How to address spike in heart disease cases, deaths, by NHF

A Professor of Medicine, Consultant Cardiologist and Past Chairman of Nigerian Heart Foundation (NHF), Basden J. C. Onwubere, told The Guardian that the burden of heart diseases in Nigeria is significantly high, worrisome and appears to be steadily increasing. Onwubere said the diagnosis and treatment costs, as well as the medical effects of heart diseases, constitute a burden.

Onwubere, who is also the Past President, of the Nigerian Hypertension Society (NHS), Past Provost, of the College of Medicine, University of Nigeria/University of Nigeria Teaching Hospital, Enugu, said there are several reports from various parts of the country on the current statistics on heart diseases in Nigeria. “One report says that cardiovascular disease is responsible for 33 per cent or ‘one-third’ of nearly half a million non-communicable deaths in Nigeria yearly. More reports are emerging,” he said.

Why the rise in heart disease in Nigeria? Onwubere blamed current changes in lifestyle: more sedentary lifestyles, taking alcohol in more than recommended amounts, eating diets that are not heart-healthy, smoking cigarettes, and others.

On the connection between COVID-19 and air pollution, the cardiologist said: “Yes, COVID-19 particularly, and air pollution to a reasonable extent made the situation in Nigeria worse. Effect of COVID-19 on heart diseases was extensively discussed during a recent World Heart Day celebration.”

On causes of heart diseases in Nigeria, he said the most common cause of heart disease in Nigeria is high blood pressure, commonly called hypertension. Others, Onwubere said, are infections and other non-communicable diseases like diabetes.

On recommendations on how to address the situation, the cardiologist said the problems with hypertension are mainly the low awareness level and the current high cost of treatment in Nigeria. He said less than 20 per cent of Nigerians who are hypertensive in Nigeria are aware.

Onwubere said the World Hypertension League recommended World Hypertension Day to improve awareness globally, including in Nigeria in the month of May every year. He said most societies- NHF, Nigerian Cardiac Society, NHS and others- comply with this programme and other activities to address the problem.

On the association of trans-fats, energy drinks and palm oil with rise in heart diseases, Onwubere said: “Trans-fats and energy drinks should be taken in recommended amounts, otherwise they constitute great cardiovascular risks.

“Palm oil when taken in quantities greater than recommended amounts can cause heart disease.”

On the affordability of treatments for heart diseases, the cardiologist said treatment for most types of heart diseases is currently done with high out-of-pocket expenses and costs are out of reach by most Nigerians. He said the government needed to fund the health sector appropriately, as well as ensure effective health insurance programmes.

Also, in commemoration of World Heart Day 2022, a Member of the Nutrition Committee, NHF, Mrs Dolapo Coker, disclosed that globally, heart disease is the number one cause of death worldwide, claiming 18.6 million lives yearly.

Speaking at the World Heart Day 2022 in Lagos, last week, she disclosed that at least 80 per cent of premature death from heart disease could be avoided if five main risk factors—tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol and air pollution are controlled.

Speaking further, she noted that a new survey by World Health Federation highlights the global concern surrounding the link between climate change and cardiovascular disease, with climate change and air pollution ranked as the third most serious issue in relation to cardiovascular health among the respondents.

She added that healthcare providers must help improve cardiovascular health and prevent cardiovascular death mortality by issuing regular reminders to at-risk groups about the dangers of extreme weather events, including tips on managing excessive heat events.

The first lady of Lagos, Mrs Ibijoke Sanwo-Olu, called for a comprehensive approach and strategy to ensure that people are aware of the threat that the disease poses.

Represented by a member, of the Committee of Wife of Lagos State Officials, Mrs Patience Ogunubi, said: “I’m excited to know that NHF is aligning with World Health Foundation to address the challenge.”

She added that The-bike-A Heart initiative is a good development on the importance of physical exercise.

She noted: “Cycling must be encouraged. Lagos is taking the lead to boost Non-Motorised Transportation. The state is working on infrastructure to ensure seamless implementation of Non-Motorised Transport plans.”

She also advised Nigerians, especially the youths to desist from an unhealthy lifestyle, such as drug abuse, lack of regular exercise, smoking excessively, alcohol, sugary foods and lack of regular check- up.

