It is an old wives’ tale that ailments of the heart are an exclusive affliction of old, rich men. What is collectively referred to as cardiovascular diseases (CVDs) now affects all age groups, causing serious illness or severe disability, precipitating death and imposing high costs.
The World Congress of Cardiology, held in Dubai this April, rallied to adopt a global goal to reduce premature noncommunicable disease (NCD) mortality by 25 per cent within the next 13 years. NCDs are responsible for more than 36 million deaths every year, and almost half of these — 17.3 million — are caused by CVDs. The event, which was co-hosted by the World Heart Federation and the Dubai Health Authority (DHA) with delegates from 130 countries in attendance, summarised the plan as ‘25 by 25’. The target is to achieve a 25 per cent reduction in premature deaths due to CVDs by 2025.
Lifestyle diseases
Speaking at the event, Dr Fahad Baslaib, head of cardiology at Rashid Hospital and president of the Emirates Cardiac Society, said that although 80 per cent of cardiovascular diseases are preventable, CVDs are still the leading cause of death worldwide – claiming one in three lives.
In the UAE, CVDs are the cause of one in every four deaths.
The World Heart Federation’s statement said it is incongruous for NCDs and CVDs in particular to continue to be viewed as ‘lifestyle’ diseases primarily afflicting those in high-income countries. “In fact, the greatest CVD burden falls on low- and middle-income countries, where 80 per cent of all CVD deaths occur, and it is increasingly impacting people during their most productive years.”
In the years leading to the fulfilment of the 25 by 25 plan, advocacy will continue to play just as critical a role as medical advances. Many people die before they can seek medical care because they ignore symptoms, or through erroneous self-diagnosis.
Dubai’s government hospitals reported a 20 per cent increase in the number of heart patients treated in 2011, compared to the previous year. According to a survey conducted by the DHA and the Dubai Statistics Centre, one in every 15 residents has hypertension, a leading cause of CVD. Patients are also younger, with an increasing number of young people being rushed to cardiac emergencies in the country.
“Twenty-five years ago, typical first-time heart patients were in their 60s but CVD now affects individuals even in their early 20s. My personal experience includes treating a young man of 20 years,” says Dr Jacob Chacko Kuttickal MBBS, MD (Internal Medicine), DM (Cardiology), specialist cardiologist at Prime Medical Centre. “Most of these individuals are smokers and others have diabetes, dyslipidaemia and stress. About 20 per cent of residents suffer from hypertension. A combination of these risk factors account for the majority of heart diseases in the UAE,” he adds.
Take charge
There are some everyday things that everyone can do to ensure better heart health and prevent heart disease, Dr Kuttickal says. “Quit smoking. Exercise for 30 minutes every day or for 10 minutes each three times a day, for five days a week. Lose weight. Count your calories and fat intake when you eat out, and beware of sweets. Walk to your office and avoid the elevator. Enjoy a hearty laugh to take away stress.”
While prevention is fine for those who are still fit, heart patients in the UAE have much to look forward to by way of treatment and care.
“Everyone can follow simple lifestyle actions — from childhood to adulthood — to ensure good heart health,” says Dr Nooshin Bazargani, Deputy Head of Cardiology at Dubai Hospital and DHA, and Board Member of World Heart Federation. “Individuals who have heart disease though, are classified as at very high risk, and they may face problems if they don’t look after themselves. For these patients, the three key factors are blood pressure, blood glucose and cholesterol. They have to lose weight and lower their BMI, avoid even passive smoking and do some aerobic exercise every day — not merely thrice a week.”
Modern technology
Dr Bazargani says modern cardiac care ensures heart patients are given clear and proven guidelines for lifelong care during their discharge from hospitals. Heart patients must then form a relationship with their general practitioners, as they are the ones who initiate, coordinate and provide care, while cardiologists must be consulted for uncertainties over medication. “If our heart patients look after themselves, we can hope not to see them again,” she says.
Earlier this year, Dubai Hospital and Rashid Hospital introduced Absorb, a procedure to treat CVDs with a scaffold that keeps blocked arteries open but dissolves in the body over time, making Dubai the first city in the Middle East and fifth in the world to offer this treatment. Absorb allows further forms of treatment in the future, unlike the commonplace procedure of inserting a metal stent.
The two hospitals also bagged another first for the region with the introduction of Transcatheter Aortic Valve Implantation (TAVI) — an alternative to standard surgical aortic valve replacement that is performed on the beating heart of patients who cannot tolerate open heart surgery or run high risks with surgery.
Rashid Hospital has become the Middle East’s first hospital and the fourth outside the US to be recognised by the Joint Commission International for best practices in cardiac care. The hospital has also achieved a ‘door-to-needle’ time of 24 minutes for unlocking arteries, surpassing the international standard of 30 minutes. For angioplasty, its ‘door-to-balloon’ time is currently 74 minutes, against a global standard of 90 minutes.
In Abu Dhabi, Burjeel Hospital recently announced it will provide 100 free heart surgeries, an initiative dedicated to the memory of late Shaikh Zayed Bin Sultan Al Nahyan. The programme is being run in association with the renowned Columbia Department of Cardiothoracic Surgery.
Dr Shamsheer Vayalil, founder and managing director of Lifeline Hospital Group and Burjeel Hospital, says, “Shaikh Zayed dedicated his life to the welfare of all citizens, and we want to continue the legacy of his kind-hearted work.
“While the solution to combating heart disease lies in education, it is too late for many people, and surgery is the only way to save lives. Sadly, not all patients have health insurance or can afford surgeries, which is why our programme gives them much-needed hope.”
— Special to GN Focus
