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Reducing Cardiovascular Diseases in Nigeria

Practise Manager, The Grays Cardiology Centre, Bisola Audifferen addressing Lagosians during the awareness programme to mark 2017 World Heart Day in Lagos recently

Decades ago, the most feared killer health challenge globally was infectious diseases, with millions of people losing their lives especially in developing and underdeveloped countries. But not anymore! Cardiovascular diseases are the new nightmare, spreading subtly but consistently into many homes, leaving tears, sorrows and deaths across the globe.

Data from the World Health Organisation (WHO) has consistently shown that cardiovascular diseases (CVDs) are the leading cause of death globally. The 2010 WHO Global Status Report on NCDs shows that in 2008, the four major NCDs; cardiovascular diseases, diabetes, cancers and chronic respiratory diseases put together killed 36 million (63 per cent) persons out of the 57 million global deaths recorded. Of these, CVDs rank number one with 17 million deaths (48 per cent) out of the 36 million NCD deaths.

Cardiovascular diseases were once previously thought to affect only developed and high income countries, but many developing, and even third world countries like Nigeria are beginning to feel the impact of the disease.

In Nigeria, over half a million people died from non-communicable diseases (NCDs) in 2012, and one out of every five Nigerian adults over the age of 30 will likely die prematurely from NCDs, including cardiovascular diseases.

Worse still, indices suggest the disease is substantially on the increase in the country as people continue to model their lifestyle and habits towards unhealthy living, thereby becoming more susceptible to the diseases.

Of the several cardiovascular diseases, experts say hypertension, closely followed by stroke is the most prevalent CVDs in Nigeria with many of the affected population unaware they are hypertensive or living with any of the deadly cardiovascular diseases, as they often do not present symptoms.

Although the current exact prevalence of hypertension in Nigeria is unknown, estimates from the last national survey conducted in 1990/92 which was published in 1997 put the prevalence of hypertension at over 20 per cent, suggesting that one out of every five Nigerians is hypertensive.

Current hospital record estimates showed that the prevalence of hypertension is 25 per cent while estimated mortality from stroke is 40 – 50 per cent within the first three months of diagnosis. Another hospital-based study showed that 39 per cent of those who survived stroke after three months died within 12 months and the remaining one per cent developed severe disability.

It is in tackling these deadly but silent killer, that experts from Grays Cardiology Centre, Lagos, are advocating for change in lifestyle, healthy living, regular checkups and proper management of the heart.

The Medical Director, Grays Cardiology Centre, Lagos, Dr. Soe Moe Aung, who is also an Associate Professor of Cardiology, while speaking to THISDAY during the Centre’s awareness programme to commemorate this year’s World Heart Day, said almost half of all adult Nigerians have one form of cardiovascular disease or the other, adding that this calls for awareness creation on prevention, regular check up and treatment of the rising health challenge.

He said there were two main factors for cardiovascular diseases, which are genetic and lifestyle.
“There is the genetic factor, which no one can do anything about, and there is the lifestyle factors which we can be modified. Overweight, lack of exercise, smoking, excessive intake of alcohol, poor dieting, are part of the risk factors that must be avoided,” he noted.

On his part, the Clinical Director, Grays Cardiology Centre, Dr. Okechukwu Usim, said one of the major problems associated with cardiovascular diseases is that they often do not present symptoms, except damages have been done to the body organs.

“That is why as we commemorate World Heart Day, the major thrust of our message is regular screening, because that is a major key to identifying the issues early, otherwise correcting them will begin to pose threats.”

Prevention and causes
Usim said ways of preventing cardiovascular diseases include healthy active lifestyle, healthy eating, exercise, and the stoppage of unhealthy habits like smoking and excessive drinking.
“A healthy active lifestyle is the number one key to chasing away cardiovascular problems. Nigerians’ current attitude of sitting for long is not helpful. We should engage in at least 150 minutes of moderate exercise per week.

“Secondly, the saying that we are what we eat is very true. If we eat well, we will be well. If we eat badly, our health will go badly. The right things to eat are fruits, vegetables and natural foods. We should discourage eating processed foods,” he added.

