As many Nigerians now die suddenly, medical experts have blamed it on the increased rate of non-communicable diseases like diabetes, heart diseases, including hypertensive Health disease (HHD), lifestyle and poor health seeking behaviour.
The experts stressed the need for comprehensive preventive healthcare, saying whatever health condition that leads to sudden death would have shown warning signs.
Unfortunately, a lot of people are not aware of these warning signs due to lack of regular medical checkup. This non-health seeking behaviour is exacerbated by the burden of out-of-pocket expenditure as the National Health Insurance Scheme (NHIS) only covers about five per cent of the country’s population, LEADERSHIP Weekend learnt.
Speaking on this, former president of the Nigerian Medical Association (NMA), Prof. Mike Ogirima, noted that there is increased incidence of non-communicable diseases relating to hypertension, diabetes, and heart diseases that will cause massive Mayo cardiac infarction while also identifying lack of equipment in the hospitals to detect health emergencies as a problem.
He said: “The public health sector is not well equipped to detect health emergencies; of course, when somebody collapses, there is a delay in taking the person to the hospital and when you get to the nearest hospital, do you have the gadgets to detect where the thing is and to effect corrections immediately? So these are the issues.”
Ogirima, however, urged Nigerians on the need to leave healthy lifestyles, eat healthily, and do moderate exercises, saying these are the things that will keep them going.
In the same vein, the senior special assistant to the FCT minister on health, Dr Ejike Orji, decried the poor health seeking behaviour of Nigerians, saying it has fallen so low over the past few years. He identified the things that can lead to sudden collapse and death as mostly metabolic and cardiac, adding that COVID 19 is also a contributor.
“When I say metabolic, I am looking at things like diabetes. Somebody can suddenly die from diabetes; if your blood sugar goes up so high, you can go into a coma and if it is not corrected immediately the person will die. The other one is hypoglycemia – when there is low blood glucose in a person’s body.
“There is also what we call a cardiac arrest; if somebody has had hypertension for about ten years without knowing and not doing anything about it, it will affect the heart, the kidney and the brain. The one that will cause sudden death is if the blood pressure shoots up so high and an artery bursts in the vein, the person can die immediately.
“The other one is if the blood pressure is high and the person has cholesterol deposited in the artery, it will deposit so high that the person’s blood, the one supplying to the heart, they can suddenly clot and close the blood supply to the heart; if the artery blocks, that person can die suddenly.
“The other thing that is causing sudden death recently is COVID 19. People may have COVID 19 without knowing it, even when they have very severe symptoms, they will still be saying it is malaria. They will be in denial, they won’t go to see a doctor and you know that the coronal virus will start from the nasal until it gets into the lungs and once people start desaturating, you will find out that within 24 hours, their blood oxygen will fall so low that it will not sustain life and they will die. Most of the people who die from coronavirus die due to that.
“The other thing that can cause sudden death is when people have Upper GI bleeding from peptic ulcer and the person did not manage it well and takes a drug that can cause massive bleeding. All of these can be found out if you do a comprehensive check every year once you are above 40; before then, every two years.”
Orji, however, told LEADERSHIP Weekend that health insurance has a big role to play because, according to him, it makes it easy for a person to access healthcare because it’s a pool resources scheme that will make you, if you have a slight headache, you will like to go to the hospital since you know you are not going to pay as you had already paid the premium for the year.”
On his part, the managing director, Society for Family Health (SFH), Dr Omokhudu Idogho, said it is difficult to attribute sudden death to one specific cause, and unfortunately autopsies are not done in many cases, making it harder to actually categorise the various causes.
He, however, said heart conditions, including poorly managed hypertensive heart disease and aneurysm are major causes of sudden deaths.
The physician also said that COVID 19 can cause sudden death as the blood oxygen drops gradually without the body recognising it until it is too late.
Idogho, therefore called for proactive health behaviours , including regular exercise, better health seeking routines like regular blood pressure checks, medical checkup once a year, living a minimal stress life and dietary modifications.
“Dietary modification includes increasing vegetables and fruits in our diets and also reducing smoking and responsible use of alcohol,” the expert advised.
Meanwhile, according to a medical journal entitled hypertension and sudden unexpected deaths, published in 2018, an autopsy study of four hundred and seventy-seven brought-in-dead (BID) person in a tertiary health centre in Lagos State showed that a total of 477 BID cases as a result of hypertensive heart disease (HHD) were recorded out of the 1016 BID cases during the period under study.
This accounted for 44 per cent of all BIDs and 4.3 per cent of all hospital deaths. The most common cause of death identified in the study was acute left ventricular failure, representing 67.8 per cent while myocardial infarction was the least common, representing 1.7 per cent.
It is becoming worrisome that hypertension, which was hitherto rare and regarded as a disease for the aged, is becoming a problem even among young people.
A consultant family physician, University of Abuja Teaching Hospital, Dr. Chira Obiora, said the current rise in hypertension among the younger generation is largely due to lifestyle changes.
According to him, high blood pressure is actually divided into two major parts – the essential hypertension and the non-essential hypertension. The essential hypertension, Obiora said, is hypertension that is basically due to lifestyle or environmental factors with little genetic compound, while the non-essential hypertension is basically due to secondary causes like kidney disease, renal disease and other diseases.
“The lifestyle of the youths has changed. It’s not like how our fathers used to when they were younger. Youths are now living a sedentary lifestyle, indulging in things that affect their kidneys, like taking excessive alcohol and substance abuse. These are some of the things that can lead to high blood pressure.
“Food intake also; some of them now take foods that contain a lot of salt (sodium chloride) due to eating junk food. These are indicated in blood pressure because the kidney cannot handle that.”
On the way out, Obiora identified changing of lifestyle, regular checking of blood pressure, regular activities and dietary modification as key.
The physician noted that time has passed when people below 30 or 40 years old will feel they don’t have business with checking their BP, saying blood pressure should be checked as regularly as possible.
Also on healthy living, a consultant cardiologist, Gwarimpa General Hospital, Dr Ada Nwakwo, told LEADERSHIP Weekend that one of the ways to prevent hypertension is through lifestyle change, diet and exercise.
She recommended at least 30 minutes of aerobic exercise five times a week, saying this, alongside a healthy diet, including reducing salt, will go a long way in reducing high blood pressure.
“There are people who always add salt to their meals; salt intake should be greatly reduced. You can use more of the spices since they have some salt content, and that will reduce the amount of salt.
“Eat plenty of fruits and vegetables, fruits that contain potassium, because they help to reduce high blood pressure. Fruits like bananas and oranges help in controlling and preventing high blood pressure.
“Also, take enough water, reduce alcohol and smoking. When you are able to do all these things, it will help in controlling not just high blood pressure but diabetes and low cholesterol level,” she advised.
According to the World Health Organisation (WHO), “Normal blood pressure in adults is measured by milimetres of mercury (mmHg) and is recorded in two numbers. The first is the systolic blood pressure (the highest pressure in blood vessels), which is the pressure when the heart contracts. It ideally ranges between 115 and 120 mmHg.
“The second is the diastolic blood pressure (the lowest pressure in blood vessels), which is the pressure while the heart relaxes and dilates. It ideally ranges between 75 and 80 mmHg. Blood pressure is considered high if the systolic measurement is 140 mmHg or more and/or the diastolic measurement is 90 mmHg or more.”