RESPONDING appropriately to the death burden from deadly non-communicable diseases such as Ischaemic Heart Disease and stroke has become one of the most daunting challenges confronting health authorities in many parts of the world. Although non-communicable diseases had long overtaken infectious diseases as the top killers in the world, the IHD, also known as Coronary Heart Disease, and stroke have been singled out as the most lethal, according to a new report by the World Health Organisation.
Going by WHO estimates, about 56.9 million people died across the world in 2016 from sundry causes. Out of that number, however, IHD and stroke emerged as the top killers, implicated in 15.2 million deaths, mostly in the low- and medium-income countries. Experts say the trend has not changed in the past 15 years. The two diseases lead a group of eight others that were responsible for more than 54 per cent of global deaths in 2016. Others include pulmonary diseases (3.0 million lives); lung cancer (1.7 million deaths); (diabetes, 1.6 million deaths); and a number of communicable diseases, including lower respiratory infections (3.0 million deaths).
In Nigeria, where statistics on any issue, including health matters, are largely unreliable, the mortality rate for heart-related diseases is estimated at 150,000 annually, but it could be more. The Minister of Health, Isaac Adewole, said that the number of Nigerians under the age of 50 years that were living with heart-related diseases stood at 23 per cent, with the prospect of a further increase in the coming years.
This is quite frightening and enough reasons for those in charge of the health sector globally to give these diseases the maximum attention that they deserve. Even the dreaded Human Immunodeficiency Virus that was once regarded as an automatic death sentence, accounted for one million deaths in 2016. This means that it could no longer be counted among the top 10 killer diseases. The situation is both a measure of how much effort has gone into controlling the spread of HIV and the extent of havoc being committed by the other diseases.
Ikechukwu Ogah, a Consultant Cardiologist at the University College Hospital in Ibadan, the Oyo State capital, captured it more vividly last year 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.”
CHD is defined by the British Hearts Foundation as the narrowing of coronary arteries by a gradual build-up of fatty materials in their walls, resulting in difficulty in oxygen-rich blood flowing into the heart. When the blood flow seizes completely, it results in a permanent damage to the heart, which is called heart attack.
On the other hand, stroke is a situation where blood supply to the brain is either reduced or completely interrupted, resulting in the denial of oxygen and nutrients to the brain. This could be as a result of the arteries being blocked or blood leaking into the brain. Consequently, the brain cells begin to die, leaving the person in need of urgent medical attention or even causing death.
Risk factors for these diseases include smoking, high blood pressure or hypertension, high blood cholesterol, lack of physical activity and being overweight or obese. Other factors that predispose a person to both heart disease and stroke include age, ethnic background or race, high salt intake, excessive alcohol intake, low birth weight and effect of other diseases such as diabetes or HIV. These are factors that people have to look out for.
Symptoms of a heart 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.
Unfortunately, considering the fact that both the CHD and stroke, like other non-communicable diseases, could be controlled by a mere lifestyle change, it is sad that many lives are still being lost to the diseases. This is partly due to lack of awareness, which prevents a lot of people from seeking medical advice or imbibing a healthy lifestyle that could help to protect their hearts.
At the personal level, there is the need to change from a daily routine of sedentary lifestyle to a life of more activity. Food intake should also change drastically from fried and processed food to more of vegetables and fruits. For those who are hypertensive, it is important to bring down the blood pressure through medication.
As Africans, who are more likely to suffer diseases such as hypertension, there is the need to cut down on the level of salt intake and to always check blood pressure levels. With age, one is more likely to fall victim to non-communicable diseases, which is why it is advisable to carry out check-ups regularly as one gets older.
At the government level, it is important for health officials to constantly avail themselves of statistics about death and causes of death so as to come up with health policies that would prevent frequent premature deaths. Above all, the government should ensure that there is a sustained programme of enlightenment so that people would know what to do about their health at all times. WHO advises, for instance, that “a country in which deaths from heart disease and diabetes rise rapidly over a period of a few years, for example, has a strong interest in starting a vigorous programme to encourage lifestyle to help prevent these illnesses.” We could not agree more.
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