The heart, our vital organ, beats silently, sustaining us by pumping blood throughout our bodies.
As we commemorate Heart Health Awareness this September, Merilynn Steenkamp, General Manager, Southern Africa Multi-Country Network at Roche Diagnostics, says we are reminded of the importance of heart health and caring for our most vital organ.
However, cardiovascular diseases (CVDs) have become alarmingly prevalent across South Africa and the rest of the continent. So, what can we do to take better care of our hearts?
Non-communicable diseases (NCDs) are expected to surpass infectious diseases in Africa within this decade. In South Africa, they already have.
According to Discovery, mortality rates from NCDs have surpassed those of HIV/Auidsa and tuberculosis combined since 2018. Among these NCDs, cardiovascular disease has emerged as the leading cause of death in the country.
Common risk factors contribute to the burden of three major CVD in Africa: hypertension, cardiomyopathies, and atherosclerotic diseases. These factors have contributed to increased rates of stroke and heart failure.
The African region, with its population of over one billion people, significantly contributes to the global burden of cardiovascular disease.
In 2019, more than one million deaths in sub-Saharan Africa were attributed to CVDs, accounting for 5.4% of all global CVD-related fatalities and 13% of all deaths in Africa. CVDs now stand as the second leading cause of death on the continent.
‘’To address these alarming statistics, we need to reflect on ourselves. Risk factors for CVDs are interconnected, much like the circulatory system powered by the heart.
“High blood pressure (hypertension) alone is responsible for over half of CVD-related deaths in Africa. Additionally, as of 2021, 24 million adults between the ages of 20 and 79 in Africa were living with diabetes,’’ Steenkamp explains.
Living with heart disease has lifelong implications, as highlighted by the SA Heart and Stroke Foundation. Recovery and rehabilitation are necessary after a heart attack or surgery.
Many types of heart disease require ongoing treatment and lifestyle changes due to persistent symptoms.
Preventing existing heart disease from worsening and causing further cardiac events, such as heart attacks or strokes, is crucial for those living with the condition.
Noting that, “The great news is that up to 80% of heart diseases and strokes that happen before the age of 70 years can be prevented by simply living a healthy lifestyle and treating conditions such as high blood pressure, high cholesterol and diabetes.”
Given the current context of the African burden of heart disease, several factors have brought us here. Rapid urbanisation and changes in lifestyle in Africa have led to an increase in sedentary habits, unhealthy diets and high-stress levels.
And it is known that increased salt consumption, low dietary potassium, obesity, and physical inactivity can play an essential role in the occurrence of both hypertension and diabetes, said Steenkamp, adding that: “Beyond changing diets and lifestyles, many African countries face challenges, including widespread poverty and malnutrition and significant gaps in providing adequate healthcare services to their populations.
“Access to medical facilities, especially in rural areas, is limited, leading to delayed or insufficient diagnosis and treatment of CVD and other health conditions.”
Diagnosis of non-communicable diseases, including CVD – the first and arguably most crucial step, at least at the beginning of any patient’s healthcare journey – remains underfunded compared to communicable diseases like malaria, tuberculosis and HIV.
More than anything, households in sub-Saharan Africa bear an immense and increasing financial burden due to cardiovascular diseases.
Due to the low levels of health insurance coverage, particularly in SSA, CVD predisposes families to catastrophic health expenditure, like many chronic health disorders.
The four A’s – Awareness, Action, Assessment and Access
Awareness begins at home
“To drive greater awareness for patients, it’s important to remember that lifestyle choices can influence cardiovascular health. Behavioural risk factors for heart disease and stroke can include an unhealthy diet and physical inactivity.
“Other severe risk factors include tobacco use and harmful use of alcohol,” advised Steenkamp.
Incidentally, alcohol is the most abused substance in South Africa. Data shows that between 7.5% and 31.5% of South Africans have an alcohol problem or are at risk of developing one.
The per capita consumption of alcohol in South Africa is 11 litres – the most in Africa.
CVD warning signs to look out for include raised blood pressure, increased blood glucose, raised blood lipids and obesity. These “intermediate risk factors” can be assessed at most primary care facilities.
Any heart-related illness is potentially dangerous. But we can take action to control our risk factors by making lifestyle changes and prioritising diagnosis.
As motivational speaker Josh Shipp said, “The choice does not belong to fate; it belongs to you.” Let’s build a cascade of better CVD management across Africa through awareness, action, assessment and driving access to diagnosis and care for every patient.