By Azoma Chikwe and Ngozi Nwabuisi

 

The human heart is an organ that pumps blood throughout the body via the
circulatory system, supplying oxygen and nutrients to the tissues and removing carbon dioxide and other wastes. If the heart is not able to supply blood to the organs and tissues, they’ll die.
In humans, the heart is roughly the size of a large fist and weighs between 10 and 12 ounces (280 to 340 grams) in men and eight to 10 ounces (230 to 280 grams) in women, according to experts/ The heart has four chambers: two upper chambers ,the atria, and two lower ones, the ventricles. The right atrium and right ventricle make up the “right heart,” and the left atrium and left ventricle make up the “left heart.” A wall of muscle called the septum separates the two sides of the organ.
The heart beats about 100,000 times per day, (about 3 billion beats in a lifetime).
An adult heart beats about 60 to 80 times per minute. The hearts of newborns beat faster than adult hearts, about 70 to 190 beats per minute. The heart pumps about 6 quarts (5.7 liters) of blood throughout the body. The heart is located in the center of the chest, usually pointing slightly left.
Study shows that about 700,000 people suffer heart attacks in the United States, and around 120,000 die yearly. It is unfortunate that such research data are not available in Nigeria, apparently most people die of heart attack in Nigeria too. Heart attacks and other form of heart disease are the leading cause of death among Americans and every other part of the universe.
Thus, if one experience a heart attack, it’s essential to act quickly to maximize the chance to survive. Notifying emergency services within the two minutes of attack and receiving medical attention may mean the difference between life and death. So, if people who suffer heart attack should seek emergency medical attention at once, they may survive.
Chief Executive Officer, Tristate Heart Foundation, Dr Olukunle Ariyo Iyanda,. lamented that deaths caused by Coronary Heart Disease in Nigeria reached 2.82 per cent (53,836) of total deaths in 2014, according to the World Health Organisation. “Even worse is the fact that only one percent can afford the cost of treatment or surgery.

Control eating habit
Dr Lawrence Agyeman Serebo has advised people to control their eating habit to enable them to stay healthy at all times. He said eating more fruits and vegetables is very good for the heart which controls the whole body.
“Eat fish high in omega such as salmon; tuna, mackerel, herring and trout, a handful of healthy nuts such as almonds or walnuts will satisfy your hunger and help your heart, berries are chock full of heart healthy phytonutrients and soluble fiber.
“ The best way to look after your heart is with a healthy lifestyle in order to achieve and maintain a healthy wealth.Smoking increases the risk of developing cardiovascular diseases
which includes coronary heart disease and stroke. Smoking damages the lining of your arteries leading to a build up or fatty material(atheroma) which narrows the artery. This can cause angina, a heart attack or a stroke. Chemicals in cigaratte smoke cause the cells
that line blood vesseis to become swollen and inflammed. This can narrow the blood vessles and can lead to many cardiovascular conditions.
“Heavy drinking can make you more likely to get serious health problems like liver disease, cancer and peptic ulcers among others. Regular or high alcohol use can hurt your heart and lead to diseases of the heart muscles called cardiomyopathy. Drinking alcohol regularly
also can raise your blood pressure,” he said.

Non-Communicable Disease
Shedding more light on the prevalence of heart diseases,Minister of Health, Prof. Isaac Adewole , said, “Nigeria is experiencing demographic and epidemiological transition like the rest of the world, such that Non-Communicable Diseases(NCDs) are becoming a leading cause of deaths. The burden of NCD’s emanates primarily from cardiovascular diseases (hypertension, stroke, coronary heart disease), diabetes mellitus, cancers, sickle cell disease and chronic obstructive airway diseases including asthma. Other leading causes of morbidity and mortality include mental health disorders, violence and road traffic injuries. This group of chronic diseases exerts a lot of stress on our socioeconomic life and put significant strain on the very fragile health care infrastructure.

