hands of surgeons at Queen Mary Hospital, he read the prominent Post headline: 'Reforms under fire on eve of Exco talks: Beijing turns up the heat with new broadside on Patten plans.' His constitutional plans raised howls of anger from Beijing and, one month later, were to draw the scathing appellation of 'sinner for 1,000 years' from Hong Kong and Macau Affairs chief Lu Ping. The following morning, Mr Patten checked in for the operation amid saturation media interest. Surgeons inserted a catheter into his groin and pushed it up the femoral vein then, guided by X-ray, through the right atrium of the heart. The tube was extended slowly until it reached the blocked coronary arteries. A deflated balloon, attached to the probing end of the catheter, was pushed into the narrowing gap and inflated to clear a path. About 40 to 50 per cent of balloon angioplasty patients suffer a relapse later in life. Mrs Patten remained by her husband's side during much of his three-night hospitalisation, leaving only to phone Laura and Kate in England and to take her husband's place at an official function. Now, almost three years after the first twinges of pain, the Pattens concentrate on exercise and a low-fat diet - not an easy task given the Governor's rigorous schedule and daily official banquets. 'The main difference in my life is that I now take a lot more exercise and I'm a bit more careful about my diet as well - though doubtless my doctors will tell me I haven't been careful enough,' Mr Patten says. 'My weight goes up and down very quickly and frequently. I always lose a lot of weight in late winter, early spring. I go on a diet during Lent and give up alcohol, then I tend to put on weight from the summer through to the winter. 'But I'm much less bulky than I was when I arrived in Hong Kong, and I'm much fitter. I probably play tennis three or four times a week and, if there's a day when I'm not playing tennis, I spend 20 minutes on the exercise bike.' Stress, hereditary factors, fitness and weight are factors critical to heart disease. Mr Patten was overweight, both of his late parents had heart conditions, and those first six months in Government House had piled on the pressure. 'I'd had three pretty gruelling years before and I think it all came together: overweight, under-exercised and a family history of heart problems and stress. But stress and pressure aren't new. 'In some ways the two jobs I'd done before I came to Hong Kong were more stressful. First of all, I was Cabinet minister responsible for the biggest domestic department in the UK. The job as environment secretary, in terms of sheer pounding work, was the toughest job I'd ever had. 'I'd get back from the House of Commons at 10pm and do two hours working on the 'box' at night, then get up at 6am and do another two hours before I went to work - and that was day after day after day. I would never work that hard again. 'I was sleeping about 41/2 to five hours a night and doing a huge amount of work,' he says. 'There were terrific political pressures, because it was when the poll tax was being introduced, which was one of my department's responsibilities. 'I was also changing and privatising the water industry and introducing the first comprehensive environment strategy in the UK all at the same time. 'And then I followed that with being chairman of the Conservative Party during a recession and trying to organise an election and campaign, attempting to look after my marginal seat. 'This has been tough, but I think all that was even tougher,' he said. Cardiologists advise patients with blocked arteries to exercise, stick to a low-fat diet and reduce stress. The first two pose problems, but telling Hong Kong's handover Governor to cut down on his stress must be a battle for any doctor. 'People who know me well say I'm more relaxed these days than I used to be,' Mr Patten insists, receiving an affirmative nod from his wife. Mrs Patten shudders and protests at the summoning of memories from their recent years in England; they were years of non-stop work, of constant travel between Parliament in London and the electorate in Bath. There was a family to raise, shopping to do, a house and garden to keep, doors to knock and a harried election campaign during which Mr Patten lost eight kilograms. But as Hong Kong's last Governor, with a small army to drive, garden, cook, clean and brief him, the most stressful aspect has been the accumulation of events, work and demands, he says. 'And probably, initially, the fact that while I had a great deal of support at home, I was very much the man in charge in Hong Kong and not working in the collegiate atmosphere which I'd been used to in the Cabinet. That probably added to the pressure as well. 'By and large, pressure for most people is the accumulation of things, dashing from one thing to another.' The fury of mainland officials, admonishing him as a 'sinner for 1,000 years' in 1993 and 'a big dictator' last month would seem to be enough to send anyone's blood pressure flying. But if such names, including the ubiquitous Fei Pang, do stress the Governor, he keeps his responses tightly controlled. 'Being called names is usually a confirmation that you're winning the argument,' Mr Patten says. 'And it's so demeaning for people to use that sort of language, that Cultural Revolutionary language. But that's for them to explain. 'But I have to say that, for me, those issues of stress are less important than diet and weight and exercise. I think I could have been under a lot less stress and have had exactly the same heart problems. 'And I doubt whether I'll have the opportunity of a stress-free existence just yet. I've just got to learn to put into each day at least some time when I'm turned off work and when I'm taking some exercise. 'I'd had problems with my health in 1982. I had a burst appendix which wasn't diagnosed, which I walked around with for a year. I had ulcers in the early 1980s.' Dieting is something Mr Patten has been intending to do for years. Only after the heart warnings did he take it seriously. 'It's pretty difficult, living the sort of life I do, with an official dinner almost every day and, this week, three official lunches, to be as careful about diet as I would like,' he says. 