Nigerians have been advised to stop smoking, reduce alcohol intake, properly manage such diseases as hypertension and diabetes, eat healthy foods with low salt, low fat, high fibre, maintain a healthy body weight and exercise regularly for at least 30 minutes twice a week to prevent heart diseases, as the world celebrated Heart Day, yesterday.
Health professionals describe heart disease as a disorder of the heart, and it is part of cardiovascular diseases. Cardiovascular diseases (CVDs) are disorders of the heart and blood vessels. They include coronary heart disease, cerebrovascular disease and rheumatic heart disease, among others.
Senior lecturer and Consultant Public Health Physician at Department of Community Health and Primary Health Care Lagos State University College of Medicine (LASUCOM), Dr. Modupe Akinyinka said some heart diseases are genetic (developed because the person has the genes that make him/her develop the disease), while some are congenital (that is the person is born with that heart defect).
She said: “However, there are risk factors that predispose one to heart diseases. Some are non-modifiable, such as increasing age, being male, having a family history of heart disease, genetic factors and having a Type A personality.
“The modifiable risk factors that result in heart diseases include having high blood pressure and high cholesterol levels, intake of alcohol, being overweight or obese, having diabetes, living a sedentary lifestyle, such as sitting at work and eating a lot of junk foods.
To prevent heart disease, she explained that people should cultivate a healthy lifestyle, eat lots of fruits and vegetables, exercise regularly, treat illnesses if present, stop smoking, reduce alcohol intake and maintain a healthy weight.
She said: “People should eat foods low in saturated fat, trans fat, and sodium (that means avoiding fast food such as meat pies). As part of a healthy diet, eat plenty of fibre-rich whole grains, fish, preferably oily fish, at least twice per week), nuts, legumes and seeds and also try eating some meals without meat. They should choose lower fat dairy products and eat skinless poultry.”
A Consultant Cardiologist, with College of Medicine University of Lagos, Dr. Akinsanya Olusegun Joseph explained that cardiovascular diseases (CVD) are the leading cause of death globally and include, coronary heart disease, cerebrovascular disease, hypertensive heart disease, valvular heart disease, peripheral vascular disease, heart failure, heart muscle disease and cardiomyopathies, among others.
He said apart from congenital heart disease, CVDs are largely chronic disorders developing, more often than not insidiously throughout life and usually progressing to an advanced stage by the time symptoms occur.
He noted that there are varying signs and symptoms of CVDs, depending on the particular disease.
He said: “Common complaints, however, include, exertional chest pain, central or left sided chest pain that occurs during activities or exertion and relieved by rest or some specific drugs.
“For some patients, the pain can occur during an emotional outburst. Pain typically lasts few seconds to minutes, and can spread to the left shoulder and upper limb. In worst case scenario, the chest pain can occur at rest, can be very excruciating and may last for several minutes to hours or may result in death when there is heart attack. There is also difficulty in breathing on exertion, which may progressively worsen to a point where the patient can be breathless at rest. Difficulty in breathing while lying down, necessitating the need for more pillows to sleep. In the worst case scenario, patient will not be able to sleep even while seated or propped up. Also, patient may wake up often, gasping for air.
“Awareness of heartbeat, known as palpitation is also a common symptom. Irregular heartbeat, a major cause of palpitation, may be the patient’s complaint.
“Cough, which may be dry initially, later becomes productive of whitish and frothy foamy sputum. Patients with stroke can present with sudden weakness of the face, arm, or leg, usually of one part of the body, with reduced or loss of function of the upper or lower limb of the affected part.
“Other symptoms include sudden onset of numbness of the face, arm, or leg, especially, on one side of the body; sudden loss of balance or coordination. Patients with peripheral vascular disease can present with activity induced numbness or pain, usually the lower limb, initially, which can progress to numbness or pain at rest of the lower limb.”
He urged people to start visiting doctors right from the time of pregnancy until the end of life to avoid CVDs.
He said: “The reason for this is because certain conditions or situation during pregnancy can predispose the unborn child to cardiovascular diseases. For instance, a woman who smokes or takes alcohol, especially during pregnancy can put the unborn child at risk of developing congenital heart disease (hole in the heart).
“A baby with intrauterine growth retardation poor growth while in the womb, with resultant low birth weight is at risk of developing CVD, later in adult life when compared with babies born with normal weight. On the other hand, very big babies at birth usually of diabetic mothers have an increased risk of developing diabetes and CVD, as well later in life.
“The types of prevention can be divided into three, which include: Primary prevention targeted at those at high risk of developing a first cardiovascular event, for instance, men and women with combinations of smoking, elevated blood pressure (BP), diabetes and dyslipidemia. This basically, involves treatment of the risk factors identified in such high-risk patients.
“Secondary prevention targeted towards those with established CVD, post stroke, post myocardial infarction. These are strategies aimed at preventing a recurrence of the CVD they had encountered. This also involves lifestyle modification, treatment of the risk factors, the CVD, and co-morbidities.
“Primordial prevention is measures targeted towards preventing the expression or appearance of risk factors. They are put in place even before birth. These include good antenatal care, avoiding risk factors that can predispose the unborn child to cardiac diseases like congenital heart disease, for example, smoking as highlighted earlier and irradiation during pregnancy, as well as avoiding infections, especially complex toxoplasmosis, Rubella, cytomegalovirus, herpes simplex, and syphilis.
“Furthermore, as much as possible, every form of nutritional deficiencies should have been corrected before pregnancy to eliminate the deleterious effects, which can include congenital heart disease on the unborn child. Educating the populace, especially our women are key in this regard.
“Individualised approach entails education, counseling on lifestyle modification, and treatment of risk factors. Institutionalised approach has to do with educating and increasing awareness of risk factors for CVD, and how healthy lifestyles prevent CVD events. It also involves making policies targeted at reducing the risk factors in the larger society, for instance, policies aimed at reducing salt and saturated fat content of foods, as well as smoking habits and tendencies. Tobacco and erring companies can be heavily taxed.
“However, we can have national days that will promote health, for example, National Walk for life day, National Exercise Day, or National cycling Day. Companies, organisations, schools and local government areas can also imbibe the above-mentioned institutionalised approaches. All these would help in having a health conscious, and healthy society”.
Chief Executive Officer of First Cardiology Consultants Clinic, Ikoyi, Lagos, Dr. Adeyemi Johnson, said heart diseases could occur at any age, as children can also have heart diseases.
“But usually, from the age of 40, one is at the risk of having heart diseases,” he said. For men, I would like to advise that they check their blood pressure from the age of 30 at least once in a year. All these heart diseases are mostly preventable, either with moderate lifestyle or medication. Even congenital heart diseases can be treated here in Nigeria.
“The good news about heart diseases is that though we were unable to treat lots of heart diseases here in Nigeria for the past two decades, but now, most of these diseases can be treated here. Over 15 years ago, we used to send 50 per cent of our patients abroad for heart surgery, but now most of the heart surgery and heart interventions can be done here in Nigeria, with high quality treatment. So, I would advise there is no need of travelling abroad, as it is better to treat patients here in Nigeria
“Coffees are healthy for the body. So, moderate intake of coffee is good for the heart. But for those with fast heart beats, coffee is not good for them.”
A Family Physician, Dr. Chukwuma Ogunbor said just one year after quitting smoking, the risk for a heart attack drops sharply. Within two to five years after quitting smoking, the risk for failure and associated diseases is reduced.