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Over the last few years, many young celebrities have died from cardiovascular diseases. Gone are the days when those who usually suffer stroke are elderly people in their 60s, 70s. Nowadays, young people in the 40s suffer stroke, heart attack, hypertension and worse still, the life expectancy has been put at 52 years. Why is this so? Why are more and more celebrities dying of these preventable lifestyle diseases? “It’s because many people take their health for granted,” explained Dr. Gbolade Taiwo Lasisi, a Consultant Physician Cardiologist. Dr. Lasisi runs Dominion Cardiac Centre in Ikeja, Lagos. “Yes, we have issues that are related to cardiovascular risks factors; risk factors that are related to the cardiovascular systems can make an individual prone to the risk of death, or risk of Cardiovascular issues or complications” What are these risk factors? “We have so many risk factors around us and the prevalent incidence of these risk factors are increasing in our environment.
Take Hypertension for example, it is very common in our environment. The incidence of Hypertension is increasing. Number one, we have people that are hypertensive, that we have diagnosed, people that have been diagnosed and are taking treatment but they are not well controlled. Then there are people who have not been diagnosed at all, that are not taking treatment; all those come together to form a large pool of people that can have issues with their blood pressure that can make them have complications. Then we have those with Obesity too; Obesity can make you prone to Cardiovascular issues. We also have issues with Diabetes. Diabetes combined with Obesity of course increases the possibility of that person having hypertension. We have sedentary lifestyle as a factor and we have High Cholesterol in your blood. All those put together can give that individual complications.
The incidence of Obesity and sedentary lifestyle are increasing because people don’t want to exercise. Diabetes too is on the increase because of what we eat; so the incidence of Diabetes is climbing. It’s not surprising that we are having increase in complications from all these issues coupled with inadequate medical attention. People don’t pay enough attention to their health, especially those that don’t take the proper treatment and are not well controlled.
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What is the link between High Blood Pressure and Hypertension?
“They are one and the same. High Blood Pressure means the Blood Pressure is elevated, but we term it as Hypertension is if it’s persistently elevated. That person is at risk if it is persistent. If you measure it the 2nd or 3rd time and it is persistently elevated, then that individual is hypertensive, particularly if the person is persistently above 140/90.
In other words, Hypertension is high blood pressure that is sustained.” How does High Blood Pressure lead to Stroke? “Let’s take a look at it. What does the heart do? The heart pumps blood to the whole body, the brains and to all the major organs of the body. It pumps this blood through what we call Blood Vessels, starting from the big blood vessels to the medium and small vessels that supply the brain.
Hypertension literally will give you an idea of the force or rate at which the blood goes through these blood vessels. The more the force, the more you have an effect on these small vessels. With increase in Blood Pressure, two things can happen to the small blood vessels. It can either rupture under high blood pressure in, we call that Hemorhagic Stroke. It’s a form of bleeding to the brain, meaning that person has suffered a stroke.
Then again because of that, sheer pressure hitting the walls of the vessels can make you develop what you call Atherosclerosis which may lead to blockage and once the blockage occurs , gradually, total blockage will occur and it will lead to a form of stroke.
So it can lead to 2 forms of strokes. Ischemic Stroke which is the blockage of tiny vessels and that part of the brain that is affected will lose its functions and will lead to a rupture leading to Hermorrhagic Stroke. Stroke has to do with the brain.”
What’s the link between High Blood Pressure and all the other ailments like Kidney and Liver Problems?
“All these major organs can be damaged by blood pressure. Like the kidney, the kidney is supposed to be perfused by blood coming from the heart. When you have sustained blood pressure, the blood pressure itself also gets transported to the kidney. It damages the kidney and the person comes down with kidney disease or chronic kidney disease.
Initially, the kidney will start leaking protein which is a sign of early kidney damage. Eventually, it will affect the ability of the kidney to filter waste product from the body and that’s when we talk of Renal Failure and as it gets more severe, it affects the blood vessels of the kidney. That is called End Stage Renal Failure. These are end organs that are targeted by hypertension.
In other to cope with this increase in Blood Pressure, the heart has to pump more and in trying to pump more, it develops Hypertrophy, where the walls of the heart thicken. If it thickens in an effort to pump more blood, eventually, it is going to affect the functions of the heart. The heart will not be able to pump again. It dilates and it leads to heart failure.
Also, the blood vessels supplying the heart may be affected by these things. Cholesterol will get deposited in the wall of the blood vessel or the coronary arteries. Those too can be blocked. Once it is blocked, that is what causes Heart Attack”. What’s the difference between Stroke and Heart Attack? “You can term Stroke to be Brain Attack,” He says. “And if the blockage occurs in the heart it is Heart Attack.
With this scary scenario painted, is it possible to avoid suffering all these health challenges?