Communication Advisor, NHF, Mr. Abiola Awe, explained that Bike-A-Heart Route initiative, which would take place in Lagos Island and Mainland next month, is to encourage Nigerians to embrace healthy lifestyles through cycling.

Corporate Communications and Branding Manager, Quest Oil, Gerald More, disclosed that the organisation is embracing cleaner energy such as solar. He also stressed the need for improved health quality.

Chief Executive Officer (CEO), i-Fitness, Folusho Ogunwale, noted that due to harmful health lifestyle heart disease is found in older people. Nowadays, he said younger generations are victims of heart disease.

Meanwhile, in one of the first studies to examine the relationship between different types of grain intake and premature coronary artery disease in the Middle East, researchers found a higher intake of refined grain was associated with an increased risk of premature coronary artery disease in an Iranian population while eating whole grains was associated with reduced risk.

The study will be presented at the American College of Cardiology (ACC) Middle East and the 13th Emirates Cardiac Society Congress, taking place in Dubai, United Arab Emirates, October 7-9, 2022.

According to the researchers, previous epidemiological studies have reported an association between different types of grain intake with the risk of coronary artery disease. The current study evaluated the association between refined and whole grains consumption and the risk of PCAD in an Iranian population.

Premature coronary artery disease (PCAD) refers to an atherosclerotic narrowing of coronary arteries in males under 55 years old or in females under 65 years old. It is often asymptomatic early in the course of the disease but may lead to chest pain (angina) and/or heart attack with the progressive development of narrowing (stenosis) or plaque rupture of the arterial wall. Risk factors for PCAD include smoking, high cholesterol, high blood pressure and diabetes.

“There are many factors involved in why people may be consuming more refined grains as opposed to whole grains and these cases differ between people, but some of the most important factors to consider include the economy and income, job, education, culture, age and other similar factors,” said Mohammad Amin Khajavi Gaskarei, MD, of the Isfahan Cardiovascular Research Centre and Cardiovascular Research Institute at Isfahan University of Medical Sciences in Isfahan, Iran, and the study’s lead author.

“A diet that includes consuming a high amount of unhealthy and refined grains can be considered similar to consuming a diet containing a lot of unhealthy sugars and oils.”

Whole grains are defined as containing the entire grain, while refined grains have been milled—ground into flour or meal—to improve shelf life but they lose important nutrients in the process. The 2019 ACC/American Heart Association Guideline on the Primary Prevention of Cardiovascular Disease recommends a diet that emphasizes the intake of vegetables, fruits, legumes, whole grains and fish to decrease heart disease risk factors.

The study recruited 2099 individuals with PCAD from hospitals with catheterization labs in different cities and ethnicities throughout Iran who underwent coronary angiography (women aged ≤ 70 and men ≤ 60). In total, 1,168 patients with normal coronary arteries were included in the control group, while 1,369 patients with CAD with obstruction equal to or above 75 per cent in at least a single coronary artery or ≥ 50 per cent in the left main coronary artery made up the case group.

Participants were given a food frequency questionnaire for dietary assessments to evaluate dietary behaviours and evaluate the association between whole grain and refined grain intake and the risk of PCAD in individuals without a prior diagnosis of heart disease. After adjusting for confounders, a higher intake of refined grains was associated with an increased risk of PCAD, while whole grain intake was inversely related to a reduced risk of PCAD.

“As more studies demonstrate an increase in refined grains consumption globally, as well as the impact on overall health, it is important that we find ways to encourage and educate people on the benefits of whole grain consumption,” Khajavi Gadkari said. “Tactics to consider include teaching improved dietary choices in schools and other public places in simple language the general population can understand, as well as on television programs and by continuing to do high-level research that is presented at medical conferences and published in medical journals. Clinicians must also be having these conversations with each other and their patients.”

Courtesy: The Guardian

Heart Failure now growing threat to health in Africa, Middle East -Experts

As Nigeria joins the rest of the world to mark the 2022 World Heart Day (WHD), researches have shown that the increasing rates of Cardiovascular Diseases (CVD) in Africa and the Middle East calls for concern.

Some regional experts in a report published in the Journal of the Saudi Heart Association have, therefore, called for urgent urgent action to stop and reverse the trend.

