Cardiologist explains increasing death rate from cardiovascular diseases

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A renowned Cardiologist, Dr Okoh Basil Ewere, has decried the high incidence of   cardiovascular diseases which are the major cause of death worldwide.

Shedding light on the burden in Nigeria, Ewere, who consults at the EverCare Hospital, Lagos, said the 21st century has experienced unprecedented surge in communicable and non-communicable diseases (NCDs).

Prominent among the non-communicable diseases have been cardiovascular diseases also referred to as a group of disorders of the heart and blood vessels.

These include heart failure, strokes, rhythm abnormalities of the heart (arrhythmias), hypertension, diseases of the peripheral blood vessels (peripheral vascular disease) and heart attack (myocardial infarction) amongst others.

He said in Nigeria, reports of the sudden death of previously apparently healthy individuals either by slumping or not waking from sleep, were on the increase.

“The possibilities here are as a result of heart attack or stroke (brain attack.”

He regretted that deaths in the past had been attributed to influence of witches, wizards and ‘village people’.

“The average life expectancy in Nigeria as of 2022 is 55 -44 years as against 36.73 years in 1960. Thus, statistically we live longer now as we now have better health care facilities and probably better-balanced nutrition than in 1960.

“This, coupled with more industrialisation has brought sedentary lifestyle, more westernised diet and attending obesity, thus creating a paradigm shift from communicable diseases like cholera to non-communicable diseases like hypertension, diabetes and heart attack.

“Heart attack occurs when a part of the heart muscle does not get enough blood to function and when this persists, leads to death of that muscle.

“This shortage of blood results from a blockage within the lumen of the vessel. This blockage typically consists of fat deposition (arteriosclerosis) and platelets within the lumen leading to narrowing and eventually complete occlusion. This process of fat deposition did not just suddenly occur but has been accumulating gradually over months to years.

 “Fats are naturally and gradually deposited in our arteries as we age and may be part of our normal ageing process and not necessarily harmful but this process is accelerated by some risk factors; hypertension, diabetes, cigarette smoking, abnormal cholesterol levels, family history of heart attack, obesity, sedentary lifestyle and age.”

Further, he said heart attacks in the younger generation may not be due to fat deposition but illicit drugs like cocaine which speeds up the heart to dangerous rates that its blood supply can no longer cope with the demand from the heart.

“Some individuals pass a transition from chest pain on activity (Angina) which is a demand and supply mismatch and pain disappears when the exercise is stopped as heart rate returns to a point when the blood supply from the narrowed artery can cope. At the other end of the spectrum is complete blockage of the artery and heart attack results.

“When symptoms of a heart attack occur, the sooner you get to an emergency room, the sooner you can get treatment to reduce the amount of damage to the heart muscle. “

On treatment, Ewere explained that health care professionals can run tests to detect a heart attack and decide the best treatment.

“The blockage in the cardiac arteries can be ameliorated by dilating the lumen of the artery, hence blood can flow through. This is done in the cardiac catheterization laboratory. The numbers of such laboratories, thankfully, are increasing in Nigeria though not enough for a population of over 200 million people.”

On prévention of the devastating effects of cardiovascular diseases,  Ewere urged lifestyle adjustments and dietary modifications such as quitting smoking, exercising, diet and healthy eating, alcohol limit, and stress control. He said mortality from a heart attack is significantly high hence, prevention and early detection is key.

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