By Ojoma Akor (Abuja) Mumini Abdulkareem, (Ilorin) & Olatunji Omirin (Maiduguri)
As Nigeria joined the world to mark the World Heart Day yesterday, experts have called for increased efforts from the federal government and all stakeholders towards reducing the burden of heart diseases in the country.
The World Heart Day is marked on September 29 every year. The theme of this year’s commemoration is ‘Use Heart for Action’.
Experts say heart diseases, also known as cardiovascular diseases (CVDs), are a major contributor to the cases of sudden deaths or people slumping and dying in the country.
According to Dr Charles Anjorin, a consultant physician and cardiologist at the University of Maiduguri Teaching Hospital, in Borno State, cardiovascular diseases are most implicated in cases of sudden deaths, which have become very frequent in Nigeria.
“By sudden death, we mean unexpected death in an individual previously thought to be quite well. Common causes of this include severe hypertension, acute heart failure, stroke, heart attack (myocardial infarction) and disorders of the electrical activity of the heart, also known as disorders of heart rhythm, “ he said.
Dr Ndubuisi Anumenechi, Chief Consultant Cardiothoracic Surgeon, National Hospital Abuja, also said heart diseases, or other diseases ultimately affecting the heart, contribute largely to frequent slumping and dying in the country.
A professor of medicine and consultant cardiologist, University of Ilorin, Prof. Ibrahim Katibi, said Nigerians and Africans are shifting away from the agrarian rural lifestyles and diets and when people walked long distances to go to the farm or school.
He said everybody now depends on vehicles and other forms of transportation.
What are heart diseases?
Heart diseases are diseases that affect the heart and blood vessels.
Dr Anjorin explained that heart diseases are conditions that affect the structure and the functions of the heart and the blood vessels.
He said most of these diseases eventually manifest through a common pathway known as heart failure, a syndrome usually characterised by exercise intolerance (which may worsen progress to difficulty in breathing at rest) and swelling of the feet (which may progress to abdominal swelling), among several other features.
He said, “Heart failure is generally defined as the inability of the heart to optimally perform its function of pumping blood to achieve adequate supply of oxygen to all the tissues of the body, a vital requirement for life.”
Burden of heart diseases in Nigeria
Prof. Katibi, said heart diseases have grown to become the most important non-communicable diseases in Nigeria, with the most important one being hypertension.
He said, “To put a figure to the casualties yearly in Nigeria, it will not be less than a million people. Indeed, there is hardly any emergency room or medical ward in a teaching hospital set up where you will not find people on admission for hypertension-related cardiovascular disease or stroke-related disorders. It is indeed a very big burden and the number is worsening.”
Dr Anjorin said heart disease is a very significant public health problem in Nigeria.
Quoting a 2016 WHO report, he said, non-communicable diseases accounted for 29% of all deaths in Nigeria and 11% of this was due to cardiovascular disease (CVD).
He said in the past 20 years, the prevalence of CVDs has increased by 150%.
He stated that in Lagos, 51.1% of out-of-hospital deaths were due to CVDs with hypertensive heart disease and subsequent heart failure being the major causes.
According to him, in years gone by, the major health burden were infectious diseases, adding that diseases such as myocardial infarction (heart attack) which was rare before, is now a common occurrence.
He further said that other common heart diseases in Nigeria include Cardiomyopathies (a heart muscle disease of as yet uncertain origin that is associated with pregnancy and found also in middle age to elderly males).
He also listed Valvular heart disease (a disease affecting the valves of the heart sequel to bacterial infections of the throat, found more in low socio-economic areas) and Coronary heart disease (a disease that may present a heart attack, due to blockage of the blood vessels of the heart, (the incidence of this is rapidly rising as we adopt a more western and sedentary lifestyle).
Others include congenital heart diseases and disorders of heart rhythm.
Meanwhile, the immediate past president of the Association of Cardiovascular and Thoracic Surgeons of Nigeria (ACTSON), Dr Uvie Onakpoya, said over 80,000 people in Nigeria require heart surgery every year.
He said eight children out of every 100 children are born with congenital heart diseases like hole in the heart, noting that in Nigeria, over 55,000 children are born every year with heart diseases
Patients’ experiences
Agnes Idris (not her real name), 49, was diagnosed with heart disease three years ago. She had to stop her previous business, which was taking a toll on her because of her condition. “I feel fatigued a lot these days but have been managing it with the drugs prescribed by my doctors,” she said.