The report highlights that heart failure is associated with significant morbidity and mortality and considerably impacts patients’ quality of life, as well as incurring a substantial economic burden, with a total estimated cost of US $1.92 billion.

It notes that the average age a person will develop heart failure in the MEA region is significantly lower than elsewhere: Africa (53 years), Middle East (56.4 years), North Africa (58.79 years), Asia (60 years) and Europe (70 years).

The experts point to risk factors such as diabetes, obesity, smoking and socio-economic transition, marked by a sedentary lifestyle, lack of physical activity and high consumption of fatty foods, as the main contributors to the higher prevalence of heart failure in the region.

They also agreed that, in certain countries, high prevalence of existing infectious diseases such as tuberculosis shifts the focus and resources from non-communicable diseases like heart failure.
Global statistics

The experts said CVD, which remain the leading cause of death globally have continued to increase despite various preventive mechanisms.

CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebral vascular disease, rheumatic heart disease, and other conditions.

According to statistics from the World Health Organisation (WHO), about 17.9 million individuals die from CVD every year, accounting for worldwide fatalities of 31 per cent.

More than four out of five CVD deaths are due to heart attacks and strokes, and one-third of these deaths occur prematurely in people under 70 years of age.

Various researches have identified unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol as the most important behavioural risk factors of heart diseases and stroke.

At least 1.9 million people die from tobacco-induced heart disease yearly, the WHO said. It also indicates that smokeless tobacco is responsible for around 200,000 deaths from coronary heart disease per year.

However, health experts said Nigerians are still engaging in unsafe practices like tobacco usage and excess alcohol intake which are fueling increase in cases of heart diseases.
Situation in Nigeria

A cardiologist and Provost, College of Medicine of the University of Lagos, Idi-Araba, David Oke, said there is a paradigm shift in the CVD pattern in Nigeria and Africa generally.

Mr Oke said although CVD were less prevalent in the past, the number has increased in recent times due to unhealthy eating and lifestyles.

“In the past we used to have a lot of diseases with less prevalence, but now due to civilisation and what is happening in the so-called developed countries, we now have more of the non-communicable diseases,” he said.

He said heart failure is also getting on the increase due to the country’s failure to battle hypertension.

He said some persons suffer from heart failure as consequences of not treating hypertension.

“If we can’t battle hypertension because of the economic situation, if we can’t purchase the drugs that is neccessary, that is to say heart failure will get more prevalent,” he said.

Mr Oke said with the current economic crisis, Nigeria is heading to a point where each family will have someone with heart failure.
Risk factors

A Consultant Cardiologist at the Lagos State University Teaching Hospital (LASUTH), Ramon Moronkola, said there are many things that can affect the heart ranging from hypertension, diabetes, high cholesterol, obesity and some lifestyles.

Mr Moronkola said lifestyles like excess intake of alcohol and tobacco use which includes cigarette smoking, have a long-term negative effect on the heart.

“All these factors highlighted can affect the heart which then leads to heart failure, a condition where the heart is not working optimally to the level required to satisfy the body system,” he said.

He said the chances of survival of patient with heart failure can be compared to that of the deadliest cancer.

He said people must cultivate the habit of living healthy to prevent the killer disease.

Mr Moronkola also noted that the chances of survival for heart failure patients will be very low in the next five years except drastic action is taken now.

“In five years, the survival of patients that have heart failure, chances of survival is less than 50 per cent. In five years, more than half of such patients might likely die if there is no proper treatment,” he said.

The consultant cardiologist also said there are some non-modifiable risk factors that nothing can be done to prevent them. Some of them included race, age and heredity.

“An example is if one’s father, mother or relative has a heart condition, it is likely the person has inherited it.

“Age is another factor, the older you get, the higher the risk factor of becoming hypertensive or developing heart diseases,” he said.
Way Forward

According to a Professor of Cardiology, Department of Cardiology in Casablanca, Morocco, Ahmed Bennis, heart failure is a serious and growing threat to health in MEA, but it does not have to be this way.

Mr Ahmed said policymakers across the region must act now to prioritise heart failure and associated diseases, through better training for health workers, national registries to ensure the collection of quality data and improved access to novel therapies.

The report also points to the lack of community-level awareness and a high prevalence of associated conditions such as hypertension and diabetes, compounded by poor accessibility and affordability of healthcare, as major barriers to the prevention of heart failure in the region.

