Burden of the heart: Cardiovascular diseases

Catherine Mwauyakufa, CNS Correspondent, Zimbabwe
To say that more poor people succumb to non communicable diseases (NCDs) as compared to the rich is not an understatement. One would wonder, why this co-relation between poverty and NCDs— if these diseases are non communicable how do they end up killing more poor people? Poverty stricken communities have little or limited recourse to healthcare, and hence access to medical screening is constrained and at times not available to them.

Cardiovascular diseases (CVDs), cancers, respiratory diseases and diabetes are the four main NCDs that account for 82% of all NCD deaths. As far as CVDs (group of disorders of the heart and blood vessels) are concerned, early detection is crucial in managing them. Another important factor is that people coming from families with a history of CVD have to be monitored and if found in need get early treatment. Now poverty plays a negative role as poor people fail to get health monitoring as required. An interesting survey taken by the Cardiological Society of India in 2015 revealed that 60% of the people were unaware that they had hypertension (high blood pressure). The total sample size was 74520 in 24 states covering 100 cities with 7500 volunteers and paramedics and the survey was done in 8 hours. 33% of the people surveyed were found to be hypertensive and their ages ranged from 31 to 45 years. Thus the disease can no longer be said to be a burden of the aged alone, as it used to be earlier. The survey also found that 60% of the people were not aware that they had hypertension (HTN).

Raised blood pressure is attributed to 13% of the global CVD deaths. An avoidable risk factor is tobacco use. CVD deaths in relation to smoking were 9%. Raised blood glucose stood at 6% while physical inactivity was at par with the latter. Obesity was just 1% lower and this growing challenge needs to be reduced. It is estimated that 1 billion people have hypertension, a silent killer. HTN often has no warning signs or symptoms. An optimal blood pressure of less than 120/80mm HG is recommended. In a webinar organised  by CNS for health journalists, Prof Rishi Sethi, Department of Cardiology at King George Medical University said that in India poor access to health facilities led to late detection of CVD with raised blood pressure being a risk factor. Controlling the risk factors is important if the chances of getting a heart attack or stroke are to be lowered. “Access to primary healthcare, which provides early detection and treatment for people at risk is poor in the low to middle income countries,” he added. There is a risk of uncontrolled blood pressure even for patients on medication for hypertension.

I spoke with Lucilla Ncobo, who has been on HTN treatment for the past 10 years. “I have been on high blood pressure treatment for 10 years. There are however, times that I have been admitted into hospital when the blood pressure rose to life-threatening levels. My family has CVD history and my dad died of heart attack. My younger sister once suffered a mild stroke that was attributed to HTN. We both observe a strict diet and take medication as prescribed,” said Ncobo, urging people to get regularly checked for high blood pressure. “High blood pressure is a silent killer and usually shows no signs with the exception when one has had a stroke or has even died,” she said. “Having blood pressure checked in health centres is done for free and I would advise that even persons not at risk should get it checked at least 3 times a year,” she pointed out. For those who raise their risk of getting a CVD from tobacco use, the only way for them to lower the risk is by stopping this habit. Within 2 years of quitting smoking, the risk of a coronary heart disease is substantially reduced and within 15 years, the risk of CVD returns to that of a non-smoker. Smoking may be pleasurable to those who do, but the risks with life-threatening consequences far outweigh that. There is no point in smoking oneself away to death.

Catherine Mwauyakufa, Citizen News Service - CNS
November 19, 2016