Tuesday, March 25, 2014

[MUST READ] Sudden death: Common but preventable


Within the past two weeks, two friends had reported the sudden deaths of two persons they had known intimately: one was the husband of a mutual friend who marked his 50th birthday on the Saturday preceding his death on a Monday.
The second person was an aunt to a friend. She was 51. The deceased had the same experience in their final moments: they slumped to death in the bathroom.
Naturally, family members, friends and acquaintances would ask endless questions as they try to fathom how an otherwise “healthy” person could just slump and die. We talked to experts who provided extensive insight into causes of sudden death and how to prevent it.
Causes
Public Health expert, Dr. Rotimi Adesanya, who is a Senior Medical Officer and Head of Medical Services, College Medical Centre, Federal College of Education (Technical) Akoka, Lagos, explains that for anybody to slump and die, two vital organs of the body must be involved.

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He explains, “These are the heart and the brain. The heart is a major organ that has to function optimally, and during intense physical activities, the heart works more, pumping blood adequately to support the brain.
“The brain is also what keeps us alive, but if it is deprived of blood supply for more than four minutes, a person can go unconscious and this could lead to death.”
Experts say sudden death syndrome, whereby people just slump and die, is caused by heart and brain attacks.
“Brain attack simply means stroke. Anyone can have stroke as well as heart attack. Those are the two conditions that kill immediately,” Adesanya warns.
He notes that most people are not aware that they have hypertension and diabetes — the two conditions that predispose people to suffer stroke or heart attack.
World-acclaimed physician, Prof. Oladapo Ashiru of the Life Detox Clinic, Lagos, corroborates this. He says, “Sudden death is usually due to problems arising mainly from the cardiovascular system or the neurological system. It can be caused by either a cardiac attack or a massive cerebro-vascular accident (stroke).
“Other diseases that could cause sudden slump leading to death include hypertrophic cardiomyopathy (a genetic disorder that has a variable presentation and carries a high incidence of sudden death). Again, sudden pressure in the heart due to intense physical activities can cause a dormant ailment in the body to become active,” Ashiru says.
Asked if sudden death could be due to certain underlying illnesses/diseases that victims were unaware of, or which they had refused to take seriously, the physicians say there is no mystery involved in many of these rapid and unexpected deaths among otherwise “healthy” persons. Adesanya notes that heart disease is the most common cause of sudden death. “About two-thirds of the time, a coroner discovers during an autopsy that the death was due to a heart abnormality which the patient was unaware of or refused to take seriously,” he says.
“For a variety of reasons, something such as a structural heart defect may cause the heart to beat out of control. This abnormal heart rhythm is known as ventricular fibrillation,” Adesanya submits.
Sudden death avoidable
Ashiru adds that usually, there should be no “sudden” death. “There are warning signals that precede sudden death. Examples include uncontrolled blood pressure and ignoring persistent headache despite taking analgesics.”
On whether sudden death is preventable, the physicians answer in the affirmative.
“Capital YES! You can save yourself by going for regular medical check-ups and eating healthy diet. Vegetables are excellent, as natural foods are good for the body and are a lot better than preserved or refined foods.
“There’s also the need to exclude excess sugar such as refined foods and sugary drinks from your diet. Avoid excess alcohol intake and smoking,” the physicians counsel.
Scientists warn that cigarettes contain nicotine, a chemical that speeds up the heart, putting the central nervous system under unnecessary tension. “If you put too much pressure on a machine, you would wear it out. The same with the human body,” Adesanya warns.
He also advises those who are fat or obese to lose weight, recommending regular exercise for everybody in order to maintain physical fitness.
Ashiru also says regular medical check-ups will prevent high blood pressure from leading to stroke or blockade of the blood supply to the heart, which can lead to heart attack. “It will also prevent sudden death from acute renal failure,” he assures.
At-risk group
Based on scientific research, physicians say sudden death is common among those who are 40 years old and beyond; while it peaks for those who are over 60.
They say the incident is rare among younger people, though athletics and those involved in any sporting event are highly susceptible.
“Sudden death in people under age 35 is often due to hidden heart defects or overlooked heart abnormalities,” they warn.
“For the average person, age 40-65 is the period one is very active, and yet so busy to look after himself or take a break for medical check-up. It is also the age that stress is on the optimum level. This include stress of work, school fees, keeping up with the Joneses, struggling for a position and many more,” Ashiru notes.
As for the sex that is more susceptible to sudden death, experts say it affects men twice as it does women. “Men are more susceptible because of activities, stress, hustling, and the survival of the fittest phenomenon,” scientists say.
Prevent it
In terms of advice for preventing sudden death, physicians say many Nigerians are falling victim of sudden, unexpected deaths because they don’t do regular medical check-ups.
“Regular medical check-up is key to preventing sudden death and should be promoted. Through it, you are able to diagnose chronic diseases such as hypertension, cancer, diabetes mellitus and respiratory diseases.
Again, experts say, frequency of sudden deaths is worsened by poor health behaviour and attitude to medical check-ups by a majority of Nigerians.
They advise those who are over 40 to do a six-monthly or yearly comprehensive medical screening in registered hospital/diagnostic centre under the supervision of their physicians.
They add that health education is very important, and it’s one reason physicians must keep preaching it.
“We need to let people know the real solution, the antidote, the cure, the prevention of sudden death,” Adesanya argues.
They add that lifestyle changes such as exercise and healthy eating should also be promoted.
“We recommend 30 minutes of exercise at least three or four times a week. So, as often as one can do it, one must. You can do any form of exercise such as dancing, walking, bicycling or the treadmill.
“Exercises keep your weight down, makes your heart work better, thereby keeping blood pressure in check; and it can also help in the management of diabetes, sometimes without medication,” Ashiru concludes.
Guard against sudden death
•Check your BP regularly
•Exercise (moderately) regularly
•Reduce salt intake
•Avoid junk meals high in fats and oils which only clog up the arteries
•Take lots of whole-grains, fruits and veggies
•Take lots of water
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