The report also urges policymakers to take the following steps to reverse current trajectories: Prioritise heart failure and its associated comorbidities alongside other infectious diseases; Develop and implement region-specific clinical guidelines on heart failure and create local data registries on heart failure.

It also calls for the training of health workers in early identification of high-risk patients, improved access to advanced diagnostics and training of primary care health workers to use the available technology and also enhancing access and insurance for novel therapies.
More awareness

A Consultant Cardiologist at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Gladys Ahaneku, said the awareness level on CVD is still very low in major parts of the country.

Ms Ahaneku said diseases like hypertension which used to be very rare in the 60s is now very high in the country.

“A lot of people that you see in the clinic are not even aware they have hypertension. Majority of them are only presented when there is an emergency,” she said.

She said some persons who are aware of their condition do not understand the severity.

She noted that education should be a part of the patient’s treatment procedure to keep them informed.

“If the patient is aware of the condition and the dos and don’ts, he/she will be better off for it and the society will also benefit from it at the long run,” she said.

Mr Oke, the cardiologist, said to end the menace of heart disease, more awareness is required especially in rural communities.

He said majority of NGOs focus on the urban areas hence neglecting rural communities where the message is most needed.

“Awareness is not at its depth, we need to pay more attention in providing awareness to those rural areas in the country then we will be good to go,” he said.
World Heart Day

The World heart day is marked on 29 September every year to raise awareness about Cardiovascular Diseases (CVD), their management, as well as their toll on the society.

The theme of the 2022 World Heart Day is ‘Use heart for every heart”.

The day which is founded by the World Heart Federation aims to draw attention to the behavior that can deter individuals from becoming predisposed to CVD, as well as to educate the masses on how to handle the potential risks associated with these diseases.

This includes an unbalanced diet, passive smoking, and lack of physical activity, which seem to be sufficient to stop 80 per cent of untimely deaths occurring from strokes and heart attacks.

The world heart federation noted that increased high blood pressure, increased blood sugar levels, being obese or overweight are all side effects of living a bad lifestyle that may harm the heart.

– Premium Times

World Heart Day: How to avoid 80% of heart-related diseases – NHF

The Nigerian Heart Foundation (NHF) says 80 percent of premature deaths from heart diseases can be addressed if tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol and air pollution are controlled.

Addressing a news conference in Lagos on behalf of the NHF, Mrs Dolapo Coker, Member, Nutrition Committee of the foundation, stressed the need to address carbon emissions by the government to reduce cardiovascular diseases.

She said that the World Heart Foundation (WHF) was calling for urgent action on climate change and health inequity, saying millions more lives now at risk from cardiovascular disease, “which is still the world’s biggest killer.”

“The year 2022 has seen historic heat waves and, with climate change disproportionately affecting the most vulnerable populations, we can expect a further widening of the gap in global cardiovascular healthcare equity.

“Climate change and related air pollution is already responsible for 25% of all deaths from cardiovascular disease, killing 7 million people annually.

Quoting Prof. Fausto Pinto, President of WHF, Coker said: “Millions of already vulnerable people are doubly exposed to extreme weather events and limited access to healthcare.

“World leaders must step up efforts on the two biggest threats of our time – climate change and global health inequity.”

Coker said that working hand in hand with the World Health Organisation (WHO), WHF was calling on governments, civil society, and global industry to meet net-zero targets, to tackle global warming and curb air pollution, and to deliver healthcare access for all .

“A new global survey by WHF highlights the global concern surrounding the link between climate change and cardiovascular disease with climate change and air pollution ranked as the third most serious issues in relation to cardiovascular health among the respondents.

“The survey also revealed that awareness of healthcare inequality is growing: in reply to a question about which global issues affected cardiovascular disease the most the second.

“The second most common answer was social inequality and access to healthcare.

“WHF is also urging healthcare providers to help improve cardiovascular health and prevent CVD mortality by issuing regular reminders to at-risk groups about the dangers of extreme weather events, including tips on managing excessive heat events.”

She commended all partner in the fight against heart diseases and promotion of healthy lifestyles in Nigeria.

