Physical exercise, healthy eating good for heart

As the World Heart Day is marked globally on September 29, Nigerians have been urged to engage in physical exercise and eat right foods, as these would help their hearts function optimally. In turn, this would go a long way in reducing the risk of having high blood pressure, diabetes and heart attack.

The heart can be made healthy with reduction of salt intake. High salt consumption has been implicated as a risk factor for hypertension, heart failure and heart attacks. However, reduced salt intake is not limited to only table salt, as it also includes salty condiments. Studies have shown that increased salt intake raises the risk of developing heart failure, stroke and renal failure, whether the patient is hypertensive or not.

On the other hand, it is beneficial to increase fish consumption, especially those rich in omega 3 fatty acid, such as Salmon. This reduces the risk of atherosclerosis, by increasing the level of good cholesterol in the body.

Other heart-friendly foods, according to experts include, groundnut, cashew nut and walnut. Cereals and such whole grains, as oatmeal are also heart-friendly, as they reduce bad cholesterol levels, increase the good cholesterol level, reduce blood pressure and the risk of developing hypertension and diabetes.

To have a healthy heart, there is also need to reduce intake of fatty meals, sugary foods and drinks, red meat, processed meal, smoking and alcohol.Increased consumption of fruits and vegetables is particularly helpful, as these have lots of anti-oxidants, which reduce the risk of atherosclerosis, heart attack, as well as cancers. They also reduce ageing process, and improve the health of other organs like the brain and kidney.

Akinsanya Olusegun Joseph, a Consultant Cardiologist with College of Medicine, University of Lagos, said cardiovascular diseases (CVD) are a group of disorders that affect the heart and blood vessels, which can be prevented through healthy lifestyle.

He said: “They are the leading cause of death globally and include, coronary heart disease, cerebrovascular disease, hypertensive heart disease, valvular heart disease, congenital heart disease, peripheral vascular disease, heart failure, heart muscle disease and cardiomyopathies, among others.

“Aside congenital heart disease, CVD are largely chronic disorders that develop more often than not, insidiously, throughout life and usually progressing to an advanced stage by the time symptoms occur.”

Joseph noted that there are varying symptoms and signs of CVD, depending on the particular disease. Common complaints, however, include exertional chest pain— central or left-sided chest pain that occurs during activities or exertion and relieved by rest or some specific drugs.

“For some patients, the pain can occur during an emotional outburst,” he explained. “Such pain typically lasts few seconds to minutes, and can spread to the left shoulder and upper limb. In worst case scenario, the chest pain can occur at rest, can be very excruciating and may last for several minutes to hours or may result in death, when there is heart attack.

“There is also difficulty in breathing on exertion, which may progressively worsen to a point, where the patient can be breathless at rest; difficulty in breathing while lying down, necessitating the need for more pillows to sleep. Worst case scenario is when a patient is not be able to sleep, even while seated or propped up. Also, patient may wake up often, gasping for air.

“Awareness of heartbeat, known as palpitation is also a common symptom. Irregular heartbeat, a major cause of palpitation, may be the patient’s complaint. There may also be cough, which may be dry initially, but later producing whitish, frothy foamy sputum, and progressively worsening easy fatigability.

“Patients with stroke can present with sudden weakness of the face, arm, or leg, usually in one part of the body, with reduced or loss of function of the upper or lower limb of the affected part. Other symptoms include, sudden onset of numbness of the face, arm, or leg, especially on one side of the body, as well as sudden loss of balance or coordination. Before stroke sets in, patient may have sudden, transient loss of vision of one eye, lasting few seconds to minutes. Patients with peripheral vascular disease can present with activity induced numbness or pain, usually the lower limb, initially, which can progress to numbness or pain at rest of the lower limb.”

He said prevention of CVD ideally starts during pregnancy and lasts until the end of life. The reason for this is because certain conditions or situation during pregnancy can predispose the unborn child to cardiovascular diseases.

For instance, a woman who smokes and takes alcohol, especially during pregnancy, can put the unborn child at risk of developing congenital heart disease or hole in the heart. A baby with intrauterine growth retardation, poor growth while in the womb, with resultant low birth weight is at risk of developing CVD later in adult life, when compared with babies born with normal weight. On the other hand, very big babies at birth, usually of diabetic mothers, also have an increased risk of developing diabetes and CVD later in life.

“Prevention can be divided into two types: Primary prevention, targeted at those at high risk of developing a first cardiovascular event. For instance, men and women with combinations of smoking, elevated blood pressure, diabetes or dyslipidemia. This, basically, involves lifestyle modification and treatment of the risk factors identified in such high-risk patients.

“Secondary prevention is aimed at those with established CVD (post stroke, post myocardial infarction.) These are strategies aimed at preventing a recurrence of the CVD they had encountered. It also involves lifestyle modification, treatment of the risk factors, the CVD and co-morbidities.

“Primordial prevention measures are targeted at preventing the expression or appearance of risk factors. This may include measures put in place, even before birth, like good antenatal care, avoiding risk factors that can predispose the unborn child to such cardiac diseases as congenital heart disease. For example, smoking, as highlighted earlier and irradiation during pregnancy.

“Also avoiding infections, especially torches complex toxoplasmosis, rubella, cytomegalovirus, herpes simplex, and syphilis. Furthermore, as much as possible, every form of nutritional deficiency should have been corrected before pregnancy to eliminate the deleterious effects, which can include congenital heart disease on the unborn child.”

Joseph explained that educating the populace, especially women, is key in this regard.Factors that prevent possibility of developing hypertension, diabetes mellitus, obesity and high cholesterol levels are also important in primordial prevention. Eating right, maintaining healthy weight, avoiding smoking and exercising regularly are all geared towards preventing development of risk factors.

This also means that very early in life, children are exposed to and taught importance of eating healthy diets, non-exposure to smoking, participation in regular exercise and sports in school.

Dr. Adeyemi Johnson, Chief Executive Officer of First Cardiology Consultants Clinic Ikoyi, Lagos, said there are many signs of heart diseases, which include hypertension, diabetes and chest pain, among others.

He said: “Hypertension is very common in Nigeria, it is very common in black people. It is very difficult to treat hypertension in black people, than in white people. Incidents of high blood pressure are very high in Nigeria, because of the diet. The average Western diet contains six grams of sodium, while average of Nigeria diet contains 12 grams, which means Nigerians eat a lot of salt. It comes from local foods, such as potato chips, noodles and cashew nuts, among others.

“Hypertension is known as a silent killer. We also have strokes, which is a result of uncontrolled hypertension or diabetes and many of these diseases do not have symptoms.

“We have started to have heart attacks. When I was in Medical School many years ago, throughout my years there, we had just one heart attack patient and he was from the United States. Today, we have seen many heart attack patients because of change in our lifestyles. We have adopted all the bad Western lifestyle. We have stopped exercising, we eat fatty foods, we don’t go to doctors and we do not take our drugs. Heart attack is described as pressure squeezing sensation in the heart.

“There is also heart failure, which occurs when the heart becomes very weak and it is not be able to carry out its functions properly. The major cause of heart failure in Nigeria is hypertension, while diabetes is the major cause of heart attack and stroke. Blindness, chest pain or being paralysed are all common signs of heart attack. Sometimes, the chest pain goes down to one arm of the chest, and sometimes both arms.

“When one is diagnosed with chest pains at the age of 40 and above, it should be taken seriously, because he/she is at risk of having other heart diseases. When someone’s heart-pump is not functioning properly or you discover you cannot sleep properly or you have swollen legs, all these are signs of heart failure.”