Exploiting the absence of a concerted government action on disease prevention, care and control, heart disease, just like many other diseases of its ilk, has been freely decimating a large number of the Nigerian population. But rather than look on helplessly, the government has to act now. There is an urgent need to go beyond raising the alarm by a few concerned experts to fashioning a special programme of containment, to help in saving many lives, some of them still in their prime.
At a recent seminar in Lagos that also attracted many specialists, the deadly nature of heart disease was spelt out in vivid terms. While a consultant cardiologist with the Lagos University Teaching Hospital, Idi-Araba, Amam Mbakwen, described it as an epidemic, Ikechukwu Ogah, his counterpart from the University College Hospital, Ibadan, hit the nail squarely on the head when he said, “Heart disease is deadlier than HIV and all forms of cancer, except that of the lungs. This is because 50 per cent of people living with heart disease don’t live for more than five years before they die.”
This is scary for a country blighted by weak and dysfunctional health care delivery system, where the slightest ailment requires a trip abroad for treatment by those who can afford it. For the majority who cannot, their fate could be a sure and imminent death. Although the experts did not support their claim with statistics, the figure of 150,000 Nigerian deaths per annum released by the Minister of Health, Isaac Adewole, at the commemoration of the 2017 World Heart Day, gives an insight into the nature of the challenge confronting the country in that area.
Together with cancer, which the minister said kills 10,000 Nigerians every year, hypertension, diabetes, among other non-communicable diseases, there is a pattern of a major shift from infectious diseases as major killers in the country to the NCDs. Thankfully, these are diseases that could be better managed or even prevented if Nigerians can adopt a healthy way of life and eat the right foods, rich in fruits and vegetable and low on fats, salt and sugar.
Heart disease – a term used interchangeably with cardiovascular diseases, according to Mayo Clinic, a non-profit medical practice and medical research group – is defined as the disorders of the heart and blood vessels, including coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions. It is a lifestyle disease, which means that it can be controlled or even prevented if people adopt a healthy lifestyle.
Symptoms of the disease vary from leg, stomach and facial swelling; shortness of breath and light-headedness, to fatigue, persistent coughing; sudden outbreak of sweat and chest pain. Other symptoms include irregular heartbeat, lack of appetite, excessive tiredness, nausea, pounding and racing heart and difficulty in breathing, especially while lying down flat.
According to health experts, the risk factors for a heart disease include being hypertensive, smoking, alcohol abuse, obesity and lack of, or inadequate level of, physical activity. Being diabetic is also a risk factor in heart disease, just as exposure to environmental pollution. Interestingly, some of the risk factors for diabetes and hypertension or high blood pressure are also shared by CVDs or heart disease. They also share the characteristics of affecting many vital organs of the body.
Among the new risk factors is infection by HIV. Akinsanya Olusegun-Joseph, a consultant cardiologist, said drugs used in the treatment of HIV patients could also pose a risk for CVD in those living with the virus. It is also hereditary, which means that one stands a chance of suffering from heart disease if there is a history of the disease or other risk factor diseases such as hypertension and diabetes in the family.
The World Health Organisation estimates that 80 per cent of CVD deaths are traceable to both stroke and heart attack. Globally, heart disease is identified as the number one killer. WHO statistics indicate that 17.7 million people die every year due to CVDs, an estimated 31 per cent of all deaths worldwide. In the United States, the cost of heart failure to the nation is estimated at $30 billion, including the cost of care services, medication and missed days of work.
Over three-quarters of CVD deaths occur in low- and middle-income countries, like Nigeria. This is why the Nigerian government should take more than a passing interest in measures targeted at reducing the heart disease burden. In fact, persuaded by WHO, all the 194 member states had in 2013 come up with a “Global Action Plan for the Prevention and Control of NDCs 2013-2020.” Under that plan, the world will be targeting a 25 per cent reduction in heart disease burden by 2025, through what it called “voluntary global targets.”
Apart from enlightenment of the citizenry through sensitisation to actions that can be taken at the personal level to contain CVDs, the government’s role include the formulation of policies, such as the ban on smoking and increasing tax on tobacco and unhealthy food items that are high in fat, sugar and salt. The government can also introduce and strengthen an integrated primary health care programme that will make early diagnosis of the disease possible because it is easier to handle at the early stages.
As high blood pressure has been identified as the leading risk factor, steps should be taken to reduce its prevalence and in cases where it is already detected, the sufferers should seek expert management to prevent a progression to heart disease. The government can help the citizens to promote a life of physical activity by providing walking and cycle paths on the major roads. Tackling heart disease or CVD is not something that can be successfully handled by individuals alone; it demands collaboration with the government to achieve a positive result.
