Rampaging heart diseases: More prevention for fewer surgeries

Cardiovascular disease has gone epidemic in Nigeria. Most disturbing is the surging demography of ailing young and old that cannot access expensive corrective surgeries. Without excusing the place of efficient and affordable care for the sick, most germane is the primacy of preventive care that should slow the rate of supposedly healthy Nigerians coming down with heart-related ailments.

Globally, Cardiovascular Diseases (CVDs) are some of the leading causes of death. The World Health Organisation (WHO) estimated that heart ailments account for more deaths than all infectious diseases combined; taking a projected 17.9 million lives yearly! CVDs are a group of disorders of the heart and blood vessels, and include coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other conditions. More than four out of five CVD deaths are due to heart attacks and strokes, and one-third of these deaths occur prematurely in people under 70 years of age.

Besides lifestyle causative factors, the Association of Cardiovascular and Thoracic Surgeons of Nigeria (ACTSON) noted that eight out of every 100 children in Nigeria are born with congenital heart diseases like hole in the heart.

Hence, over 55,000 children are born every year with heart diseases. Shockingly, the association hinted that a whopping 80,000 people now require heart surgery yearly. In 2022, however, only 212 heart surgeries were done nationwide – for reasons not unconnected with the cost of care, availability, and other sad realities of the moribund health system.

Notably, there are few numbers of cardio-thoracic surgeons in our country that has over the years relied on foreign health missions and medical partnerships to prune down numbers on the waiting list. Currently, according to ACTSON’s last check, there are only 60 cardio-thoracic surgeons catering for Nigeria’s over 200 million people. That is grossly inadequate, and a no-brainer that the sick, who also have the misfortune of being poor, are on borrowed time.

That dire situation, which is the reality of most Nigerians, has more than ever before made expedient the preventive alternative. For a fact, the most important behavioural risk factors of heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. The effects of behavioural risk factors may show up in individuals as raised blood pressure, raised blood glucose, raised blood lipids, and overweight and obesity. These “intermediate risks factors” can be measured in primary care facilities and indicate an increased risk of heart attack, stroke, heart failure and other complications.

Tellingly, changes in lifestyle can improve or even prevent cardiovascular diseases. Against the backdrop that smoking is a major risk factor for heart disease, quitting is one of the best ways to reduce the risk of heart disease and its complications. Also, it is important to eat healthy foods rich in fruits, vegetables, and whole grains; and limit sugar, salt and saturated fats.

In addition, maintain a healthy weight and ensure regular health checks to know your numbers, and whether you need to take action as high blood pressure and high cholesterol can damage the heart and blood vessels. Again, regular exercise helps control diabetes, weight, high cholesterol and high blood pressure, which are conditions that may put a strain on the heart.

In addition, it is incumbent on all to, as much as possible, manage stress, and practice good hygiene by regularly washing hands and brushing/flossing your teeth to keep yourself healthy. Good sleep habits are highly recommended by experts, because poor or routine inadequate sleep may increase the risk of heart disease and other chronic conditions. Where lifestyle changes prove inadequate, regular health checks will be priceless in early detection and timely remedy that saves the hassles of complications, and pains of surgeries.

Unfortunately, heart surgeries are as risky as they are the exclusive preserve of the very rich in Nigeria. In a country where almost 90 million people live in extreme poverty, how many Nigerians can afford $10,000 average cost of an open heart surgery?

In several parts of the world, and some African countries including Sudan, Uganda, and Egypt, governments pay for heart surgeries to lift the cost burden off the emotionally frail shoulders of the sick. Regrettably, such OHS treatment framework is weak and appalling in Nigeria.

Notwithstanding, it raises the need for legislation and policy on cardiac surgery, to enable patients access surgeries at affordable rates at both private and public health facilities.

Above all, the time has come for all hands to be on deck, to lead the charge on prevention and early diagnosis of the rampaging disease. Relevant Ministries, Departments and Agencies of government (MDAs), Nollywood and NGOs should, through the mass media, continue to sensitise Nigerians on the causes, prevention, and consequences of late detection, as well as harp on early checks that lays the foundation for better outcomes of treatments.

Since everyone has a role in addressing the disease burden, it is also important that more individuals and groups should look in the direction of equipping heart centres in public hospitals, to ensure better access to care.