'But when I can actually control my own diet I'm not too bad. I'm more careful than I used to be. I don't eat many dairy foods and hardly any cheese - I used to eat a lot of cheese - and only very rarely anything like a chocolate.' Mr Patten gazes enviously at his wife, who has never counted calories. 'I don't have to worry about my weight, but I'm being careful about my cholesterol. I'm told it's a bit higher than it should be, but then I don't have any of the other indications. I'm not overweight and don't have the family history,' she says. 'I'm just cutting down on things that are obviously high in cholesterol like shellfish, fried foods, eggs and trying to eat things that are good for you, like porridge and bran. Red wine is good for you and olive oil.' Mr Patten now breakfasts on porridge and coffee, lunch is a bowl of pureed vegetable soup or consomme and crackers, and dinner is a low-fat three-course meal. It is food far removed from his anticipations as he told Hello magazine in 1992 of the territory's optimism 'and more superficial pleasures, like the fact that you can eat as well in Hong Kong as anywhere in the world'. But the Governor still dreams of banned gourmet delights. 'I only have to look at a cookery book to start putting on weight,' he complains. 'I've started reading a wonderful book about the recipes of southwest France, which gives away its cholesterol content in the title. It's called Goosefat And Garlic. The garlic's all right. The goosefat - it's Russian roulette.' Chris Patten gave up smoking 13 years ago but blames the residual effects for helping to build debris in his arteries, which, left untreated, could have killed him. 'I'm sure that I paid the price in 1993 for 20 years of smoking,' he says. 'My last cigarette was tossed into the Grand Canal in Venice in 1982. I have about three cigarettes a year, on special occasions. 'It's smelly. I really smell it on people if they smoke. And when there are people in the house smoking a lot, or in my office, I don't stop them because I don't believe in bullying, but the whole room smells after them. Cigars are worse. 'I would advise everyone to give up smoking. But people have to make the decision for themselves. 'It's not easy. 'When I really felt well, when I was walking along a beach in winter or when I'd just climbed a hill or had some exercise, I loved having a cigarette. I'd never had a cup of coffee or a glass of alcohol without having a cigarette with it, because I started smoking when I was 15. The truth is, when I gave up smoking I put on 28 pounds. 'This used to be a slim chap.' Mrs Patten also blames years of smoking for her husband's narrowing arteries and urges the couple's three girls to stay away from cigarettes. 'You see a lot of kids smoking these days and you say to them, 'But you know it's a major factor in lung cancer'. They say, 'Oh well, I'll give it up when I'm a bit older',' she says. 'But they forget two things. One is that it's very difficult to give it up, and, when you're talking about the effect on your heart and arteries, these things are built up over many, many years. They might be able to clear their lungs out, but their arteries aren't that easy.' The Pattens' middle daughter, Laura, who set off a photographic blitz when she arrived in Hong Kong in a miniskirt in the summer of 1992, has flirted with smoking, says Mrs Patten. 'I think she's off now, thank goodness. Kate has never smoked and Alice, so far, hasn't smoked,' she says. Mr Patten is usually up at 6.45am and by 7.30am is launching a tennis challenge to any Government House staffer who'll take him on for an hour. 'I don't spend much time any more on the rowing machine. I find it extremely painful and pretty boring. I do it occasionally. There's nothing to take your mind off what you're doing. When I'm on the exercise bike I read; I've got a lectern and I read while I'm doing it. 'If there's one thing that causes me maximum stress, it's the prospect of being bored.' His Fanling residence borders the Royal Hong Kong Golf Club, but Mr Patten says he is no golfer. 'I've just started taking one or two lessons, but, so far for me, it doesn't seem to be an entirely stress-free occupation. I get so furious with myself as the ball sets off at odd angles.' Keen golfer Mrs Patten chides her husband: 'It keeps your mind off your work.' 'It makes me bloody cross,' the Governor retorts. Long-time Government House housekeeper Elspeth Collins-Taylor says the kitchen has reformed its British high-fat ways since Mr Patten's angioplasty. 'Afterwards, the doctor came along and told us how to cook for him and what he could and couldn't eat. The dieticians came and sat down with us and said, 'He can eat this, he can't eat that' and they gave us some recipes to get us started,' Ms Collins-Taylor says. 'We cut out cholesterol. That's quite easily identifiable. You can tell by looking at something whether it's got tonnes of cream in it, or if it's oozing butter. 'He just loves avocados and they're horribly bad for you, so we don't have them. He loves things like caviar and that's horrendous, so we don't serve it. He eats it out sometimes. And lobster, which he enjoys, is very high in cholesterol, so we don't have lobster anymore. 'But there's very little that we can't find a substitute for, or convert by using other things. He's always loved mousses and pates and we can still make them because there are so many things you can use instead of double cream and butter. 'He still eats lamb and steak and pork. Maybe it's not perfect, but we cook it carefully to make sure we don't add anything to it and take away as much of the fat as we can.' But nothing has met with complaints. 'The Governor just enjoys eating,' Ms Collins-Taylor says. 'Give him a bean stew and he's very happy with it. Give him caviar and lobster and he's delighted with that, too. 'Officially, he doesn't have snacks in between. But he likes to have a snack before dinner with a drink, so we give him dry roasted almonds and carrot sticks and olives, or non-cholesterol potato chips. You can buy them in Oliver's. 'The hardest thing is that if you want him to follow the diet for a long time you've got to make it interesting, so he doesn't crave anything. We've got to have variety so that when he's out, he doesn't feel the necessity to blow it.'