Jan 222014
 

717879391_126285Our Komla Dumor’s tragic sudden passing has spawned reflections, especially among similarly upwardly mobile young professionals with the world to conquer. To put the more medical aspects of heart attacks into perspective, I defer to my colleague and brother, Dr. Yaw Ofori-Adjei, a Physician Specialist at the Korle Bu Teaching Hospital. Firstly, he is better qualified to do this. Secondly, it will buy me time to put my thoughts together on Komla since I can’t seem to find the words to describe how I feel. I must point out however that the focus on heart attack is purely because of the public discussion it has spawned and not because any autopsy has determined the cause of our brother’s death.

Yaw writes:

I was racing down the George Walker Bush Highway towards an appointment to which I was late for. It had been a heavy clinic that day making me close much later than I had envisaged. I was trying hard to remain within the speed limits whiles formulating a plausible excuse to give to the person I was meeting. Suddenly I felt this sharp pain in my chest; I was suddenly drenched with sweat. No! This cannot be happening; I am getting a heart attack! My training as a physician suddenly kicked in. I remembered I had in my car several tablets of Aspirin that had been given me as drug samples by a pharmacist. I pulled over at the side of the road, chewed four tablets immediately and washed it down with a bottle of mineral water I kept handy.

As I was reflecting on the events of the previous few seconds I asked myself why I would be getting a heart attack. Yes, I am not as active as I used to be when I was much younger but at least I try to do some brisk walking for 30 minutes every other day. I am aware that my abdominal girth has increased gradually in size that it would now rival my wife’s early pregnancy bump, but you can hardly call that obesity. Besides I am only 36 years old.

Sadly though, in my work as a hospital physician, I am increasingly coming across many patients, some of whom are much younger than me who are suffering complications of cardiovascular diseases such Strokes and Heart Attacks. Decades ago such ailments were unheard of in our part of the world let alone be seen in young people in the productive age group like we are seeing now. This week, we have lost a promising young Ghanaian, who was only 41 years. Though unconfirmed, a heart attack has been mentioned. As sad an event as this is, possible heart attacks in relatively young people are not isolated. Every day in our emergency rooms we see patients that fit this profile suffer a similar fate.

The prevalence of cardiovascular disease in our part of the world is said to have reached epidemic proportions. In most African countries, cardiovascular disease is second most common cause of death after infectious diseases. It is projected that between 1990 and 2020, the burden of cardiovascular disease in Africa will double with a large proportion of victims being middle aged. This would consequently negatively impact on our development drive and poverty alleviation efforts as a nation.

Strangely enough though, the causes of cardiovascular diseases are not unknown to us. The epidemic proportions of cardiovascular diseases we are seeing now have been blamed largely on the westernisation of our society. We are living more sedentary lifestyles; we spend hours behind our desks typing away at our computer keyboards, our market women are obese and would sit at one place from morning to evening without getting up to stretch their legs. We do no exercise. Our diets have also significantly changed. We have given up on our healthy traditional diets and now indulging in cholesterol laden fast foods, diets that were foreign to our culture and previously unknown before the advent of this epidemic.

Increasingly now too, we are seeing lots of young people, men and women alike, engage in the social vice of alcohol abuse and the use of recreational drugs. Alcohol has been implicated in the development of hypertension, coronary heart disease, stroke, and heart failure. The recreational drug cocaine and cigarette smoking have been implicated as less common causes of heart attack showing up as severe coronary artery spasms. The coronary arteries which are the vessels that supply blood to the heart can undergo severe spasms (tightening) leading to a heart attack. Emotional stress and pain has also been implicated in the cause of coronary artery spasms.

The net effect of our newly adopted lifestyles is that we are getting more cases of hypertension, obesity, diabetes, and high cholesterol levels culminating in complications of strokes, heart attacks and finally death. There is therefore an emergent need for us as a nation to start encouraging therapeutic lifestyle changes to prevent the development of these cardiovascular diseases. Prevention is always better than cure.

In the aftermath of my little scare on the N1, I have had myself thoroughly checked by my doctors. My cardiologist assures me that there is nothing to worry about. I am however not leaving anything to chance. I have instituted my own therapeutic lifestyle changes. I am exercising more, eating healthy and have targeted to reach my ideal body weight for height by the end of the year (fingers crossed). Fortunately, I did not require any medication. If I did, I would have taken them religiously. Unfortunately lots of people we see in our emergency rooms with complications of cardiovascular disease such as heart attacks have been previously diagnosed. They have however failed to follow the treatment because they are in denial, are unable to comply with treatment or are seeking healing from a higher authority elsewhere. With our limited resources, there is little that can be done for them when they present in our emergency rooms in dire conditions.

As we reflect, let also recognise that many more young people are dying in their productive years to these cardiovascular diseases with resultant emotional trauma and economic shock to their families. As a nation seeking to further develop our middle income status and alleviate poverty amongst our people, we cannot afford to have our most productive age group dying from very preventable diseases. The time to arrest this epidemic is now.

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