Excessive weight can cause heart attack — Expert

Kolo

An Associate Professor of Medicine and Cardiology, Department of Medicine, University of Ilorin, Kwara State, Dr. Philip Kolo, tells ARUKAINO UMUKOROabout heart attack and how to prevent it

How would you define heart attack and how vulnerable are Nigerians to it?

Heart attack is a serious medical emergency in which the blood supply to the heart is suddenly blocked usually by blood clot, leading to serious damage to the heart muscle. In medical parlance, heart attack is called acute myocardial infarction, and it is a common cause of sudden and unexpected death in affected persons.

In terms of epidemiology, previously, heart attacks were very rare among Africans, especially those residing in Africa. But there has been a gradual increase in the incidence of heart attacks among Nigerians. This is believed to be due to the sophistication and improvement in nutrition, unhealthy diet and reduction of physical activities.

What age group and gender are prone to heart attacks?

The age group most affected is usually the middle- age and elderly population. It is more common among Caucasians than blacks or Africans. Also, men seem to be more affected than women, although one must plead caution here, because the presentation in women may not look typical as it occurs in men. So, it is possible that many of the cases are meek in women. But generally, the disease tends to affect men more than women. Other groups most affected include individuals that have hypertension, diabetes; those who live a sedentary lifestyle or don’t do a lot of physical activities and obese people. Cigarette smoking, like I mentioned earlier, is also a risk factor.

What kind of food rich in cholesterol should people not take too much?

One should start early to begin to watch one’s consumption of food rich in cholesterol, especially when one reaches the age of 30-35 going on 40, as some of the ability to metabolise these cholesterol may not be as effective as they were when one was younger. The conditions of many of the cardiovascular diseases that we see in adults usually start at a younger age. We should start watching our diet early.

Generally, red meat – beef, goat meat, and some bush meat — has a lot of cholesterol.  White meat (fiber) like meats from chicken and birds contain less cholesterol compared with red meat. Fish oil contains omega-3-fatty acids which is cardio-protective. Some also say that in place of red meat, they take intestines from cows (shaki), but these also have a lot of cholesterol, so they should be avoided altogether. If one looks at meat from animal organs, including liver, as long as they are from cows, they have a lot of cholesterol. So, we usually advise people to avoid eating too much of cow meat.

Also, one fries food substances to make them more appealing, but the danger of frying is that fried meat, eggs and related products tend to convert the cholesterol to more harmful fatty acids or trans fat (trans fatty acids). It is better we boil our food instead and eat them.

What are some of the symptoms of coronary artery disease?

The spectrum of manifestation is many. Those who have these narrow arteries usually have predictable chest pains. For example, if they walk like two or three poles, the chest pain begins, it subsides when they rest. This is called stable Angina Pectoris, a chest pain that one can predict. Some would describe the pain as a feeling of heaviness or constriction on the chest. Such pain may spread to the arms, the neck or part of the abdomen above the umbilicus. The second mode of manifestation is unstable angina, that is, chest pain one cannot predict or does not get better. Unlike stable angina, which gets better with rest or drugs, unstable angina does not usually get better with rest or drugs. But these are different from acute myocardial infarction – heart attack. There are special tests that can be done in the hospital to differentiate unstable angina from the two types of acute myocardial infarction, these are ECG (Electrocardiogram) and cardiac biomarker (troponin). The ECG would determine the kind of treatment the individual would be given.

However, a good number of chest pains may not be related to the heart. But when you look at the signs, one would be able to differentiate it. Usually, the pain from the heart is specific, and the individual tend to hold the left side of the chest in such situation. This kind of pain is usually brought on by physical exertion.

What should be done immediately when one notices someone having a heart attack?

One of the major problems that we have with patients with heart attack is late presentation to the hospital. In Nigeria, because most people are not aware about heart attack, when they experience the symptom, they tend to seek for treatment at nearby chemists or health workers living around them. In developed countries, there are specific code numbers one can call on during an emergency such as 911 0r 999.