Mami, 56, lost his younger sister to an enlarged heart. She had delivered her fourth child but fell ill a month after. He said the doctors said she needed a major heart surgery but the family could not afford it and she died after a few months.
Another sufferer who simply wants to be identified as Usman said he was first diagnosed of hypertension and obesity before heart disease. He said he has cut down on fast foods and is working on his weight as he takes his prescribed medicines.
Drivers of heart diseases in Nigeria
Dr Ndubuisi Anumenechi, Chief Consultant Cardiothoracic Surgeon, National Hospital Abuja, said poor diets, sedentary lifestyle, smoking, high sugar in meals, and environmental pollution are major contributors in the country, aside from others like congenital heart diseases that some people are born with.
Similarly, Dr Anjorin said the risk factors for heart/cardiovascular diseases in Nigeria can be grouped into two; the first group includes factors that cannot be altered, meaning nothing much can be done about it.
These include age, gender, race and family history. For example, an older person who is a male of the black race and with a history of heart or cardiovascular diseases in the family (mother or father’s side) is more likely to have heart disease.
The second group consists of conditions that can be changed or modified, such as “embarking on regular exercises rather than being sedentary or sitting all day, stopping smoking or alcohol ingestion, reducing salt intake, taking lots of fruits and vegetables, early treatment of diseases such as high blood pressure, diabetes mellitus or high blood lipids (fat), weight reduction, and paying serious interventional attention to air (environmental) pollution.”
Also, Prof. Katibi the Professor of medicine and consultant cardiologist, University of Ilorin, said while heart attack is a bigger problem in the Western world, hypertension, heart/kidney failures and stroke as a result of hypertension are the common ones in Nigeria and other African countries.
“But because of westernisation and sedentary lifestyles, lack of regular exercise, too much consumption of junk/fast foods, we are now seeing increasing cases of heart attacks in Nigeria, particularly in those areas that are more urban like Lagos, Kano and Abuja among others.”
He therefore warned that people with sore throat and skin rashes need to be properly treated to avoid rheumatic heart diseases in adulthood which may cause vulgular problems that will need heart/kidney surgeries outside the country.
Reducing heart disease, deaths in Nigeria
The experts outlined ways for Nigerians to protect themselves from the diseases and reduce their prevalence in the country.
Dr Anjorin said, “To reduce the rapidly rising morbidity and mortality due to heart and cardiovascular diseases in our environment, the adage of “prevention is better than cure” should be imbibed.”
He said this should start from government policies that improve the health of the individual, such as exercise periods at work, including the provision of safe walkways on all roads constructed, control of environmental pollution, making primary health care and checks affordable or free and seriously slashing the cost of drugs to give the masses a stress-free lifestyle.
He noted that the Nigerian Cardiac Society led by its president, Prof. Augustine Odili, has been at the forefront of advocacy for the prevention of cardiovascular diseases in the country.
“As an umbrella body for all doctors and allied health workers that take care of heart diseases in Nigeria, the association marks the global World Heart Day (celebrated on 29th of September, each year) with many advocacy programmes all over the 36 states of Nigeria and the Federal Capital Territory.”
The theme for this year’s World Heart Day is “Use heart for action”, encourages a departure from sedentary lifestyle through regular exercise,” Dr Anjorin stated.
Prof Katibi advised that people can protect themselves from heart diseases and also reduce the burden in Nigeria by doing “a comprehensive medical check-up annually whether you are sick or not, avoid a sedentary lifestyle and try to spend at least 30 minutes to one hour every other day to exercise.
“Avoid fast food because of potential obesity with increased chances of suffering complications. Eat mostly green leaves and vegetables, a low salt diet and avoid the consumption of surgery items like soft drinks and artificial juices. Instead, go for natural fruit juices like pineapple, watermelon and oranges etc.”
He stressed that mental activities are not a form of exercise but exertion that may lead to stress.
“Even physical activity that is work-related, like driving is a form of stress. Walking is the cheapest and most effective form of exercise and I recommend an hour every other day.
“That is why we encourage people who spend a lot of time sitting, like journalists, to break off intermittently after about an hour or two to walk around in the office or around the compound. You can even have your laptop or other devices on your treadmill and be working while exercising simultaneously”, he advised.
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