In his goodwill message, Mr Foluso Ogunwale, the Chief Executive Officer, I Fitness, who described heart as most important organ in the body, decried prevalence of harmful lifestyles and physical inactivity among many Nigerians.

“If the heart is that much important, it means that at one point we need to match the brake and examine how we live over lives so that we can perhaps live a happy and healthier life.

“The issue of physical health, physical exercise and the issue of nutrition and harmful lifestyles that potentially cause heart diseases can be addressed,” Ogunwale said.

Another NHF’s partner, Quest Oil Group, said that the issue of heart health was a concern to the firm, hence the commitment to address carbon emissions to reduce heart risks.

Its Corporate Communications and Branding Manager, Mr Gerald Moore, said: “For us at Quest Oil, we believe that good health is good business and that is why we innovatively changed the energy mix that we provide our customers.

“We now have different systems that can change from fuel to gas. We have gas as our transition fuel. We also provide LPG which is cleaner fuel.

“We also started something innovative in our stations, which is to replace the existing fuel generators with the solar power system.

“We believe that will significantly reduce the carbon emissions and give out stakeholders the opportunity for a better health,’ Moore said.

In her remarks, wife of Lagos State Governor, Dr Ibijoke Sanwo-Olu, said it was extremely important that people desist from unhealthy lifestyles to build heathy population which in turn would enhance productivity in the state.

Sanwo-Olu, who was represented by Mrs Patience Ogunnubi, Member, Committee of Wives of Lagos State Officials, said that the increase in the statistics of cardiovascular disease called for comprehensive approach and strategy.

“This is to ensure that people are aware of the serious threat that the disease posed.”

She advised people to embrace deliberate lifestyles and choice that can help to address the trend.

Recall that the NHF has outlined a month long activities to mark the 2022 World Heart Day which include bike a Heart Route (cycling rides), medical health talks and check, walks, mini health exhibitions, distribution of fliers and i Fitness exercise.

More older adults should be checking blood pressure at home, study suggests

Only 48% of people age 50 to 80 who take blood pressure medications or have a health condition that’s affected by hypertension regularly check their blood pressure at home or other places, a new study finds.

A somewhat higher number – but still only 62% – say a health care provider encouraged them to perform such checks. Poll respondents whose providers had recommended they check their blood pressure at home were three and a half times more likely to do so than those who didn’t recall getting such a recommendation.

The findings underscore the importance of exploring the reasons why at-risk patients aren’t checking their blood pressure, and why providers aren’t recommending they check — as well as finding ways to prompt more people with these health conditions to check their blood pressure regularly. This could play an important role in helping patients live longer and maintain heart and brain health, the study’s authors say.

Past research has shown that regular home monitoring can help with blood pressure control, and that better control can mean reduced risk of death; of cardiovascular events including strokes and heart attacks; and of cognitive impairment and dementia.

The findings are published in JAMA Network Open by a team from Michigan Medicine, the University of Michigan’s academic medical center. The data come from the National Poll on Healthy Aging and build on a report issued last year.

The poll, based at the U-M Institute for Healthcare Policy and Innovation and supported by Michigan Medicine and AARP, asked adults aged 50 to 80 about their chronic health conditions, blood pressure monitoring outside of clinic settings, and interactions with health providers about blood pressure. Study authors Mellanie V. Springer, M.D., M.S., of the Michigan Medicine Department of Neurology, and Deborah Levine, M.D., M.P.H., of the Department of Internal Medicine, worked with the NPHA team to develop the poll questions and analyze the findings.

The data in the new paper come from the 1,247 respondents who said they were either taking a medication to control their blood pressure or had a chronic health condition that requires blood pressure control — specifically, a history of stroke, coronary heart disease, congestive heart failure, diabetes, chronic kidney disease or hypertension.

Of them, 55% said they own a blood pressure monitor, though some said they don’t ever use it. Among those who do use it, there was wide variation in how often they checked their pressure — and only about half said they share their readings with a health provider. But those who own a monitor were more than 10 times more likely to check their blood pressure outside of health care settings than those who don’t own one.

The authors note that blood pressure monitoring is associated with lower blood pressure and is cost-effective. They say that the results suggest that protocols should be developed to educate patients about the importance of self blood pressure monitoring and sharing readings with clinicians.