He called on Nigerians to stop certain habits if they want their hearts to remain healthy. “The chief of these bad habits is smoking. This fries out our arteries leading to heart attack, stroke or even sudden death. Once we can avoid smoking, whether first hand or second hand it will go a long way in saving our hearts and lives. Also, excessive alcohol intake should be discouraged. But moderate intake of alcohol like red wine is okay to keep the metabolism well,” he added
He added that overweight could contribute to cardiovascular diseases.

He said as a general guide, it was best Nigerians do health screenings regularly so they can tackle any likely health issue on time, as late detection is often a problem in many health issues, especially on cardiovascular diseases.

“We often say as a general guide, before one enters primary school, that child should undergo a health check. If someone enters secondary school, there should also be a basic check. But the problem we often have is adults seem to be overtaken by work, without realising that our health is also very important.”

Management and treatment
Also, Usim explained that many cardiac problems are treatable. “For high blood pressure, treatment is of two folds. First is lifestyle and the second is medication. For some people, lifestyle alone can correct the blood pressure, for others, they may need both lifestyle and medication.

“Another thing is the cholesterol level. Once one has excess fat in the system, the likelihood of these fats deposited in the blood vessels cause progressive occlusion of the arteries leading to blockage. If it happens in the heart it causes heart attack, if it’s in the brain it causes stroke,” he added.

Continuing, he said: “when someone has a heart attack, we have new drugs that can bring he heart back to life. If the person is brought on time to Grays Cardiology Centre, the technologies and drugs we have here can put the heart back in shape.

“Once the person is brought here on time, we access the vessels, go to the heart, identify the blocked artery, open it up and put in a stent. It’s a perfect cure for heart attack. It’s called coronary angioplasty and angiography.

“Before, when someone has a heart attack, it’s almost like a doomsday. But with our technology the person’s life can be saved. We have saved many at this centre,” he added.

According to the Practice Manager, Grays Cardiology Centre, Mrs. Bisola Audifferen, part of the programmes outlined to commemorate the day is holding series of lectures to enlighten Nigerians on prevention, management and treatment of cardiovascular diseases.

“We are doing free blood pressure check, free Basic Mass Index (BMI) check, glaucoma check, free X-rays, visual acquits check, free resting electrocardiogram check, free resting blood sugar check, free consultations, among others.

“Those who will be diagnosed of high blood pressure and other issues will be booked for a follow up and will be given a 50 per cent treatment voucher which is only valid for October, 2017. So such patients will not have to pay full treatment fee, but half. We also make sure we emphasise to people that it’s not all about consultations, but diagnosis and treatments which all work together to provide quality care.

“As part of our corporate social responsibility, we also do health talks in public gatherings, social clubs and companies where we emphasise the need for healthy lifestyle. This is because at Gray’s Cardiology Centre, we believe the heart is a very vital organ, so people need to know how to manage it through lifestyle choices,” she explained.

While encouraging Nigerians to get free blood pressure check any time of the year at the centre, at 6 Ladipo Bateye Street, GRA, Ikeja, she said Grays Cardiology Centre boasts of state-of-the-art modern equipment including art stress echocardiogram, resting electrocardiogram, 24 hours ambulatory monitor, ECG, two bed intensive care units, ventilators, infusion pump, syringe, and several other automated equipment.

“The medical director here is an associate professor of Cardiology, there are other in-house cardiologists and cardiology nurses working round the clock. So we have the personnel that can give critical care for the survival of persons with cardiovascular issues.”

But with elitist ambience and facilities mostly seen in developed countries, Audifferen says treatment at the centre is not expensive. “I always tell people that because they come into a building with state-of-the-art equipment and classy environment doesn’t make the place expensive. I tell them a standard healthcare facility should naturally be like that. What we are actually doing is to let people know this is what an ideal hospital should be.

“We are not expensive but we are very competitive. Registration here is N5,000. We are the first independent cardiac centre on the Mainland. And you should check other hospitals, you can’t pay N5,000 registration to see a cardiologist. The least you get is N10,000. But here, it is N5,000. I have once paid N35,000 to see a specialist in another hospital for just 10 minutes,” she added.

Audifferen noted that since the centre opened June 16 this year, they have seen over 400 patients.



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