Dr. Peter Olujimi Odutola
Cardiovascular disease is on the rise in the developing nations. Traditionally, it has been a disease of the developed world in the last 50 years but with changing diet and lifestyle pattern, there is an increasing prevalence in the so-called “Third World” countries. Lifestyles commonly associated with significant morbidity and mortality from cardiovascular disease which include eating too much sodium (salt) or not enough potassium, lack of exercise, drinking too much alcohol, smoking and high caloric intake are increasingly adopted, particularly in lower-income and developing countries. In the next few paragraphs, I will be talking a little bit about the most common causes of cardiovascular disease known to man, hypertension, and diabetes.
Hypertension and Type 2 diabetes are like Siamese twins, and they commonly co-exist together in the same individual. Patients with diabetes have hypertension twice as often as those without the disease. Moreover, patients with hypertension do have what we call “Insulin resistance” and so are likely to develop diabetes more than those without hypertension. Insulin is a hormone which helps to remove excess glucose from the bloodstream and thus lowers the blood glucose. In cases where there is “Insulin resistance”, insulin is not able to work properly and because of this, blood glucose builds up in the blood and ultimately in the body causing devastating effects on the heart, brain, kidney and the blood vessels.
Hypertension
So many things have been written about hypertension so I will not go into too many details. But let me emphasize that the most important phrase when it comes to hypertension is that it is a SILENT KILLER. What this means in essence is that hypertension does not necessarily have to produce symptoms before it can result in the death of an individual. The typical symptoms of hypertension like persistent early morning headaches, anxiety, chest pain, bleeding from the nose, palpitation and blurring of vision may be completely absent. In the absence of the typical symptoms, it mostly causes buildup of plaque in the walls of the coronary arteries of the heart, the blood vessels that supply oxygen and blood to the heart. The cholesterol deposits that make up plaque restrict the inside of arteries and reduce blood flow. Atherosclerosis, or artery hardening, is the medical term for this process. A heart attack may be brought on by decreased blood supply to the heart.
Diabetes
As you are likely aware, diabetes is a debilitating disease that renders the sufferer unable to perform optimally the way we are designed to. People who suffer from diabetes complain about reduction in the quality of life mostly resulting from a constellation of symptoms. The symptoms of diabetes include excessive hunger, excessive thirst, or fatigue, weight gain or weight loss, frequent urination, blurred vision, or poor wound healing. The most consequential effects of diabetes are those which usually result in morbidity and mortality for those suffering from the disease.
The most frequent cause of morbidity and mortality in diabetes is cardiovascular disease. The different forms of cardiovascular disease range from myocardial infarction, angina, peripheral vascular disease, and heart failure. In heart failure, the heart can’t pump blood well. This may cause your legs to swell and cause fluid to accumulate in your lungs, making it difficult to breathe. Other complications include diabetic nephropathy, which is becoming increasingly common in Nigeria, diabetic retinopathy leading to blindness, diabetic foot disease which may cause amputation mostly in the legs and the feet, and diabetic neuropathy a debilitating disease in which patients complain of tingling sensations and severe nerve pains. Stroke or cerebrovascular disease is another major complication of diabetes which deserves mention here. The buildup of plaques which occur in the arteries of the heart also affects the brain arteries. This clogging of the arteries will ultimately lead to the sluggish flow of blood and in severe cases cessation. Stroke then results with slurred speech, inability to walk due to paralysis of the limbs and in some cases death.
Other factors that can also raise your risk for heart disease include smoking, being overweight or having obesity, not getting enough physical activity, eating a diet high in saturated fat, and drinking too much alcohol.
Testing for Heart Disease
Regular check with the doctor is very essential to our daily living. The doctor has the responsibility to check your blood pressure, lipid profiles and other necessary tests as deemed fit. For this article and its relevance, I will limit myself to lipid profile, ECG (EKG), Echo and Exercise stress test.
Lipid profile is done to check for three kinds of fat in the blood namely: LDL (“bad”) cholesterol, HDL (“good”) cholesterol and triglycerides. Too much LDL (“bad”) cholesterol in your blood forms plaque on the inside of the arteries as mentioned above. Too little HDL (“good”) will allow space for LDL to wreak havoc. High levels of triglycerides also contribute to the hardening of the arteries. The doctor will determine the levels of these fats and will be able to advise you accordingly whether you will need advice or treatment.
ECG (EKG)
It is done to measure your heart’s electrical activity. In cases of abnormality, the doctor will use it to make a diagnosis and offer appropriate advice.
Echocardiogram
An echocardiogram (echo) is done to examine how thick your heart muscle is, how well your heart pumps and the movement of the blood in the various chambers.
Exercise stress test
A treadmill test to see how well your heart functions when it is working hard.
Take Care of Your Heart
The lifestyle changes that can help lower your risk for heart disease:
Eat more fresh fruits, vegetables, and whole grains.
Eat fewer processed foods like fast food.
Drink more water.
Take less sugary drinks.
Avoid alcohol.
Physical activity – 30 minutes of walking daily is good enough to keep your weight in check.
Sleep well as much as possible.
Dr Odutola, Physician and Researcher forwarded this piece from Chicago, Illinois, USA
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