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| The contemporary Nigerian Socio-economic Conditions and Incidences of Cardiac diseases –what Management options are available. |
 PRINTABLE VERSION |
More often than not, societal pressures, job losses etc drive people into alcohol. Excessive alcohol intake usually gives rise to a feeling of temporary Dutch courage. A sour reality being that drinking too much alcohol can raise blood pressure, which increases the heart’s workload, and can lead to heart failure/stroke. It could also cause irregular heartbeat. Similarly, owing to work pressure and tight schedules, most Nigerians have less time for exercise, these leads to obesity especially in women. Indeed, excess weight increases the heart load. It also raises blood pressure and blood cholesterol.
Heart disease is the number one killer of women. A woman has a 50% chance of dying from her first heart event compared with a 30% chance for a man. Heart diseases are causing much havoc in the world, killing millions of people every year without warning or recognized symptoms and Nigeria is no exception. Unfortunately, heart related diseases have not been given its deserved attention despite its devastating nature. Sadly, many people may not consider themselves at risk. The world hypertension day (May 13, 2006) offered Nigerians another opportunity to be reminded of not only hypertension, but also other cardiovascular health in general. Urgent steps therefore have to be taken. What management options are consequently available?
Adverse risk factors maybe managed with respect to the natural history of the disease process. Three phases maybe identified: efforts to prevent the occurrence of adverse risk factors, management of established adverse risk factors before the occurrence of clinically manifested cardiac diseases and the management of risk factors after the disease development.
The most effective measures for the management of adverse risk factors will be aimed at the prevention of the occurrence of cardiac disease. This generally must start early in childhood. It involves establishing good health habits, proper nutrition in childhood without the intake of excess calories, engaging in vigorous but non-violent sports and prevention of Cigarette smoking.
The food and beverage industry will play a prominent role in reducing the high incidence of cardiac diseases by coming up with healthy food and beverages to Nigerians. Food and snacks with high salt content, high saturated fats content and refined carbohydrate must be discouraged. Maintenance of an ideal weight should be the starting point of any prudent diet. Moderate reduction of the amount of fat especially saturated fat coupled with a prudent decrease in the intake of cholesterol lowers the blood level of cholesterol by (5-15%). This can be achieved by replacing saturated fat with polyunsaturated vegetable fats and oils such as corn, cotton seeds, and soybeans.
Public enlightenment through the mass media is another veritable tool in preventing and managing heart diseases. Enlightenment should not only be carried out by health care professionals but also by every stakeholder in heart disease treatment and control- e.g. pharmaceutical companies, non-governmental organizations. Free screening exercises should also be conducted for members of the public. Enlightenment campaign should focus on cardiac disease risk factors mainly dietary factors, hypertension, smoking and physical activity. Efforts should be made to create a supportive physical and behavioral environment in keeping with the principles of social learning theory.
There are not many centers that deal with the treatment of heart diseases; among the available ones some are in the private sector and others in the public sectors. The level of cardiac manpower available in the country is low and the cost of cardiac medicare is not within the reach of the common Nigerian. Thus, the Nigerian government both at the federal and state level should as a matter of necessity make money available for the health sector especially in the procurement of heart treatment facilities.
Drug therapy is not left out in the management of cardiac disease. A number of hypolyridemic drugs are available for the treatment.
The age long saying that prevention is better than cure cannot be over emphasized. In fact, scientific evidence clearly demonstrates that treatment practices need to focus more on primary prevention rather than on managing individual risk factors in isolation.
REFERENCES
1. Environment Health perspective vol 110, Number 3, March 2003, available at http://www-ehponline.org/members/2002/110p.307-317htm (accessed 15th May 2006.)
2. Socioeconomic Differences in Avoidable Mortality in Sweden 1986-1990, International Journal of Epidemiology, vol 25, No23 June 1996 pg. 560.
3. The Seychelles Heart study II: Methods and Basic findings available at http://www. seychelles.net / study / at Issue /org 2.htm (accessed on 15th May 2006.)
4. UNESCUP Ministerial Conference on Environment and Development on Asia and the pacific 2000-held in Kitakyusha Japan 31 August-5 September 2000 pg 1-5
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ifeoma umeche
Ifeoma Umeche lives in Abakaliki.
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