Professor Adewole Adebiyi, a cardiologist at the University College Hospital Ibadan, says in this interview with SADE OGUNTOLA that no death is actually sudden, except for road traffic accidents, but there is usually something underneath that was not discovered. Excerpts:
How do you perceive cases of sudden deaths we record daily in Nigeria? Is it something that is normal?
Now, sudden, unexpected death is the proper terminology. Sudden unexpected death is usually defined as a death that occurs unexpectedly or within 24 hours of the onset of symptoms. Many times when I hear sudden, unexpected deaths, it is often related to a heart-related issue. The commonest causes are a heart attack or abnormal heart rhythms. Also, stroke can cause sudden, unexpected death.
So, when you hear death occurring in a manner that you’re not expecting, you should consider the heart. Most times, it is the heart that develops a problem. But no death is actually sudden.
For instance, some people have elevated blood pressure over the years. They had not bothered about checking their blood pressure. It has been there, causing damage to their body over the years. The first sign of that elevated blood pressure may be the person suddenly dropping dead. He may have been having occasional headaches and chest pain that he ignored or assumed to be signs of other things. So, in the real sense of it, no death is actually sudden, except for road traffic accidents. Those are the sudden things. But regarding medical things, there’s usually something underneath that was not discovered.
Experts preach exercises for better health. How best can individuals fit exercises into their daily routine for a healthy heart?
Exercise is important, but that is not the only thing required for a healthy heart. I tell people that there is no miracle drug anywhere. But the nearest thing that you have to a miracle drug or a cure-all is exercise because of its numerous benefits across all the body systems that exercise gives you. Really, what exercising means is that you move your body. We are not just talking about exercise; we’re talking about physical activity. For example, you cannot preach exercise to a bricklayer or a carpenter who is involved in lifting things from morning till night. His job entails a lot of physical activity.
However, most of us are sedentary. We drive to our offices, we take the elevators rather than climb the stairs, and at work, we sit down from morning till evening. For us, we talk about having leisure-related physical activity. So it’s the physical activity we’re talking about, and it requires just some thoughts about it.
The World Health Organisation recommends that individuals should have at least 30 minutes of moderate-intensity physical activity every day, not less than five times a week. So you can probably wake up early enough to take a 30-minute brisk walk. That is the minimum that is recommended per day and at least five days in a week. One thing about exercise is that little is good; more is better.
Can you break up or split the recommended time for the exercise routine into two?
Yes, but it requires some creativity to do it. Probably you have 10 minutes to walk here, and you have five minutes there. Probably instead of parking your car close to your office, you park somewhere away, and then you walk to your office. You are on the fourth floor; instead of using the elevator, you take the staircase up. It’s just to keep moving. Remember, I said physical activity.
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If I want to take to walking as a form of physical activity, do I need to have a heart checkup before I start such a programme?
Actually, the guideline is that before you start any increase in your activity, you should see your doctor, especially if you’ve been sedentary before. Let them check on you. They need to check your blood pressure, listen to your heart, probably do an ECG, and check your body system, including the blood sugar and cholesterol levels. Those are standard medical examinations.
I remember some years back, I think it was Nigeria Customs Service that was doing recruitment, and they asked individuals who had not run to do 10 kilometres. Some people die from doing that because sudden, unaccustomed exercise can be dangerous. If you are doing exercise, you wouldn’t just start one day and say that you must run 2 kilometres when you’ve never done 50 meters before or anything that is stressful before. You are not accustomed to it.
Can physical activity help to lower the risk of irregular heartbeat, heart attack, and other things like stroke?
Earlier I mentioned that physical exercise or physical activity is like a miracle drug. It reduces the risk of cardiovascular disorders all over. It lowers the risk of blood pressure, ensures weight reduction, and the risk of some cancers, osteoporosis (weakening of the bones), and so many other things. So physical activity is extremely important, and I think it’s something we should not neglect. It can help to reduce the risk of cardiovascular disease and deaths due to diseases of the heart or blood vessels. The most common ones include sudden heart attacks or strokes.
Is stair climbing sufficient for the elderly to improve their chances of living longer?
I will not compartmentalise physical activity into merely climbing stairs is okay, but how many stairs will they have to climb in a day? But we are talking about at least 30 minutes of physical activity. How are you going to get all that recommended duration of physical activity in a day just by climbing one or two flights a day? It might not be sufficient. There’s a minimum amount that is recommended; you can exceed it. Climbing the staircase is a form of exercise, but it might not be sufficient.
Some fitness coaches will say, Take 10,000 steps daily. So you can try to reach the total number of steps that the system expects you to do. And if you think you can climb the stairs for 30 minutes, fine, but I wonder which stairs you climb for 30 minutes.
They talk about knowing your numbers. What are the numbers you need to know regarding your heart health?
Know your numbers is the slogan of the World Heart Federation. And when you talk about knowing your body numbers, we talk about knowing what your blood pressure, blood sugar, and cholesterol levels are, as well as your body’s weight. You are supposed to keep track of these numbers.
These days, people wear fitness trackers. Can a fitness tracker boost heart health?
The benefits of wearing a fitness tracker are many. For instance, if you have been sitting down for long, it may give a reminder that you need to stand up and move because you have been sitting down for close to an hour. We are saying taking a number of steps per day is important. How are you going to know that unless you have something to monitor? Some people use their phones to track the number of steps they take in a day. Some people wear fitness bands or smart watches to track the number of steps taken. There are all the ways of tracking whether you are really moving or not.
Many times, some of my colleagues say, Oh, I walk around a lot. That is, until they put on a tracker and see that the walks they claim to do are not more than 3,000 steps in a day. Yes, little is good, but more is always better. But if they are used to 3,000 steps per day, it can be increased to 5,000 steps per day. This progressively increased with time. But really, it is a progressive increase in the amount of physical activity that you are doing that is important.
What are those heart checkups that you should have from age 40?
Those heart checkups are part of a standard medical checkup. When you go for a standard medical checkup with your doctor, they should check your blood pressure. They should monitor your weight for your height to determine whether you are fat and, where necessary, advise if you need to lose weight. You should check your blood sugar and the cholesterol level. Then some will say, Do an electrocardiogram (ECG). That’s a recording of your heart to see how the heart is beating. Get an ECG done. That is the minimum, and then you can get a doctor to just do a general body examination to be sure that there are no problems.
There are age-appropriate preventive measures that individuals can also take throughout their lifespan. Women can have a self-breast examination or a mammogram to screen for breast cancer. Some people to prevent colon cancer do a colonoscopy if they have a family member that suffered from colon cancer. At the age of 40, and if you are a man, check your prostate-specific antigen.
Although a pelvic examination and pap smear are advised for all women above 21 to detect cervical cancer in time, it is a more vital health test for women over 40. A pelvic examination and pap smear are tools used to detect strains of Human Papillomavirus (HPV), the root cause of cervical cancers. Impaired hearing affects mental processes and can hurt quality of life, so you can have your hearing tested every 10 years until age 50, then annually after age 60. A yearly eye examination is also important.
A study said 90% of heart diseases are preventable through a healthy diet, regular exercise, and abstinence from smoking. How true is that?
Up to 80percent of cardiovascular diseases can be prevented by maintaining normal body weight, sleeping well and reducing stress, eating well, exercising, and abstaining from smoking and alcohol. In fact, no amount of alcohol is good for the body. It is also important to maintain good social connections with all relationships, including family and friends. All these are things that promote good health. They prevent a large number of diseases by just trying to live a healthy lifestyle.