Source: Science Daily

World Heart Day: Experts alert to steep rise in heart attacks, stroke in Nigeria

THURSDAY, September 29th was World Heart Day (WHD) and cardiologists have alerted to a steep rise in cases of heart attack, stroke and kidney failure in the country.

Heart diseases, also called cardiovascular diseases, are heart conditions that include diseased vessels, structural problems and blood clots. Most common types are coronary heart disease, high blood pressure (hypertension), cardiac arrest, heart failure, arrhythmia, peripheral artery disease, stroke and congenital heart disease.

The theme of WHD 2022 is ‘Use Heart For Every Heart.’ The World Heart Federation has created this day to raise awareness about cardiovascular disease.

Cardiologists in interviews with The Guardian and in recent publications said cases of hypertension rose by about 700 per cent in 25 years, from 4 million people in 1995 to 27 million in 2020 in the country.

They said over 11 million Nigerians are living with diabetes, obesity and high cholesterol levels. They blamed hypertension and diabetes for the increased prevalence of stroke, heart failure, heart attack and kidney failure.
They insisted that diabetes, obesity, smoking, socioeconomic transition, marked by a sedentary lifestyle, lack of physical activity and high consumption of fatty foods, are the main contributors to the higher prevalence of heart failure.

The cardiologists also identified a lack of community-level awareness, and high prevalence of associated conditions such as hypertension and diabetes, compounded by poor accessibility, and affordability of healthcare, as major barriers to the prevention of heart failure.

They said heart failure is associated with significant morbidity, and mortality and considerably impacts patients’ quality of life, as well as incurring substantial economic burden, with a total estimated cost of US $1.92 billion globally.

They said the chances that an average age a person will develop heart failure in Africa is significantly lower than elsewhere: Africa (53 years), the Middle East (56.4 years), North Africa (58.79 years), Asia (60 years) and Europe (70 years).

The experts include Consultant Cardiologist with the Lagos University Teaching Hospital (LUTH), Dr. Akinsanya Olusegun-Joseph; Executive Director, Nigerian Heart Foundation (NHF), Dr Kingsley K. Akinroye; and Consultant Cardiologist, the University of Port Harcourt and Chairman, Hypertension Working Group, NHF, Prof. Osarentin James Odia.

Others are Professor of Cardiology, Department of Cardiology in Casablanca, Morocco, Dr. Ahmed Bennis, and Professor of Cardiology at the University of the Witwatersrand in South Africa, Dr. Eric Klug, in their study published Tuesday in the Journal of the Saudi Heart Association.

Meanwhile, to address the steep spike in heart diseases and the implications, the experts recommended massive awareness campaigns about heart diseases, causes and prevention with lifestyle changes that can keep the menace away.

They said energy drinks could predispose one to abnormal heartbeat, hypertension, heart attack and sudden death.

The cardiologists said palm oil is very good for the heart, but overheating or bleaching it can alter the property, convert it to bad oil, with increased chances of causing heart disease.

Olusegun-Joseph said: “The burden of cardiovascular disease (CVD) is on the increase in Nigeria. CVD accounts for a sizeable number of admissions in our hospitals, with over 30 per cent of CVD-related deaths yearly. Several studies from every region of the nation show this increasing trend of CVD morbidity and mortality.

“There is a significant increase of hypertension in the country with about one-third of the population hypertensive. The prevalence varies from one region of the country to the other, however, ranging from 20 per cent to over 45 per cent in some communities.

Studies show that the prevalence of hypertension has increased astronomically among Nigerians, from around 4 million in 1995 to over 27 million of the population as of 2020, and it is still increasing. Worse still awareness of hypertension is very low among our people, though slightly better than before. The same increasing trend is noted for diabetes mellitus with over 11 million Nigerians living with diabetes; obesity, and high cholesterol levels.

“The result of all these is an increase in the prevalence of stroke, heart failure, heart attack, and kidney failure which are now very common cases in our hospitals. There is hardly any day in the hospital that we don’t have more than four new admissions of people with stroke and heart failure, and more than two cases of kidney failure. On some occasions, we can have more than seven admissions of these diseases. Unfortunately, this is the trend in most of our secondary and tertiary hospitals.”

