A Professor of Medicine in the Department of Medicine, Faculty of Clinical Sciences, University of Ilorin, Philip Manma Kolo, has warned that there is no effective treatment for advanced stages of heart failure, saying prevention remains the best strategic option.
Prof. Kolo, who delivered the 236th Inaugural Lecture of the University, said the only definitive treatment for the late stages of the condition is cardiac transplantation, lamenting, however, that donors are not readily available because, according to him, the heart is not a paired organ, while the cost of the procedure is also highly prohibitive, adding that many of the patients who require this surgery are on the queue for a long time.
The Inaugural Lecturer said patients with broken heart syndrome need psychosocial support, in addition to avoiding stressful situations, adding that interventions towards reducing stress such as biofeedback, meditation, yoga, physical rehabilitation and exercise can be very helpful to some patients with this syndrome. He added: “The mainstay of therapy is the treatment of heart failure using ACEL, ARBs, Beta blockers, ARNI and SGLT2 inhibitors.”
Systemic hypertension, diabetes mellitus, obesity and other non-communicable diseases, which according to Prof Kolo are major cardiovascular risk factors, should be declared public health emergencies in the country with all efforts directed at community education on diet and lifestyle choices to prevent these conditions.
He said: “Pre-hypertension and mild elevation in blood pressure should not be ignored, but treated properly after individuals’ risks are fully assessed. Physicians inertia in treating hypertension should be discouraged for early medical intervention.
“Medication adherence and persistence by patients with hypertension and other cardiovascular diseases should be encouraged. Patients should not abandon their medications for non-orthodox drugs such as Tiansi, bitter cola, snail water and GNLD drugs.
“Offsprings of hypertensive parents should be considered as a special group that needs early assessment, hypertension screening and monitoring for future cardiovascular events. They should be discouraged from cigarette smoking and ethanol abuse.”
He stressed the need for government at all levels to join hands together and establish Heart Institutes in the six geopolitical zones of the country, like in Philippines, India, among others, which would make open heart surgery available in Nigeria and take care of patients with structural heart diseases, adding that there is also the need for the establishment of cardiac catheterization laboratory in major Teaching Hospitals in the country to address cardiac diseases that are amenable through interventional procedures.
Prof. Kolo also advocated training and re-training to provide expertise in the field of cardiovascular medicine and cardiothoracic surgery for regular open surgery.
While urging government to provide defibrillators in public places to address cases of patients with cardiac arrests outside the hospital, the Inaugural Lecturer stressed the need for regular training of all hospital staff as well as other health institutions to be able to offer first aid to patients with cardiac arrests.
He added: “Government should provide legislative support to those who wish to donate their organs, including the heart, if they are involved in conditions causing brain death.”