Today is World Heart Day. The aim is to inform people around the globe that heart disease and stroke are the world's leading cause of death. Together with bodies such as the World Health Organisation (WHO), the World Heart Federation spreads the news that at least 80 per cent of premature deaths from heart disease and stroke could be avoided if the main risk factors which are tobacco, unhealthy diet and physical inactivity are controlled. World Heart Day started in 1999 and is held on the last Sunday of September every year.
The essence of having the Day is to raise awareness and encourage individuals, families, communities and governments to take action to reduce the burden of cardiovascular disease (CVD) and prevent the 17.3 million deaths that occur each year, advancing toward the goal of reducing CVD deaths by 25 per cent by 2025.
Overeating, lack of exercise, unhealthy diets and high blood pressure, cholesterol and glucose levels are all factors which can trigger heart disease and threaten our own lives, and those of loved ones. Heart Day was set up to drive home the message that heart problems can be prevented.
This health day is marked globally to encourage people to make lifestyle changes and also to promote education about ways to be good to your heart. This lesson is becoming increasingly relevant as reports of obesity, poor diet and physical inactivity in children and young people become more common.
The World Heart Federation said the 2013 World Heart Day will highlight a life-course approach to the prevention and control of CVD with a focus on women and children and show what actions can be taken through a person's life to reduce their risk of cardiovascular disease (CVD): "Today, we have an opportunity to prevent the future impact of heart disease and stroke by enabling heart-healthy living from childhood throughout adulthood."
In an interview with Dr Ezekiel Ogunlewe, consultant cardio-thoracic surgeon, Lagos University Teaching Hospital, Idi Araba (LUTH) and Senior Lecturer University of Lagos, he highlighted the different risk factors of cardiovascular diseases and ways they could be curtailed in the country.
Here are the excerpts:
What are those things that can cause heart attack especially in a woman?
The problems of heart disease in women are the same as that of men. Both have similar cases of heart disease. The peculiar thing about women and heart-related diseases is that there are some cases which the American College of Cardiology has seen, especially in women who are pregnant. They noticed heart-related diseases in women who develop diabetes during pregnancy called gestational diabetes or who have preeclampsia which is a medical condition characterised by high blood pressure and significant amounts of protein in the urine of a pregnant woman. They found out that these women have a tendency to have heart disease after they must have given birth or developed it later in their life. Such women must be referred to a cardiologist who will monitor and follow them up to prevent future heart diseases.
This year's focus of the World Heart Day is also on the children. In what ways can heart-related diseases in children be avoided?
In preventing heart diseases in children, we should start from the onset to prevent them from getting any type of heart disease. This starts from when they are conceived. When a woman is pregnant, she should avoid taking concoctions and things that can affect the child in the womb, especially during the first three months of life when all the organs including the heart are being formed. The woman should be careful not to take anything that is not prescribed by the doctor all through her pregnancy so that the baby will not be born with a heart problem. This way you prevent the baby from having cases like a hole in the heart. Most of the time the problems children have from birth is as a result of the junk the mother ate during pregnancy. If a woman can prevent all these kinds of bad habits, then a child is prevented from having any kind of heart defects from birth. In the developed world, where they have too much food and eat mostly junk, they have childhood obesity predominant in their children. Childhood obesity will have an effect on the heart as the child grows older. Here in Nigeria, we have to be careful what we give the children before we also start seeing children with childhood obesity. Too much sugar, ice cream and sweet things should be curtailed. We should also encourage exercises among the children.
In what ways can cardiovascular diseases be avoided?
When we talk of prevention, we are talking of risk factors that may lead to heart disease and stroke. They include the kinds of food you eat, your lifestyle and eating junk foods which all have an adverse effect on the heart. If you are physically inactive and don't exercise, it can have effect on the heart. Also, those who are hypertensive or have diabetes must make sure that they are treated well. If you are hypertensive, make sure your blood pressure (BP) is well controlled. Hypertension is not a killer if you take your drugs and see your doctor to be sure it is well controlled. The best way to prevent heart diseases is to change your lifestyle, eat healthy food and exercise.
It is also important to do a yearly check-up by doing a lipid profile. This is to check your cholesterol level. If it is high, you work on bringing it low. Also do an electrocardiogram (ECG) and an Echocardiogram (ECHO) to see how the heart is functioning. Then you should also ask dieticians the kind of foods to avoid. Major foods to avoid are those that contain too much fat. Taking too much soft drink and fruit juice and all these things that contain refined sugar should be avoided. Stopping all these things will help the heart to function well.
Also, we should start encouraging people to take Aspirin. It is good to take an Aspirin once daily to prevent stroke. It has been discovered that if a person has a tendency to have stroke or heart disease but starts taking Aspirin once a day, they are likely not to have it again. This is a preventive measure which people who are enlightened and have travelled widely have discovered and have taken in as a habit and those in the western world know the importance of this thing. One tablet of 75mmg of Aspirin taken daily helps a lot in preventing a heart attack or stroke.
Is heart diseases adequately treated in Nigeria?
This is the area where we need to concentrate on by building personnel and infrastructure in the country so that anyone that has heart disease can go there and be treated. We need heart centres with modern facilities across the country, especially for cases of emergency.
It is a pity that we don't have such facilities in the country. How many of the hospitals have facilities for open heart surgery? In some cases in Nigeria, the person will need to travel a day or two before he's even able to meet professional cardiologists like us.
You won't believe that for the use of an ordinary Pacemaker, they will refer a case of a patient from as far as Maiduguri to Lagos whereas every state should also have such facilities. A Pacemaker is a small device like a battery that keeps the heart functioning when the natural battery of the heart is bad. Why refer patients and risk them dying before they get help?
Even when we talk about such cases like hole in the heart, how many are being handled in the country? We have professionals who can handle these things but no infrastructure for them to work with. LUTH is trying now. We want to partner with some people to start this kind of operation but the equipment is almost N200 million. The government has so many projects it's handling and may not be able to foot that kind of bill but we need such facilities to be all over the country to cater for the population. Having these infrastructure are also ways we can prevent people from dying from heart disease.
Is that the reason people travel outside the country for heart-related problems?
Nigerians travel abroad for such cases, especially to India. Someone said that one third of patients in India are Nigerians and about half of them are there for heart disease cases. This means that 1/6 of the patients in India are Nigerians with heart disease. So the government needs to wake up and address the situation. They should help to see that these facilities are built in the country.
We need to build these modern facilities because nobody knows the next patient. Look at the former governor that died recently. I'm sure if he was in a hospital abroad, where there are up-to-date facilities, he may not have died. The government should know that this could happen to anybody and it occurs suddenly without warning. They should do something to upgrade and build more heart centres in the country. We need to train personnel, buy infrastructure and to get it on ground and running.
