Cardiovascular diseases still on ‘rampage’ as world marks ‘Heart Day’
In recent times, over 17.1million lives are said to have been lost annually to the global burden of cardiovascular diseases (heart attacks and strokes) and other non-communicable diseases. However, according to the World Health Organisation (WHO), this figure represents a leading threat to global health and development.
With over 80 percent of CVD-related deaths occurring in developing countries like Nigeria, India, China, etc. which can least afford the social and economic consequences associated with the disease, these figures are projected to rise further to almost 23.6 million people by 2030, a move that is said to seriously affect the number of people who contribute to the Gross Domestic Product (GDP) of any nation.
Giving these worrisome indices, health experts have tasked Nigerians to maintain healthy lifestyles through healthy diet, regular physical activity and avoid tobacco smoke even as a comprehensive and integrated action by government and stakeholders in the health sector is needed to prevent and control CVDs in the country.
While noting that the theme for this year’s celebration “One world, one home, one heart” is aimed at enlightening people on the growing incidence of CVDs globally with a view to seeking measures of reducing heart-related diseases, Akinroye stated that at household level, sufficient evidence is emerging to prove that CVDs contributed to poverty.
According to the Akinroye, “For example, catastrophic health care expenditures for households with a family member with CVD can be 30 percent or more of annual household spending. At macro-economic level, CVDs place a heavy burden on the economies of countries in Africa, including Nigeria and this calls for attention.
“Currently, a large proportion of people with high cardiovascular risk remains undiagnosed and often even those diagnosed have insufficient access to treatment. When diagnosis is made, it is frequently at a late stage of the disease, when people become symptomatic and are admitted to hospitals with acute myocardial infarction or stroke and when costly high-technology interventions are required for treatment,” Akinroye disclosed.
For Anam Mbakwem, consultant nephrologist, Lagos University Teaching Hospital, (LUTH), Idi Araba, Lagos , although there is no country- wide data on cardiovascular diseases in Nigeria , the prevalence of hypertension in the country is estimated at 20 percent.
While noting that CVDs has been shown to form the bulk of admissions in the nation’s academic hospitals, Mbakwem revealed that the mean duration of admission is between 5 and 6 hours, with approximately 34 percent dying within 1hour of presentation and about 50 percent dying in less than four hours. The commonest cause of death is stroke.
“While cases of hypertension are expected to rise as population ages, an estimated 75 percent of amount spent on hypertension is related to hospitalisation cost. Risk factors associated with heart disease and stroke include raised blood pressure, cholesterol and glucose levels, smoking, overweight, obesity and physical inactivity,” Mbakwem stated.
Over the past decade, the world have been strengthening efforts to fight the growing burden of CVD with policy changes to combat tobacco use, advances in medicine and a new recognition for the need to prioritise non-communicable diseases, including CVD, as a public health emergency which would positively affect the lives of millions of people around the globe.
Against the milieu of success, one must not forget that CVD continues to be the number one killer worldwide; hence the need for further improvements in heart health in Nigeria to identify the challenges still ahead and make recommendations as to how these can be addressed cannot be over-emphasised.
For Mbakwem, “Early detection is key to improving outcomes of CVDs. Affordable tools (e.g. clinical measurements, laboratory investigations, cardiovascular risk assessment charts, and affordable blood pressure measurement devices) needs to be available at healthcare institutions across the country for early detection of people with disease and those at high risk. Since CVDs are asymptomatic in early stages, such tools need to be proactively utilised to detect those at risk of developing heart attacks or strokes.
Echoing the sentiments of Mbakwem, Akinroye noted that if rising trends of cardiovascular diseases are to be halted and reversed, current approaches to addressing them need to be reformed. He maintained that at present, the main focus of health care for CVD in Nigeria and other developing countries is tertiary care-based.
“Tertiary care, including stroke units, coronary care units and rehabilitation units, play an important role in improving outcomes of people who suffer CVD events. However, balancing investment in primary, secondary and tertiary care is vital for sustainability of CVD programmes.
“Furthermore, unhealthy behaviours of people, including tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol, need to be modified. These behaviours are shaped by economic growth, globalisation, urbanisation, social determinants and corporate influences. Health literacy, individual efforts and health education by health professionals can play an important role in modifying these behaviours. However, changing the behaviour of people is difficult and cannot be accomplished by such efforts alone,” Akinroye noted.
Lending his view, Sidney Smith Jnr., president, World Health Federation, noted that policy makers and medical professionals urgently need to work together to develop policies and strategies to improve medical care for patients of low socioeconomic status and minority groups, and develop methodology for their implementation.
“Healthcare professionals should be made aware of health disparities and how to address these via medical education campaigns, policy makers and health system should promote health resources to ensure adequate treatment reaches minority groups and those of low-income,” Smith concluded.
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