Experts warns on the increase in heart disease cases and deaths to commemorate world heart day

To mark the World Heart Day (WHD) today, medical experts have alerted to spike in heart disease cases and death in the country. They blamed the situation on rise in smoking, diabetes, high blood pressure, obesity and air pollution.

According to them, heart disease is the number one cause of death worldwide, claiming 18.6 million lives per year, followed by cancer. Studies show that heart disease deaths have increased since 2019, while deaths from cancer dropped slightly over the same period.

The experts, however, noted that at least 80 per cent of premature deaths 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.

The medical expert bodies include: the Nigerian Heart Foundation (NHF), World Heart Federation (WHF), American Heart Association and the World Health Organisation (WHO).

Executive Secretary, NHF, Dr. Kingsley Kola Akinroye, told The Guardian, yesterday, that the gradual increase in the prevalence of heart disease in Nigeria is a major concern, as it is the commonest cause of death in adult population. Akinroye said hypertension is the number one heart disease affecting not less than 10 million adults in Nigeria and only about one-third are on effective treatment.

Akinroye, who is also a cardiologist, said a recent study from Lagos documented hypertension as the most common co-morbidity among COVID-19 infected individuals, and is a primary cause of high mortality.

“The lockdown of COVID-19 pandemic significantly affected the care and treatment of individuals with hypertension. This has continued to worsen with drastic reduction in the workforce of health personnel in Nigeria (doctors and nurses) in the last 18 months, who migrated to other countries,” he said.

Akinroye further explained: “Since late 2019, the pandemic has added a disturbing storm for the heart. Though heart disease claims the lives of 18.6 million per year, the 520 million people living with heart disease worldwide have been disproportionately affected by COVID-19. People with COVID-19 and heart disease are among those with highest risk of death and of developing severe conditions.

“In addition, the fear of the virus led to a sharp decline in hospital visits by heart patients for routine and emergency care, and unfortunately while patients steer clear of hospitals, their health is compromised further.

“Heart disease has many causes from smoking to diabetes, high blood pressure, obesity and air pollution. Over the last 10 years in Nigeria, the proportion of people suffering from the above risk factors is rising sporadically.”

Also, a consultant physician and the Medical Director of Cardiocare Multispecialty Hospital, Dr. Oyindamola Awofisoye, has lamented the alarming increase in cardiovascular-related deaths in the country, adding that the burden in Nigeria is highly underreported.

Cardiovascular disease is a significant public health concern responsible for 11 per cent of over two million Non-Communicable Disease (NCD) deaths in Nigeria yearly. It is also responsible for a high burden of morbidity and disability. Most people with the disease are not aware until catastrophes like stroke, heart attack or death occur.

Awofisoye said: “We have many Nigerians coming down with heart attacks, heart failures every day and a lot of these people had to pay out of pocket for their procedures while many people are unable to fund this kind of care in many situations.

“You are aware of people who develop breathing problems and suddenly slump and die. This is one of the many ways in which heart disease can manifest.”

Awofisoye advised Nigerians to live a healthy lifestyle and do screening intermittently as well as have their blood pressure checked regularly once they are getting up to 35 – 40 years.

He said: “Unfortunately, many Nigerians still take pride in making statements like, ‘I have not been to the hospital before, I have never checked my blood pressure before because I am not feeling anything.’ No, it is not supposed to be like that. We don’t have to live with that mindset. The risk factors for this kind of heart blockages can be identified early and also corrected early.”

Akinroye, on his part, reinforced the need for not only individual behavioural change, but societal change.

“The theme for WHD this year is ‘Use Heart to Connect’ and NHF is asking individuals, professionals, communities and governments to “use heart to connect to make informed choices for society, loved ones and ourselves.”

He further explained: “The theme for this year is a call to action about using our head, influence and compassion to beat heart disease, Nigeria’s number one killer. Over the last 18 months, the Nollywood industry has lost a lot of stars and we clamour for a change in this trend. Nigerian Heart Foundation is calling the government of Nigeria for recognition and urgent protection of our only surviving and growing industry in the country, Nollywood.”

Speaking further, Akinroye said equity in healthcare and rapid development in digital care will reduce inequalities, thereby transforming the diagnosis, prevention and management of heart disease in lower and middle-income citizens and ultimately reducing the fatality rate in the country.

The cardiologist called for effective integration of heart diseases in the Basic Health Care Provision Fund (BHCPF) and inclusion in the state social health insurance benefit packages in all the 36 states and the Federal Capital Territory (FCT).

“The government will through this implementation of National Health Act of 2020, reduce the number of illness and death from heart disease in a bid to achieve WHO target of 25 per cent reduction in heart disease mortality by 2030.

“Also, a healthy eating plan, weight loss and improved aerobic fitness can significantly reduce blood pressure and improve heart health in people with resistant hypertension – a condition in which blood pressure remains high despite the use of three or more antihypertensive medications.”

According to a new research published yesterday in the American Heart Association’s flagship journal, Circulation, people with treatment-resistant hypertension successfully reduced their blood pressure by adopting the Dietary Approaches to Stop Hypertension (DASH), eating plan, losing weight and improving their aerobic fitness by participating in a structured diet and exercise program at a certified cardiac rehabilitation facility.

Uncontrolled high blood pressure (130/80 mm Hg or higher) despite the use of three or more medications of different classes, including a diuretic to reduce blood pressure is a condition known as resistant hypertension.

Although estimates vary, resistant hypertension likely affects about five per cent of the global population and may affect 20 per cent to 30 per cent of adults with high blood pressure. Resistant hypertension is also associated with end-organ damage and a 50 per cent greater risk of adverse cardiovascular events, including stroke, heart attack and death. Diet and exercise are well-established treatments for high blood pressure.

In June 2021, the American Heart Association advised that physical activity is the optimal first treatment choice for adults with mild to moderately elevated blood pressure and blood cholesterol, who otherwise have low heart disease risk.