Experts decry increase in cardiovascular diseases due to poor lifestyles

Cardiovascular diseases are on the rise in Africa not only because of the foods but also because of the environment.

According to Kenya Cardiac Society president Bernard Gitura, obesity is among the leading causes of cardiovascular diseases (CVD) and can be described as an epidemic for Africa and Kenya.

“If we are going to win the battle to reduce cardiovascular diseases, we have to tackle this epidemic,” said Gitura.

He spoke during the 15th Pascar Congress being held in Mombasa.

He said cardiovascular care is expensive and there is a need to reduce the costs involved by doing more research on better ways to treat and encouraging governments to concentrate on prevention.

Despite the costs involved in treatment, governments still ignore preventive measures, which can make the cost of cardiovascular care cheaper.

According to World Heart Federation president Prof Fausto Pinto, 80 per cent of cardiovascular diseases, including arrhythmias, congenital heart disease, deep vein thrombosis, pulmonary embolism, among others, are preventable.

However, most governments, especially in Africa, spend less on prevention and end up spending more on treatment.

This is paradoxical, he noted.

“Globally, we are spending about 95 per cent of the health budgets on treatment. Only about five per cent on prevention” said Pinto.

According to cardiovascular experts, about 18 million people die of CVD around the world annually, the leading cause of mortality in the globe.

To put it into perspective, in the last two years, slightly over three million people have died of the Covid-19 pandemic around the world.

“So it’s taken two years to kill a sixth of the number of people who die from CVD. So CVD is unquestionably a very important, probably the most important pandemic that the world is facing,” said Mohamed Jeilan, the scientific chair of the 2021 Pan-African Society of Cardiology (Pascar).

Pan-African Society of Cardiology president Prof Saad Subahi said cardiovascular risk factors including obesity, hypertension, diabetes, smoking, dyslipidaemia, among others, are more very prevalent in Africa compared to the rest of the world.

“The highest prevalence of hypertension in the world is actually in Africa,” said Subahi.

He said the reduction of the risk factors can reduce mortality, with studies showing prevention can reduce CVD mortality more than treatment.

“In Africa, we have to concentrate on prevention because it is the easiest way to reduce mortality,” said Prof Subahi.

Pinto said their aim is to reduce primitive mortality due to cardiovascular diseases by a third by 2030.

“This is a very difficult target to achieve because of the problems we are facing globally,” said Pinto.

Research still remains key in coming up with policies to prevent CVD, he noted.

He decried the lack of support for some of the prevention measures.

“Preventing is better and cheaper than treating. That’s why we’re so much concerned with sometimes the lack of support for some of the prevention measures that we recommend,” said Pinto.

Pan-African Society of Cardiology (Pascar) secretary-general Elijah Ogola said the Covid-19 pandemic exacerbated the strain of CVD because Covid-19 has severe effects including death on people with underlying CVD.

“People that have heart diseases are at the highest risk,” said Ogola.

He said the pandemic also interrupted healthcare service thus disrupting the delivery of care for people with CVD.

Jeilan said he is happy a fully equipped heart attack suite has been established at the Coast General Teaching and Referral Hospital, a first outside Nairobi, in the public sector.

He said technologies that help in the care of CVD are costly because of the taxes that are imposed by the government in Kenya.

Gitura said the rural-urban migration and the fast urbanization of most African cities have put a strain on the lifestyle which has led to poor diets.

“People are not exercising enough because they are busy trying to find the next meal. People are more stationary and the diets have changed,” said Gitura.

The fast-food culture is pushing obesity and diabetes cases up, he noted.

“Increased cigarette smoking and excessive imbibing of alcohol amongst the youth is also putting the generation at risk,” said Gitura.

The challenge, he said, is to mitigate these issues.

“We know what to do but are we ready to do it?” posed Gitura.

Kenya Cardiac Society president said they are pushing for the inclusion of cardiovascular drugs and investigation equipment as basic requirements in hospitals.

He said the basic electrocardiogram (ECG) machine should be available in all health facilities.

He said cardiovascular investigations should also be included in the NHIF so that even outpatients can access the services via government funding.

“Another area we are pushing for is the inclusion of cardiovascular drugs in the essential list of drugs. For a very long time the essential drugs list from the ministry has not included most of the cardiovascular drugs that treat hypertension, cholesterol, etc,” said Gitura.

Pascar treasurer Prof Amam Mbwakwem called on African governments to increase budget allocation to health.

She said most people are paying out of pocket for cardiovascular treatment.

“We need to start eating a lot of fruits and reduce salt intake,” she said.

“And do more exercises.”

Jeilan said the process of getting drugs into Kenya has increased its cost due to high taxation as compared to other countries.

Subahi said the reduction of cardiovascular diseases is better done by prevention rather than treatment. But it needs education of the public on public health.

Many patients all over the world do not realise they have problems, he noted.

“Most of the hypertension patients do not recognize it. Most of those who recognize do not take treatment and most of those who take treatment are not well controlled,” said Subahi.

Pinto said educating children, from a very early age, about nutrition, is one way of preventing cardiovascular diseases.

“There is a whole new world of new medicine. But these are expensive and just continues our norm of being good at treating and bad at preventing,” said Pinto.