You’re young, fit, and healthy, and you hardly ever need to go to the doctor, so heart disease should be the last thing on your mind, right? Wrong, say medical experts, who are seeing an increase in young urban Kenyans suffering from heart attacks. Every year, 1 in 8 deaths among Kenyans is due to heart failure. And while heart attacks are thought to happen only to elderly people or those with unhealthy lifestyles, there is a growing rate of heart attack prevalence among young Kenyans in their twenties and thirties.
According to the Ministry of Health estimates, 25% of medical admissions to hospitals and 13% of deaths in Kenya are due to cardiovascular disease, with heart attacks, strokes and heart failure contributing to the majority of such cases.
Myocardial infarction (MI), better known as a heart attack, occurs when a part of the heart muscle doesn’t get enough blood. The more time that passes without treatment to restore blood flow, the greater the damage to the heart muscle. Patients suffering from a heart attack often don’t receive timely treatment because they fail to recognise the importance of their symptoms and don’t seek assistance – or when they do, they present late with complications.
According to the Philips Foundation, who have partnered with the initiative Heart Attack Concern Kenya (HACK) to increase access to heart attack care, an estimated 50% of patients having heart attacks die before reaching a hospital. Of further concern, states the Foundation, is that heart attack care in underserved communities is characterised by limited intervention and treatment capacity, which means that someone having a heart attack may not be able to immediately get the emergency care that they so desperately need.
It’s vitally important, therefore, for people to understand the risks that could lead to having a fatal heart attack and how to lessen them, says Dr. Henry Ddungu, medical expert and spokesperson for the World Thrombosis Day (WTD) campaign.
Thrombosis, commonly known as blood clots, plays a significant role in people having heart attacks. “Coronary arteries – which are wrapped around the outside of the heart – supply blood to the entire heart muscle, which needs oxygen-rich blood to function,” explains Dr. Ddungu.
These coronary arteries can develop plaques – a build-up of cholesterol, fibrous tissue, and inflammatory cells – in a process called atherosclerosis. If these plaques become unstable and rupture, a blood clot can form at the site in a process called arterial thrombosis. If that blood clot blocks a coronary artery, blood can’t reach the heart, which leads to a heart attack. When the heart muscle is deprived of oxygen for an extended period due to a blocked coronary artery, it can become damaged, the severity of which depends on the size and location of the blocked artery.
“Signs of a heart attack include chest pain or pressure, shortness of breath, light-headedness, pain in the jaw, neck and back, and pain in one or both arms or shoulders. In such an instance, seek immediate emergency medical help,” cautions Dr. Ddungu.
Fatal link between clots and heart attacks
While the primary cause of a heart attack is atherosclerosis and the rupture of an atherosclerotic plaque, a blood clot can play a pivotal role in the acute event. The strong interplay between blood clots and heart attacks makes it clear that in order to reduce your risk of having a life-threatening heart attack, it’s important to reduce the risk of thrombosis, the often preventable underlying pathology of the top three cardiovascular killers – heart attack, thromboembolic stroke, and venous thromboembolism (VTE).
This week, on September 29, World Heart Day is celebrated to draw attention to cardiovascular diseases. Research from the American College of Cardiology shows that heart attacks, which were once characterised as an “old man’s disease”, are increasingly striking people under the age of 40 – including women – with numbers rising globally every year. Much of this rise in younger people can be attributed to lifestyle changes, like increased periods of time sitting in front of computer screens, eating more ultra-processed and fast foods and less time spent exercising.
Likewise, thrombosis can affect people of all ages, even though certain factors put some at higher risk. Thrombosis is a significant public health issue, yet so many people are unaware of it. Risk factors for thrombosis include hospitalisation, surgery, cancer, prolonged immobility, family history, oestrogen-containing medications, and pregnancy or recent birth.
Managing risk factors for atherosclerosis, such as high blood pressure, high cholesterol, diabetes, smoking, and an unhealthy diet, is essential in reducing the likelihood of plaque formation and subsequent clot-related heart attacks. Reducing risk factors and seeking medical attention for heart disease risk assessment and management can help lower the risk of heart attacks and related complications.
Additionally, says Dr. Ddungu, medications like antiplatelet agents (e.g., aspirin) and anticoagulants may be prescribed to help prevent or treat blood clots in individuals at risk of heart attacks.
According to the World Health Organisation (WHO), most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity and harmful use of alcohol.
“It all comes back to prevention,” concludes Dr. Ddungu. Understanding the risk factors and what you can do to lessen them enables you to be an active participant in your health and wellbeing and this knowledge could very well save your life, or that of a loved one.
