Our hearts are killing us in SA

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love your heart The most common heart condition that can be easily diagnosed is bradycardia, in which the heart beats too slowly to maintain adequate functioning. Photo: Istock
love your heart The most common heart condition that can be easily diagnosed is bradycardia, in which the heart beats too slowly to maintain adequate functioning. Photo: Istock


Hypertension, obesity, diabetes, lack of exercise and smoking are some of the major causes of premature death from cardiovascular aetiologies among South Africans in the age group of 34 to 64.

According to the SA Heart and Stroke Foundation, 30% of the population has some form of cardiovascular disease (CVD). Heart disease is one of the biggest causes of mortality in the country – more than all cancers combined.

As the country recognised September as heart awareness month, the foundation said it was concerning that CVD, once a disease associated mostly with the elderly, now accounted for more than half of deaths in people younger than 65.

Internationally acclaimed South African cardiologist Dr Iftikhar Ebrahim said heart disease and strokes were the biggest killers in South Africa after HIV and Aids: “Every hour, 10 people have strokes and five people have heart attacks. Eighty percent of cardiovascular deaths are in patients younger than 65. Hypertension affects one in three people in South Africa, two out of three women suffer from obesity and one in three men are obese. Also, one in 10 people in South Africa are diabetic.”


According to Ebrahim, some of the symptoms of CVD include shortness of breath, especially as a result of physical effort; chest discomfort; and a feeling of pressure that may radiate to the arm or even the neck and jaw, and gets worse with exercise and better with rest. Swelling of the feet, shortness of breath when lying down and dizziness or fainting are also some of the symptoms.

Ebrahim said that, in order to lead a healthier life, people need to find out if they suffer from high blood pressure.

If it is the case, they should decrease their salt intake, consult a doctor for blood pressure medication and ensure they monitor their blood pressure regularly.

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“Maintain healthy eating habits, avoid processed foods [fast food], decrease sugar and salt intake, avoid refined carbohydrates, and increase fruit and vegetable intake. People also need to measure their glucose levels and, if they are elevated, visit their doctor for advice and medication. If you are diagnosed with diabetes, it is vital to avoid all sugars and carbohydrates. Take your medication regularly and monitor your blood glucose levels. Also, you need 30 minutes of exercise five times a week. Even a brisk walk will lead to a decrease in blood pressure and glucose levels, and assist in losing weight and increasing blood flow,” Ebrahim said.

Peter Mehlape, managing director of Medtronic Southern Africa, said bradycardia, where the heart beats too slowly to maintain adequate functioning, was the most common heart condition and could be easily diagnosed.

He said: 

“Simply paying attention to your heartbeat can reveal whether you need treatment or the implantation of a pacemaker – a simple surgical procedure that can prevent early death and enable you to lead a full, normal life,”

A pacemaker is a small, battery-operated device implanted in the chest, which corrects conduction abnormalities in the heart by sensing when the heart is beating too slowly. It then sends a signal to the heart to make it beat at the correct pace. Ebrahim said a normal resting heart rate should be between 60 and 100 beats per minute. Anything below 60 beats per minute is considered to be slow.

“I would advise anyone with a heart rate persistently below 50 to have their doctor check it and have an electrocardiogram done. However, a heart rate persistently below 40 beats per minute requires urgent attention because it would indicate a heart block,” Ebrahim said.

He said a third-degree heart block was the most common and the most serious.

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“It occurs when there is almost no communication between the upper and lower chambers of the heart. The heart cannot maintain blood flow to the brain, leading to dizziness and syncope [fainting],” he said.

Dr Kaveshree Govender, a cardiologist specialising in heart rhythm disorders, said implanting a pacemaker was a simple procedure that could often be done at a day clinic with conscious sedation instead of full anaesthetic.

Govender said: 

“Patients can continue with their normal lives after the operation, although they won’t be able to lift their left arm above shoulder height for six weeks.

“After that, they need check-ups every six months, but can expect to enjoy a normal, full life,” he said.

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