Heart disease worry given Bajan eating habits

by George Alleyne

Do not wait until over age 50 to check medical status as regards non-communicable diseases, learn nutrition facts while instilling and practising prevention habits from young, shift consumption habits based on culture, and involve schools and non-governmental organisations in this thrust.

These are views of health care professionals who believe that such preventative practices are key to Barbados reducing its alarming rate of NCD infections, especially heart attacks, stroke and diabetes.

These collective opinions, voiced Tuesday, come against a backdrop of an average one Barbadian dying daily from heart attack; there being an estimated one in five nationals with diabetes, the main affliction that leads to heart attacks; and strokes increasing by 15 per cent between 2010 and 2018 with the latter year registering 682 incidents.

“The efforts at primary prevention need to start early,” said Consultant Neurologist Professor David Corbin, who advised that childhood obesity must be tackled head-on by discouraging children’s consumption of harmful foods such as sugary drinks.

“The seeds are sown very early in life. We can’t wait until they’re members of BARP (Barbados Association of Retired Persons) to start thinking about primary prevention . . . develop the culture in the schools.

“We need to get out there and have meetings with the six-formers and fifth-formers and make them understand that they have their future and the future of the country in their hands and it’s a choice that they need to make”.

The Co-Director of the Stroke rehabilitation Unit of the Queen Elizabeth Hospital (QEH) said that when those preventative practices are ignored, “we see the end result of many of these things in the hospital but [by then] it’s too late”.

Professor Corbin was at the time speaking as a member of a panel that fielded questions from the audience following a presentation by Dr Abdon Dasilva on ‘Stroke and Heart Disease in Barbados through the Years’.

The family physician’s lecture and following panel discussion were sponsored by the Heart and Stroke Foundation in observance of that organisation’s 35th anniversary and World Heart Day.

Other panellists at this function in the ‘Walled Garden’ of the Barbados Museum and Historical Society were Dr Aderemi Soyombo; heart attack survivor Nigel Griffith, along with Dr Dasilva. Moderator was Dr Dawn Scantlebury.

Much of the comments in this article stemmed from questions and observations posed by Clinical Pharmacologist Dr Kenneth Connell, who asked, “what are we doing wrong as a civil society organisation that we haven’t managed to change the narrative of policy-makers to address primary prevention?”; and president of Diabetes and Hypertension Association of Barbados, Trudy Griffith, who said, “I don’t think we’re doing enough with regards to primary care in Barbados”.

The top five risk factors for heart disease and stroke are any kind of vascular disease or high blood pressure; diabetes; smoking; high cholesterol; and family history, explained Dr Scantlebury, a QEH consultant cardiologist.

She said that to decrease risk, Barbadians must “eat healthier; exercise; make sure you are at a healthy weight; don’t smoke; and control your diabetes or your blood sugar; your blood pressure and your cholesterol”.

A sobering fact she shared is that in the absence of the NCD and lifestyle risk factors plus family history, “one risk factor for having a heart attack or stroke is just being alive”.

“So, anybody is at risk but the more of these risk factors you have the higher your risk”.

She explained that a person without any of the risk factors may have a one-in-one thousand likelihood of suffering a heart attack, “but if you have two or three of these risk factors you may be one in 50 people… If you are diabetic your risk of having heart disease is going to be pretty high”.

Diseases within the blood network also heighten the heart attack risk.

The Barbadian lifestyle brings on many of these NCDs.

“It’s almost inbred in our culture, souse on Saturday, ham at Christmas, the sweet drinks, the rums. Everything that we do is so circled around food – very unhealthy food at that,” she said.

“That is Barbadian culture. So, the question is how do we change our culture.”

Nigerian-American Dr Aderemi Soyombo, a non-invasive cardiology specialist, believes that Barbados’ universal health care system makes it easier to enforce preventative medical care as people should be made to get a physical examination once a year and those who do not should be denied that free care, “because that physical you get once a year might prevent you from getting a heart attack 10 years down the road. It’s going to cost much more money than getting a physical once a year for 10 years”.

The QEH Cardiovascular Services Consultant said NCDs such as hypertension and diabetes could be picked up early in the annual examinations.

She said overconfident young people ignore annual medical examinations, “you’re in your 30s you feel great, ‘I’m not sick I can’t have a heart attack’ but meanwhile all those things are building [inside]”.

These people however show up at the hospital in their senior years suffering a heart attack or stroke.

Dr Dasilva said, “one of my biggest problems is trying to get people to modify their risk, particularly with people who are overweight”.

“It’s very difficult to have people lose weight for a lot of reasons. But I think one of the problems is because we have not impressed on our patients that losing weight is not an option. It should be seen as part of your treatment and as important as taking medication.”