On the reason for the rise in heart diseases, Olusegun-Joseph said: “The reason for the increase in CVD that we are experiencing are multifactorial, mainly due to behavioral and lifestyle changes. There is an increase in poor lifestyle choices. People eat more processed food, increased salt intake, increased patronage of fast food establishments, increased sedentary lifestyle, increased poverty, increased stress (emotional, financial, mental, social etc), cigarette smoking, and increased obesity, including childhood and early adolescent obesity, polluted environment (increased dirty environment, increased noise pollution, increased fumes from generator set etc).”

On recommendations on how to address the situation, the LUTH cardiologist said: “The first and most important is what you are doing now- education and enlightenment of the populace. We must educate our people. There must be a massive campaign to drive awareness among our people about heart diseases, the causes and prevention with lifestyle changes that can keep it away!

“We must cut down on salt and high cholesterol intake. Exercise often, weight loss for those who are obese, intake more fruits and vegetables, smoking cessation, stop or reduction in alcohol intake, maintain a cleaner environment with no or very minimal air pollution, healthy drinks like smoothies, hibiscus drink, green tea, instead of sodas and refined, processed drinks.”

Olusegun-Joseph said trans fats predispose to heart disease by causing inflammation, predisposing to atherosclerosis, and causing endothelial damage. He said trans fat will cause an increase in bad cholesterol, and low-density lipoprotein (LDL), which can predispose to obesity, stroke, heart attack, and peripheral arterial disease.

The cardiologist said energy drink is a double barrel: firstly, it has very high caffeine content which can predispose to the abnormal heartbeat (arrhythmia), hypertension, heart attack, sudden death etc. “All of these have been reported in people following energy drink intake. Secondly, the excessive refined sugar in it will cause subclinical inflammation, predispose to atherosclerosis, obesity and diabetes to mention a few,” he said.

Does palm oil cause heart disease? Olusegun-Joseph said: “Palm oil is used to cook without excessively heating it is very good for the heart. It has tocotrienol, a very potent antioxidant. It also contains tocopherol, palm olein and other substances that promote heart health. However, overheating or bleaching of the oil can alter the property of the oil and convert it to a bad oil making it more atherogenic with increased chances of causing heart disease.”

Akinroye said Low and Middle-Income Countries (LMICs) such as Nigeria Nigeria bear almost 90 percent of the burden of premature deaths due to CVDs, as most individuals affected are between the ages of 45 – 74 years, resulting in low life expectancy rates.

Akinroye said, in Nigeria, the economic burden of CVDs on individuals and families is enormous. “Since post-COVID-19 era, the cost of treatment of CVDs has risen sporadically since payment is mostly by out-of-pocket spending,” he said.

Akinroye said hypertension is the commonest CVD affecting not less than 33 percent of the adult population. He said the main CVDs burdens are- hypertensive heart disease 48.9 percent, stroke 24.4 percent, heart attack ( coronary heart disease) 8.9percent, arrhythmias (irregular heartbeats), heart failure, cardiomyopathy and valvular heart disease from the remaining 17.8 per cent.

Odia said about one-third of deaths and disabilities from NCDs are due to heart diseases. He said this is borne out from hospital-based studies and a few population-based studies.

Odia recommended: “Public health advocacy, improved primary health care services. Funding for research and development in our tertiary hospitals. Assessable health insurance.”

Bennis said: “Heart failure is a serious and growing threat to health in the Middle East and Africa, but it does not have to be this way. Policymakers across the region must act now to prioritise heart failure and associated diseases, through better training for health workers, and national registries to ensure the collection of quality data and improved access to novel therapies.”

Klug said: “Whilst local guidelines are available in South Africa (click), too many lives are being cut short in this part of the world due to gaps in how we identify and treat heart failure. This problem also places a huge economic burden on already over-stretched health systems. This paper clearly lays out what needs to be done to avert further suffering. In honour of World Heart Day, we are calling on policymakers to turn words into action.”

The study urged policymakers to take the following steps to reverse current trajectories:
•Prioritise heart failure and its associated comorbidities alongside other infectious diseases
•Develop and implement region-specific clinical guidelines on heart failure
•Create local data registries on heart failure
•Train health workers in the early identification of high-risk patients
•Improve access to advanced diagnostics and train primary care health workers to use the available technology
•Enhance access and insurance for novel therapies

Source: The Guardian