Dispelling myths about heart disease

According to Dr Charles Olaro, the director of clinical services, Uganda is undergoing a shift in the burden of diseases away from communicable diseases. In the 1990s, non-communicable diseases (NCDs) accounted for only 20 percent but this number has gone up to 40 percent and it is expected to rise up to 60 percent.

The NCDs contribute about 33 percent of all deaths in the country and are responsible for one in every four premature deaths, 24 percent probability for men and 20 percent for women.

Premature death and mortality morbidity (morbidity refers to an illness or disease. Mortality refers to death) is not just a health issue but also negatively affects the socioeconomic development and long-term fiscal sustainability of government and public services.

“When we conducted an NCD investment assessment on how NCDs affect the economy, we found that Uganda would benefit from investing in four policy intervention packages that would reduce exposure to risk factors such as tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity,” Dr Olaro says.

The assessment was also in the key clinical interventions for the most prevalent non-communicable diseases such as cardiovascular diseases. There are many myths surrounding this term and with the right information and action, you can prevent heart failure or help to improve your health even after diagnosis. 

High blood pressure is not a big deal 

Contrary to that belief, Dr Barbara Kakande, a cardiologist at UMC Victoria Hospital, says high blood pressure leads to damage of blood vessels, the heart, kidneys, the brain and other body organs. 

According to webmd.com, normally, your heart beats regularly, pumping blood through the vessels all over your body. As the blood is pushed by the heartbeat, the blood in turn pushes against the sides of your blood vessels. Blood vessels are flexible and can widen or constrict as needed to keep blood flowing well. For a variety of reasons, your blood may begin to push too hard against the blood vessels. This elevated blood pressure, which can cause your arteries to become stiff over time, is how problems begin.

Average and below average weight people are protected from heart diseases. 

READ: Obesity rising in Africa - WHO

Obesity contributes directly to the development of high blood pressure, cholesterol abnormalities, diabetes, and sleep disorders, all of which contribute to heart disease and death. 

“However 15 to 30 percent of people with normal weight might actually have a normal-weight obesity (excess fat internally). There are also many other heart diseases that are not a result of obesity. These include rheumatic heart disease (scarring of heart valves), endomyocardial fibrosis (scarring within the heart chambers), and other cardiomyopathies (heart muscle abnormalities),” she explains.

Young people do not need to worry about heart disease

While it is true that heart disease is prevalent among older people (60 years and above), Dr Robert Ssooka of Makerere University Hospital says a good number of heart attacks happen among people below 45 years. 

“Moreover, how you live your earlier years determines how healthy your later years will be. For example, if you eat lots of processed foods, you are prone to heart disease. Additionally, if you live a sedentary lifestyle, then you are likely to face issues with heart health,” he says.

Coughing vigorously during a heart attack could save your life.

READ: Changes you should make to your diet after 40

Dr Kakaknde says ‘cough CPR’ is proposed to be a lifesaving manoeuvre, where one physically forces blood from the chest up to the brain and other blood vessels because of the pressure exerted from the cough. 

“Patients with heart attacks typically have a disruption in the supply of blood to the heart muscle, and there is no evidence that coughing significantly improves the blood flow through the heart blood vessels,” he says.

Heart disease is a man’s disease

Heart disease is actually the commonest cause of death in both males and females. Men are thought to have more of the risk factors such as high cholesterol, high blood pressure, diabetes, obesity, and physical inactivity. It is these that may predispose them to heart attacks at a younger age than women. 

“Nonetheless, women (especially the younger ones) are almost twice as likely to die shortly after developing a heart attack (days to weeks) than men who have had a heart attack. While symptoms of heart attack are similar in both men and women, women are more likely to complain of nausea, sweating, vomiting and pain in the neck, jaw, throat, abdomen or back,” Dr Ssooka shares.

If you have a heart disease, you should take it easy (should not exercise or be physically active)

Just like any other muscles, regular light to moderate exercising will strengthen the heart muscle. Dr Kakande says it is postulated that exercise can  reverse damage resulting from sedentary, aging hearts,  and even help prevent risk of future heart failure. 

“The medical doctor will advise the patient, after assessing them, about the ideal type, intensity and duration,” he adds.

It is okay to have high blood pressure when you are older

While it is normal for the blood vessels to stiffen with age, it does not mean that it is good for you. In that state, the heart is forced to pump harder, against the stiff vessels. 

“That way, with time, the blood pounding against the artery walls causes more damage to them. The overworked heart muscle then becomes less effective and yet it has to continue attempting to pump harder to meet the body’s demands for blood. This vicious cycle causes further damage in the blood vessels, which increases the risk of heart attacks, strokes and kidney failure,” Dr Kakande shares.

Vitamins and other supplements can protect you from getting heart disease

Various researches have not shown major scientific benefit from antioxidant and other supplements in the prevention or treatment of heart diseases. Dr Kakande says it is thought that the body absorbs and utilises vitamins and minerals best when they are acquired through foods, rather than through supplements. 

“Rather, tests will be done to establish the presence of certain deficiencies and the needed supplements prescribed,” she says.  

Angioplasty or stenting the heart arteries and bypass surgery ‘fix’ your heart

While angioplasty and bypass surgery can do wonders for relieving chest pain /angina as well as improving quality of life, they do not stop the underlying disease.

 “It is, therefore, imperative that the factors that contribute to damage of the blood vessels/atherosclerosis are addressed to reduce the risk of the returning of the angina/pain thus the risk of developing (other ) complications such as heart attacks or strokes,” Dr Kakande says.

Early diagnosis

Cardiovascular diseases have the greatest impact on the economic burden of NCDs in Uganda, contributing up to 65 per cent of the total budget (Shs3.4 trillion). 

With the above myths in play, it is little wonder that approximately 97,000 Ugandans die of cardiovascular disease every year and the challenge. Dr James Kayima, a cardiologist at Nakasero Hospital, says many patients underrate the signs and symptoms of heart diseases and only come to the hospital when their condition has gone out of hand.

“We have the capacity to handle about 90 percent of the heart problems as a country and only 10 per cent cases need referral out of the country. The most important thing is to make sure that one goes for regular medical check-ups. This way, diseases are caught early when the possibility for treatment is still high,” he says.

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