Cardiovascular diseases: The world’s leading killer

Francis Okoye, CNS Correspondent, Nigeria
In a webinar organised for the media by Citizen News Service, in the lead up to World Heart Day 2016, health experts spoke on cardiovascular diseases (CVDs). They discussed ways and means to protect oneself from them, as they are the world’s leading cause of death, killing 17.5 million people every year.

The experts included Rachael Shaw, project manager World Heart Federation, Prof Dr Rishi Sethi, Department of Cardiology, King George’s Medical University KGMU, and Alice Granger Gasser, programme development manager, World Heart Federation. Ashok Ramsarup, former senior programme  producer at South African  Broadcasting Corporation (SABC) moderated the programme. It has been a year since our governments committed to achieve the sustainable development goals (SDGs) 2030, one of which is to reduce mortality from non communicable diseases (NCDs) by 1/3 by 2030. CVD is one of the 4 main NCDs—the other 3 being diabetes, cancer and chronic lung disease.

Facts about CVDs

CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, congenital heart disease and deep vein thrombosis, and pulmonary embolism. In 2012, 31% of all global deaths were attributed to CVDs, with 75% of them occurring in low and middle income countries. Majority of cardiovascular diseases are caused by risk factors that can be controlled or modified— high blood pressure, cholesterol, overweight/obesity, tobacco use, lack of physical activity and diabetes.

High blood pressure: Nearly 1 billion people have high blood pressure 2/3 of whom are in developing countries. 13% of the global CVD deaths are due to to hypertension.

Tobacco: Tobacco causes 9% of all CVD deaths. The risk of developing CVDs is higher in female smokers, young men and heavy smokers.

Diabetes: CVDs account for 60% of all mortality in people with diabetes.

Physical activity: Insufficient physical activity is the 4th leading risk factor for mortality from    CVDs. 3.2 million deaths are attributed to insufficient physical activity worldwide.

Cholesterol lipids: Raised cholesterol levels increase the risk of heart disease and stroke. 1/3 of all ischemic heart disease is attributed to high cholesterol. Raised cholesterol is estimated to cause 3.6 million deaths globally.

Obesity/over weight: 2.88 million people die each year as a result of obesity. Obesity is strongly related to CVDs risk factors such as type 2 diabetes, and raised blood pressure.

Smoking: There are about 1 billion smokers in the world, most of whom are at risk of CVDs.

Women’s health: 1/3 of all women deaths are from CVDs— one of the non modifiable risk factors for CVDs is gender. Men are at greater risk of having CVDs than pre menopausal women. However, once women are past menopause, the risks are similar, while for stroke no gender has less or more risk of it than the other.

How to protect oneself from CVDs

The World Heart Federation leads the global advocacy efforts for action to prevent, control and reduce the global burden of CVDs. Some steps suggested by the health experts are:

1. Get blood pressure checked regularly as high blood pressure is a silent killer, often with no warning signs or symptoms. Many do not know they have it. The best way is to buy a blood pressure monitor to check blood pressure daily or once in two days.
2. Quit smoking. Studies show that within 2 years of quitting smoking, risk of coronary heart disease is substantially reduced and within 15 years the risk of CVDs returns to that of a non smoker.
3. Be physically active. Experts say that we need to do at least 30 minutes of moderate physical activity 5 times per week, or 20 minutes vigorous physical activity 3 times per week.
4. Eat healthy. High intake of saturated fat, trans fat and salt should be controlled. High intake of fruits, vegetables and fish reduces the risk of CVD. WHO recommends salt intake of less than 5 grams/person per day to help prevent CVDs.
5. Avoid stress and depression as they double risk of CVDs.

Controlling risk factors and taking change of the heart can reduce chances of heart attack or stroke by more than 80%. According to World Heart Federation, addressing behavioural risk factors can prevent most CVDs. CVDs must be made a priority issue among decision makers like politicians, civil servants, and bureaucrats who have the power to implement solutions for impactful change. Policies that will lead to better heart health should be implemented. Decision makers mostly focus on disease treatment than prevention, and that too more of infectious diseases. We need a change of mindset. Cardiologists, physiologists, psychiatrists and journalists all have to join hands fighting and educating people about CVDs. The media should give attention to CVD agenda in the same way they have done with HIV. Efforts should also be made to reduce tobacco consumption in the world. NCDs are a huge barrier to development and economy and we cannot reduce NCDs without fighting CVDs. FCTC implementation and health system strengthening are important tools in the fight against CVDs.

 Francis Okoye, Citizen News Service - CNS
September 27, 2016

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