“Oh yes, the good thing is that they are largely preventable, because there are risk factors involved. All you need to do is to address all these risk factors. What causes High Blood Pressure? With age, Blood Pressure tends to go up. The major thing is to make sure that you are screened to find out if you are hypertensive or not. High Blood Pressure can be controlled. If Blood Pressure is controlled you can actually control and reduce all these complications. So you have to address the issue of blood pressure. Check if you have a family history or when you are more than 40, or even less than 40 and you have the issues of Blood Pressure, make sure you get screened; test and know your Blood Pressure. If it is persistently above 140/90 then you need to check it out”
How?
“There are different ways to do that. There are different measures starting with lifestyle modifications. You can modify your lifestyle, regular exercise, brisk working, for example for 45 minutes, 4 times a week, that is enough to reduce blood pressure. It reduces blood pressure to some extent and prevents diabetes and it can reduce the overall Cardiovascular risk that the person has.
Exercise is really very important. The Blood Pressure can be well reduced by all these lifestyle modifications. You can also reduce you salt intake, you can reduce your weight. The individual can also be placed on medication. If you are on medication you can do fine, once the blood pressure has been brought down to acceptable limits, less than 140/90. You can actually prevent all these complications”.
How about Diabetes?
“It is also a question of diet, weight and lifestyle. So if you address all these things, watch your diet, do regular exercise, if you reduce your weight and keep your weight on acceptable levels, you can actually prevent Diabetes and if you have Diabetes, you need to adjust your diet, or take medications to keep your blood pressure within acceptable limits”
How about the issues of Cholesterol?
“You have values of acceptable Cholesterol in the blood. Once we know the of acceptable level for that person, apart from diet, there are medications to bring them down. So, all these things are largely preventable. You can prevent them by screening and by treating them once they are present”.
Dr. Lasisi was asked why many of those who suffer such health challenges, these days are younger people. In years gone by, many of those who suffered Hypertension and other health challenges are usually those aged 60 and above. Why has the age dropped to 35 and above. Why are many young executives and corporate players being hit by all these debilitating diseases?
“You are right. What we have noticed now is that unlike before where these complications actually start from middle age, now as early as in their 30’s you tend to see people having high blood pressure.
It has to do work and lifestyle. We have found out that people who live in urban setting have a tendency to have high blood pressure and the blood pressure tends to increase compared to people in the rural setting.
So, the stress of urban life, stress of daily work, lack of attention to their health, combine to increase the prevalence of these ailments largely in young people.”
Does the increase in all these lifestyle issues have anything to do with reduction in Life Expectancy Rate in Nigeria? “Yes. Majorly, there is one thing that I have noticed in many young people. Most young people tend to believe that they are okay. That they don’t need medical attention and they keep going and wait it is too late when they already have complications.
Once you are in your late 30’s or you are in your early 40’s you are no longer young. You might be young in mind but you need to check your self. Many young people bring their aged father to the clinic for checkup , but for them to check themselves up is a problem. They need to pay attention to their own health.
They need to go for regular health screening to get screened for all these common ailments, all these common cardiovascular risk factors that can lead to complications. If you screen for it, then you will be able to detect it. But if you don’t screen for it, all these risk factors really catch up in the middle age when one is around age 30 and mid 40s and that is why the Life Expectancy in our environment has been put around 50″
Why is Hypertension or High Blood Pressure seen as a silent killer? “It’s because we know Hypertension is a silent killer. Most people who suffer High Blood Pressure don’t show any symptoms.
All they will have is markedly high blood pressure and they will be going about with it but it is just waiting to explode.
You can call it a silent killer because it shows no symptoms. The person may not experience any symptoms. This is coupled with the fact that some people when they start medication, they are bothered about the side effect of that medication because it is difficult to convince somebody who has no symptoms now to take medication.
When they take the medication and they have one or two side effects from this medication, they will believe the medication is what is making them sick not the Blood Pressure. So, we really need a lot of health education, to educate them about the fact that this condition not having symptoms does not make it less deadly.
It’s very deadly. It’s a silent killer. It can kill even though it many not show any symptoms”
Does Alcohol and Cigarette contribute to this killer diseases? “Oh yes. Cigarette and Alcohol are risk factors. They are Cardiovascular risk factors just like all the other ones combined with all those ones I have mentioned like Hypertension, Diabetes, Sedentary Lifestyle, Obesity, Cigarette Smoking too is a risk factor for cardiovascular diseases. It damages blood vessels and it causes all these complications. Alcohol consumption too is a risk factor for all these Cardiovascular diseases.
What role does diet play in trying to prevent and cure these diseases? “Oh, yes balanced diet that is low in saturated fat, with plenty of vegetables and fruits are all we advocate. That you should take balanced diet, low in saturated fat and take a lot of vegetables and fruits. The saturated fat that you are running away from is what we see in poultry diet and animal farm like red meat, meat organs like liver, lungs, kidney, yoke of egg, poultry skin, whole milk, cheese, those are the saturated fats that we should keep away from.
So , you are advised to take a balanced diet that is low in saturated fats and flour and take a lot of vegetables as well as reduce your salt intake, all those are heart-friendly diets that you can live on.s
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