Lifestyle diseases as a result of eating foods high in calories are a leading cause of heart disease among the affluent. PHOTO BY ISMAIL KEZAALA

By Agnes K. Namaganda (email the author)


Posted Thursday, September 2 2010 at 00:00

The incidence of heart disease is going up the world over. While developed countries have implemented programmes of dealing with it by way of prevention, early diagnosis, treatment and rehabilitation, developing countries are suffering a severe blow from the ailment. However with lifestyle changes, heart diseases can be averted, writes Agnes K. Namaganda.

The waiting benches are fully-packed by 8a.m. I count about 100 people all braving the chilly Tuesday morning and hopefully waiting for their turn to see a specialist. Their general attitude though is not as dismal as say, at medical ward where despondence and pain is written on the faces of almost all the patients. I am at Uganda Heart Institute in Mulago.

The director of the institute, Dr John Omagino is busy with ward rounds. There are other admitted patients that must be attended to besides the queues outside. I am given an afternoon appointment. He has a queue outside the office but agrees to talk

The incidence of heart disease is going up world over, Dr Omagino says. While developed countries have developed programmes of dealing with it by way of prevention, early diagnosis, treatment and rehabilitation developing countries are suffering a severe blow from the ailment. But what are the causes for the sudden rise in the numbers of heart disease sufferers? “It’s an issue of population,” the heart specialist states. “In every 1000 children, at least, one though sometimes up to 10 children are born with a heart complication.” So as the population increases, we are likely to see more children born with the disease.

Causes
When not born with heart disease, children (and sometimes adults too) can acquire it later as a streptococcus infection of the throat as a result of sleeping in crammed accommodation quarters. This infection manifests as a sore throat and can be easily controlled with penicillin drugs but in their absence, the body develops anti-bodies to fight it off. Unfortunately, Dr Omagino says that these anti-bodies will not only fight the organisms but will cause harm to a number of internal organs with the heart getting the most affected. The heart disease gravitates into adulthood when it is discovered.









Going through a stressful situation once in a while is not bad. Dr Omagino though notes that routine stress on the heart due to trying to meet unrealistic expectations, and working under stressful deadlines and targets causes a constant circulation of chemicals like adrenaline which are dangerous to the body and can result in a heart complication of some sort.

Ingested drugs like heroin, cocaine, nicotine and alcohol contain agents that lead to an increased blood pressure and thus heart disease.

Lifestyle diseases as a result of eating foods high in calories from animal fat and cooking oil are a leading cause of heart disease among the affluent. “If there’s no form of physical activity, it means the body will be taking in more calories in excess of its requirements. Because it does not throw away the excess, it stores it everywhere around the body-under the skin and in blood vessels leading to their narrowing. With narrowed blood vessels, the heart will be working harder to pump blood around the body which can lead to heart failure,” the heart specialist explains.

Challenges of treating heart diseases in Uganda
Due to lack of sufficient diagnostic facilities, Dr Omagino says the country is only able to successfully catch a paltry 10 per cent of the congenital (present at birth) heart diseases. “While all babies in developed countries undergo a compulsory heart check-up at birth, we do not have the capacity to do it. With improved diagnostic services, we can capture at least 50 per cent of the cases at birth,” he says.

Treatment of heart diseases also involves capacity to make accurate diagnosis, offer medical treatment and interventions that include devices like pacemakers or outright surgery to repair or widen narrowed points besides replacement of valves, Dr Omagino says. But the ability to do this is absent. He also notes that lack of supportive government policy that recognises heart disease as an emerging epidemic isn’t helping matters.

Dr Omagino says; “Getting the public educated about the risks should be a definite policy.Ensuring that every baby born undergoes an appropriate cardiac check-up should be another. And ensuring that there are facilities to encourage exercises should be a policy. Primary schools had so much playground space but now, one can register a school on a quarter of an acre with the children not having enough space to run around and exercise.

Something’s wrong! Someone should be looking at the amount of salt in the foods in the supermarkets to ensure they are the right quantity. Someone should be declaring the correct kind of oil to be used in restaurants. And the medical examination public servants undergo before getting jobs should be coupled with continuous examinations to ensure they do not become amorphous like they usually do. Someone should be in charge of that.”

As a director of the heart institute though, Dr Omagino argues that none of the above challenges can even measure up to that of lack of specialised human resource in the field. “The issue of finance and infrastructure are minor compared to the lack of recognition as specialists because traditionally, public service does not recognise them, so they are not paid any differently for their competencies. Because they are valued in other countries and paid as such, it is difficult to have enough numbers to run the hospitals.

The few of us who remain are doing our best but are over-stretched. We are suffering a burn-out syndrome. Just working in intensive care unit is enough strain because you have emergency conditions 24 hours but then you also have ward rounds and out-patients to deal with. Until there’s a system for recruiting, training and maintaining this human resource, the above challenges will remain. But with the right team, the rest will be a walk-over, he argues.

Signs that there could be a problem
According to Dr Omagino, be cautious if there is;
• A tendency to get tired quickly.
• General body weakness.

• Unnecessarily sweaty and sticky palms
• Difficulty in breathing
• Discomfort in your chest area
• Inability to inhale deeply.
• Swelling of the legs and abdomen

Managing heart disease
• Get a diagnosis through investigation by a cardiac specialist.
• Get treatment or surgery for your condition.
• Go for regular check-ups during treatment and even after operation