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Take your heart in your hands, keep it safe – Joseph

By Paul Adunwoke
29 September 2019   |   3:06 am
Today is World Heart Day. Consultant Cardiologist at the Lagos University Teaching Hospital (LUTH) Dr. Akinsanya Olusegun Joseph explained to PAUL ADUNWOKE how to keep a safe heart

Today is World Heart Day. Consultant Cardiologist at the Lagos University Teaching Hospital (LUTH) Dr. Akinsanya Olusegun Joseph explained to PAUL ADUNWOKE how to keep a safe heart.

What are cardiovascular diseases?
CARDIOVASCULAR diseases (CVD) are a group of disorders that affect the heart and blood vessels. They are the leading cause of death globally and include- Coronary heart disease, Cerebrovascular disease, Hypertensive heart disease, Valvular heart disease, Congenital heart disease, peripheral vascular disease, Heart failure, heart muscle disease (cardiomyopathies), to mention a few.

Apart from Congenital heart disease, CVDs are largely chronic disorder developing, more often than not, insidiously throughout life and usually progressing to an advanced stage by the time symptoms occur.

What are the symptoms to watch out for?
There are varying symptoms and signs depending on the particular disease. Common complaints, however, include: exertional chest pain- central or left-sided chest pain that occurs during activities or exertion and relieved by rest or some specific drugs. For some patients, the pain can occur during an emotional outburst. Pain typically lasts a few seconds to minutes, can spread to the left shoulder and upper limb. In a worst-case scenario, the chest pain can occur at rest, can be very excruciating and may last for several minutes to hours or may in death when there is a heart attack.

Difficulty in breathing on exertion, which may progressively worsen to a point where the patient can be breathless at rest.

Difficulty in breathing while lying down, necessitating the need for more pillows to sleep. Worst case scenario, the patient will not be able to sleep even while sited, propped up. Also, the patient may wake up often, gasping for air.
Awareness of heartbeat, known as palpitation is also a common symptom. Irregular heartbeat (a major cause of palpitation) may be the patient’s complaint.

Cough, which may be dry initially, later becomes productive of whitish, frothy (foamy) sputum.

Progressively, worsening easy fatigability.

Patients with a stroke can present with sudden weakness of the face, arm, or leg, usually of one part of the body, with reduced or loss of function of the upper and/or lower limb of the affected part. Other symptoms include sudden onset of numbness of the face, arm, or leg, especially on one side of the body; sudden loss of balance or coordination.

Before stroke sets inpatient may have a sudden, transient loss of vision of one eye, lasting few seconds to minutes.
Patients with peripheral vascular disease can present with activity-induced numbness or pain, usually the lower limb, initially, which can progress to numbness/pain at rest of the lower limb.

How can cardiovascular diseases be prevented?
Prevention of CVDs ideally, starts during pregnancy and lasts until the end of life. The reason for this is because certain conditions or situation during pregnancy can predispose the unborn child to cardiovascular diseases. For instance, a woman who smokes and /or takes alcohol, especially during pregnancy can put the unborn child at risk of developing congenital heart disease (hole in the heart). A baby with intrauterine growth retardation(poor growth while in the womb), with resultant low birth weight, is at risk of developing CVD later in adult life when compared with babies born with normal weight. On the other hand, very big babies at birth (usually of diabetic mothers) have an increased risk of developing diabetes and CVD as well later in life.

The types of prevention can be divided into:
Primary prevention- targeted at those at high risk of developing a first cardiovascular event (e.g. men and women with combinations of smoking, elevated blood pressure (BP), diabetes or dyslipidemia). This basically involves lifestyle modification and treatment of the risk factors identified in such high-risk patients.

Secondary prevention- targeted towards those with established CVD (post-stroke, post Myocardial infarction). This is strategies aimed at preventing a recurrence of the CVD they had encountered. This also involves lifestyle modification, treatment of the risk factors, the CVD and co-morbidities.

Primordial prevention- measures targeted towards preventing the expression or appearance of risk factors. Measures put in place even before birth. This includes good antenatal care, avoiding risk factors that can predispose the unborn child to cardiac diseases like Congenital heart disease, for example, smoking as highlighted earlier, irradiation during pregnancy. Also avoiding infections especially TORCHES complex (TOxoplasmosis, Rubella, Cytomegalovirus, HErpes simplex, and Syphilis). Furthermore, as much as possible, every form of nutritional deficiencies should have been corrected before pregnancy to eliminate the deleterious effects (which can include congenital heart disease) on the unborn child. Educating the populace, especially our women is key in this regard.

Factors that will prevent the possibility of developing hypertension, diabetes mellitus, obesity, high cholesterol levels are also important in primordial prevention.

The prevention strategies can be personal (individualized) and/or population (institutionalized) based approaches. Individualized approach entails education, counseling on lifestyle modification, and treatment of risk factors. Institutionalized approach has to do with educating and increasing awareness of risk factors for CVD and how healthy lifestyles prevent CVD events. It also involves making policies targeted at reducing the risk factors in the larger society -, e.g- policies aimed at reducing salt and saturated fat content of foods, as well as smoking habits and tendencies. Tobacco and erring companies can be heavily tasked. Furthermore, we can have national days that will promote health e.g- National Walk for life day; National exercise day, National cycling day.

Companies, organisations, schools, local government areas can also imbibe the above institutionalised approaches. All these will help in having a health-conscious, and healthy society.

What types of food would help in preventing cardiovascular diseases?
Food is very important in the prevention of CVD, just as it can predispose to increased risk.
Heart-healthy eating: reduce your salt intake. Increased salt has been implicated as a risk factor for hypertension, heart failure, and heart attack. Reduced salt intake is not limited to table salt, but includes salty condiments.

Increase your intake of fish, especially those rich in omega 3 fatty acid like Salmon. They reduce the risk of atherosclerosis.

Increase intake of nuts like groundnut, cashew nuts, and walnuts. Cereals and whole grains like oatmeal are also heart-healthy.

Reduce cholesterol and fatty meals. This will help in reducing the risk of accumulation of cholesterol in the blood vessels with resultant reduction of atherosclerosis. Also, reduce your intake of sugary food and drinks, red meat and processed meal.

Increase the intake of fruits and vegetables. They have lots of antioxidants, which are beneficial to heart health, reducing the risk of atherosclerosis, heart attack as well as cancers. They also reduce the aging process and improve the health of other organs like the brain and the kidneys.

Stop or reduce alcohol intake. Increased alcohol intake can predispose one to hypertension, elevated fats, especially the Triglycerides and heart attack.

Stop smoking. Smoking increases the risk of developing hypertension, heart attack, heart failure. It also increases the risk of developing cancer, degenerative diseases of the brain like Alzheimer’s disease.