Disease burden
“The WHO data has consistently shown that cardiovascular diseases (CVDs) are the leading cause of death globally. The 2010 WHO Global Status Report on NCDs shows that in 2008, the four major NCDs namely cardiovascular diseases, diabetes, cancers and chronic respiratory diseases put together killed 36 million (63%) persons out of the 57 million global deaths recorded. Of these, CVDs ranks first with 17 million deaths (48%) out of the 36 million NCD deaths.
“ Furthermore, the 2014 report showed that in 2012, the 4 major NCDs claimed 38 million (68%) lives out of the world’s 56 million deaths, and over 40% of the deaths were premature deaths under the age of 70 years. CVDs alone killed 17.5 million people representing 31% of all the global deaths and 46% of NCD deaths.
“ Over 75 per cent of the CVD deaths occurred in low-income and middle-income countries (LMIC), of which Nigeria is one. During the same period, heart attacks and strokes alone accounted for 80% of all the CVD deaths, and together they all to the top three causes of years of life lost due to premature mortality.
“In terms of prevalence, hypertension is the leading CVD in Nigeria and the world at large. Although, the current exact prevalence of hypertension in Nigeria is unknown, extrapolation from the last national survey conducted in 1990/92 which was published in 1997 put the prevalence of hypertension at over 20 per cent, suggesting that one out of every five Nigerians is hypertensive.
“ Current hospital records estimates showed that the prevalence of hypertension is 25% while estimated mortality from stroke is 40 – 50 per cent within the first three months of diagnosis. Another hospital based study showed that 39 per cent of those who survived stroke after three months died within 12 months and the remaining 12 per cent developed severe disability.
“ We should not be too surprised about the figures stated so far because we know that sudden deaths are commonplace and everyone seated here can recall immediately recent cases of prominent Nigerians who have died suddenly and majority of these are probably due to heart attack, stroke or diabetic complications.
“ We can also easily call to mind numerous relatives and friends who are living with disability resulting from stroke or limb amputation from diabetes. I can also say without fear of contradiction that at least 5 out of 10 adults have elevated blood pressure and more than half of these are not aware of their situation. This is frightening because the dire consequence of neglected hypertension is stroke without warning.
“ The economic consequences are enormous. Deaths from these causes mean permanent loss of livelihood and affected individuals who survive loss productivity and in both cases the families suffer. Socially it is traumatic for the affected individuals who survive as they are virtually dependent on others for even most routine of chores and this can be psychologically devastating. Family members who take care of these individuals are also unproductive and families can plunge into penury for these reasons.
“The cumulative economic losses due to NCDs under a ‘‘business as usual’’ scenario in low – and middle-income countries have been estimated at US$ 7 trillion in 2011-2025. This sum, far outweighs the annual US$ 11.2 billion cost of implementing a set of high-impact interventions to reduce the NCD burden (WHO NCDs Global report 2014).
“ In Nigeria, the economic loss from heart disease, stroke and diabetes alone was estimated by WHO at US$400 million in 2005 and projected to rise to US$8 billion in the next 10 years unless we take drastic and sustained actions. Otherwise, we will keep counting loses.”

Risk factors
Prevention is not only better but also cheaper than cure, it is important to leverage commitment and enthusiasm to advance this course. Fortunately, the NCDs share common risk factors.
The major NCD risk factors are use of tobacco products, unhealthy diet, harmful alcohol intake, physical inactivity and air pollution. These factors are aggravated by poor awareness, harmful cultural practices, beliefs and misconceptions by the public.
Tobacco use is the most sjgnificant risk factor of NCDs and accounts for 80% of the six million premature deaths annually in low and medium income countries including Nigeria. 5.6% adults (4.5 million adults) currently use tobacco products out of which 4.1 million are men and 0.45 million are women. In addition, 29.3% of adults (6.4 million adults) are exposed to tobacco smoke when visiting restaurants, hotels and other public settings.
Alcohol consumption is another risk factor and this is quite high in Nigeria, with a per capita consumption of 10.57 litres to rank among the highest in Africa. So also is physical inactivity. About 30.3-74.6 per cent of Nigerian children and youths aged 5-25 years are not sufficiently active (NHF, 2013) and 80 per cent of working class adults in urban areas in Nigeria do not meet the WHO recommended level of physical activity.
Adewole said, “ Unhealthy diets contribute significantly to the development of NCDs in Nigeria. Sadly, there is widespread low consumption of protein, fruits and vegetables and increasing patronage of fast food outfits by the population. There is also large promotion of sweetened products such as carbonated drinks, pastries, candies, and other refined sugars, while excessive intake of salt is promoted by food additives such as monosodium glutamate (MSG) common in local delicacies such as suya, kilishi, isi-ewu, ngwo-ngwo, among others. The high caloric intake resulting from refined sugars promote overweight and obesity especially in a country where exercise is not a form.
“You will recall that in the not too distant past, noncommunicable disease were erroneously believed to be the problem of the affluent. But the reality is that both the rich and the poor are affected and the poor actually bear the greater brunt for obvious reasons.
“ The poor generally find it more difficult to access requisite health care services for prevention and adequate management of NCDs. The reason is not all financial. They also usually have a lower levels form education, which constrain them from adopting preventive measures. Also they are more exposed to some risk factors especially air pollution arising from use of inefficient fuel for cooking.

Lifestyle
“ I want to also use this opportunity to advise Nigerians to adopt healthy lifestyles to stem the rising tide of cardiovascular and other NCDs. To this effect, I am advising that fruits and vegetables should be included in every meal we take. Fatty foods and fizzy drinks loaded with sugar should be reduced and possibly avoided.
“ Every individual should do minimum of 30 minutes physical exercise per day at least five times in a week. Alcohol, when necessary, socially should be taken sparingly and binging should not be done. Similarly tobacco in any form must be avoided and conscious efforts must be made to maintain tobacco smoke free environment,” he said.