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Nigerians in the face of COVID-19 and cardiovascular diseases

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By Olu’Seun Esan

The incursion of the dreaded coronavirus (COVID-19) in Nigeria through the index case on February 27 added another worry to the array of fears for Nigerians. Lack of effective emergency management system and an ailing health management system has made the COVID-19 situation in Nigeria more worrying.

The novel coronavirus was first detected in Wuhan City, China, in December 2019 and since then it has rapidly spread across the world. On March 11, the World Health Organisation (WHO) declared COVID-19 a pandemic. Even though COVID-19 has been ravaging other parts of the world, the index case in Nigeria awaken Nigerians to the stark reality of the virus. Since then, it has criss-crossed almost all parts of the country like a whirlwind.

But one strong fact we now understand is that several underlying health conditions can complicate how the body respond to COVID-19 infection. Cardiovascular diseases (CVD) come across as one of the commonest non-communicable diseases(NCD) in Nigeria. In Nigeria, research by WHO in 2018 shows NCD prevalence stand at 29%, cardiovascular diseases at 11%, cancer 4% and diabetes 2%.

ALSO READ: Pandemics in history: Was Nigeria prepared for COVID-19?

Cardiovascular disease (CVD) is a general term for health conditions affecting the heart or blood vessels. It’s usually associated with a build-up of fatty deposits inside the arteries and an increased risk of blood clots.It can also be associated with damage to arteries in organs such as the brain, heart, kidneys and even the eyes.

CVD is one of the main causes of death and disability worldwide, but it can often largely be prevented by leading a healthy lifestyle. The most common types includes coronary heart disease, high blood pressure (hypertension), cardiac arrest, heart failure, arrhythmia (improper beating of the heart), peripheral arterial disease, stroke and so on.

The consumption of trans fat is clearly a leading risk factor of Cardiovascular diseases. Other risk factors include smoking, lack of exercise, unhealthy diet, among others. The World Health Organisation in its nutrition advice for adults during the COVID-19 outbreak recommended eating fresh and unprocessed foods, drinking enough water, eating moderate amount of fat and oil as well as eating less salt and sugar.

One basic way to prevent sickness and diseases is the promotion of healthy diet. Trans fat is one of the commonest type of fat, which is already taking the market by storm. Consuming trans fats has been shown to increase the risk of coronary artery disease in part by raising levels of low-density lipoprotein (LDL, often termed “bad cholesterol”).

Trans-fat occurs naturally in small, safe quantities in milk and meats, but industrial trans fat is added often in unhealthy quantities to many cooking oils that are used in packaged, processed and fried foods. Consumption raises bad cholesterol and increases the risk of coronary heart disease, Alzheimer’s disease, dementia and other cognitive diseases. Trans-fat consumption is estimated to have killed more than 500,000 people in a year, including 1,261 Nigerians.

The World Health Organisation (WHO) has called for the elimination of industrially-produced trans fat from the global food supply by 2023. The spread of COVID-19 lends new urgency to this call. Coronavirus are known to cause respiratory or intestinal infections in humans and animals. Acute respiratory infections, including influenza, respiratory virus, and bacterial pneumonias, are well-recognised triggers for cardiovascular diseases (CVD), and the underlying CVD is usually associated with co-morbidities, which may increase the incidence and severity of infectious diseases.

Statistics on link between COVID-19 and cardiovascular diseases

A large proportion of affected COVID-19 patients have been reported to have underlying CVD. Unfortunately, multiple studies have shown that patients with underlying cardiovascular co-morbidities, such as hypertension and coronary artery disease, are more likely to suffer from a severe COVID-19 infection that requires intensive care services; it has been known to have complications like Acute Respiratory Distress Syndrome, which in turn may result in death.

One study showed that patients infected with COVID-19, who had underlying hypertension had increased odds of death compared to those without hypertension. Similarly, coronary artery disease was associated with increased odds of death. The Chinese Centre for Disease Control and Prevention reported that patients with cardiovascular disease had a case fatality rate of 10.5% and those with hypertension had a case fatality rate of 6%, both of which were higher than the overall case fatality rate of 2.3%. Patients with hypertension accounted for 13% of the COVID-19 cases, but they comprised 32% of the COVID-19 deaths.

Patients with cardiovascular disease made up 4.2% of the COVID-19 cases, but were responsible for 18.3% of the COVID-19 deaths. This may be due to the fact that patients with history of coronary artery disease or acute coronary syndromes may have reduced or impaired cardiovascular functional reserve. The virus targets the lungs, but it could affect the heart, especially a diseased heart, which has to work harder to pumpblood throughout the body.

In February, the American College of Cardiology (ACC) issued a bulletin to warn patients about the potential increased risk and to encourage additional, reasonable precautions. The bulletin went further to explain that “in general, you can think of it as something that is taxing the system as a whole. That could exacerbate problems for someone with heart failure, where the heart is already having problems pumping efficiently. Someone with an underlying heart issue also might have a less robust immune system. And in those with chronic medical conditions, the body’s immune response is not as strong a response when exposed to viruses.”

All this bears credence to why prevention of disease and a healthy lifestyle is an advantage in times like this. Government must help its citizens to stay healthy.

Importantly, the time has come for the government to take serious the control of food available for public consumption. Substances like trans fat in food can only exacerbate the public health burden of non-communicable diseases; it can only get worse in a time like this when the human has to fight a pandemic. Trans fat consumption, just like tobacco use, is a ticking time bomb that tends to distress the already over-burdened health facilities. The Government must ensure that citizens eat what is healthy, as healthy diet can prevent up to 30% of health issues. Citizens too must ensure that they cautiously watch what they eat.

Making oneself vulnerable to diseases through nutrition will come to affect the wellbeing and economy of the family and indeed the nation. There is no better time for Government agencies to intensify its effort to reduce the risk factors of CVDs most, especially trans fat and tobacco. A healthy people is the greatest asset of any nation.

Olu’Seun Esan, a development consultant wrote from Abuja.

Vanguard

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