‘40% of adult Nigerians are hypertensive’

Dr. Kingsley Kola Akinroye

Dr. Kingsley Kola Akinroye

• Diabetes increases heart attack, stroke, coronary artery disease risk
Dr. Kingsley Kola Akinroye is the Executive Director of the Nigerian Heart Foundation (NHF), past Vice President of World Heart Federation (WHF) and Africa Epidemiological Association (AEA). Akinroye in this interview with The Guardian ahead of the National Summit on “Lipids and Cardiovascular Health in Nigerian Population” at the Nigerian Institute of Medical Research (NIMR), Yaba, Lagos on April 21, 2016, and the World Health Day (WHD), today, April 7, 2016, said among other things that the prevalence of hypertension in Nigeria is between 30 and 40 per cent in the adult population above the age of 15 years. CHUKWUMA MUANYA writes. Excerpts:

Why the national summit on lipids and cardiovascular health in Nigerian population?
The Nigerian Heart Foundation, in recognition of the rising prevalence of cardiovascular disease in Nigeria and the importance of Prevention through promotion of Heart-healthy diets is organising the Summit. The National Summit is being organised in furtherance to the 2013 World Health Assembly, which endorsed the Non Communicable Disease (NCD) Action Plan 2013 – 2020 and recommended promotion of healthy diets by Member States, International Partners and Non-governmental organisations.

The Summit participants will include researchers from universities, research institutions, Non Governmental Organisations (NGOs), and policy makers from Federal Ministry of Health, Federal Ministry of Agriculture and state ministries, National Agency for Food, Drug Administration and Control (NAFDAC), Standard Organisation of Nigeria (SON); international organisations and agencies; consumers, manufacturers of vegetable oils and other relevant stakeholders.

What does NHF intend to achieve by hosting the Summit? What assurances do we have that it is not just going to be a jamboree?
NCDs have been included in the Sustainable Development Goals, of which cardiovascular disease is the number one NCD in Nigeria. We are convinced that NCDs should be included in the National Health Plan of the country so as to achieve sustainable development goals. It is intended that the summit will support the World Health Organisation (WHO) target of reducing heart attack and stroke by 25 per cent by providing practical tools to prevent Cardiovascular Disease (CVD).

Nigerian Heart Foundation has been actively involved in the prevention of risk factors for CVD- tobacco, unhealthy diet, physical inactivity and alcohol consumption- and in policy implementation in the country as related to cardiovascular disease prevention example tobacco; which Nigerian Heart Foundation had been a strong partner with government and other NGO over the last 20 years that is with the enactment of Osun, Ekiti, Lagos States Tobacco policy and the National Tobacco policy.

In addition, Nigerian Heart Foundation has been involved in an initiative on the Heart Check Food Labelling programme, which has been in existence since 1998. It is a partnership between NAFDAC and food manufacturing companies in the country, which is in line with the role of other National Heart Foundations, in promotion of Heart healthy products. Examples are the Australian Heart Foundation, New Zealand Heart Foundation, Heart and Stroke Foundation of South Africa and American Heart Association.

It is our intention that Nigerian Heart Foundation should take its pride of place in Africa and issue a consensus statement on the controversial issue on the relationship between lipids and cardiovascular health in the Nigerian population. To achieve this objective, the summit has brought partners from the Federal Ministry of Health, Federal Ministry of Agriculture, National Institute of Medical Research (NIMR) and National Center for Disease Prevention and Control (CDC), NAFDAC, SON, other research institute, universities, Civil Society Organizations (CSOs), consumers, food manufacturers and other relevant stakeholders.

The outcome of this summit will encourage more needed research in this area, which has not been adequately dealt with and exchange of relevant information in cardiovascular health.

What is the statistics of heart disease in Nigeria? Is the situation rising or coming down?
Prevalence of hypertension in Nigeria is between 30 per cent to 40 per cent in the adult population, above the age of 15 years. Prevalence of Ischemic heart disease is uncertain, though rising; it is less than in 10 per cent of the adult population.

What are the common heart diseases in Nigeria?
Common heart diseases in Nigeria include cardiomyopathy, rheumatic heart disease, and congenital heart disease, which are at low prevalence.

We are aware that the situation for hypertension, ischemic heart disease is increasing in the population. In addition, the increasing prevalence is as a result of the increasing risk factors for cardiovascular diseases.

What are the contributing factors?
The contributing or risk factors are unhealthy diet, increasing physical inactivity and increasing sedentary behavior, increasing tobacco consumption, and increasing alcohol consumption.

What can Nigerians do to reduce the incidence of heart diseases?
The incidence of heart disease can be reduced by: promotion of healthy diets; less consumption of diets with high cholesterol, less salt in diets (less than 5gms in diets); reduce tobacco consumption; less sedentary activity/ increase physical activity; reduce alcohol consumption; and reduction of the mean blood pressure in the population and those with elevated blood pressure to use blood pressure tablets regularly.

The government should encourage the local manufacturing of hypertensive drugs. They should provide support for treatment centers, support initiative on cardiovascular rehabilitation centers. It is recommended that Nigeria should have about three to four cardiovascular rehabilitation centers, since stroke is the commonest consequence of hypertension in Nigeria.

What are the local and cheap solutions?
The local and cheap solutions include: promotion of healthy diets; less consumption of diets with high cholesterol, less salt in diets (less than 5gms of salt per day); reduce tobacco consumption; less sedentary activity/ increase physical activity; and reduce alcohol consumption.

Thursday April 7 is World Health Day with the theme Diabetes. What is the relationship between diabetes and heart disease?
Diabetes and Heart disease are both NCDs. They have common risk factors like hypertension, lipid disorders and obesity. Diabetes increases the risk of heart attack, stroke and coronary artery disease.

What are the roles of exercises and daily intake of aspirin?
Exercise reduces blood pressure, blood sugar. Physical activity is very important in prevention and management of CVDs. High sedentary activity increases cardiovascular disease. Daily intake of aspirin helps to improve blood flow in blood vessels especially the tiny blood vessels of the heart.

NHF has recently been endorsing some vegetable oils as heart friendly. Why?
There is high association between high level of blood cholesterol and cardiovascular disease. The availability of low level of cholesterol in the vegetable oils, presence of other chemicals that promotes healthy heart qualifies vegetable oils to be certified by Nigerian heart Foundation.

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