‘Heart failure on the rise in Jamaica’

Eight years ago, track and field coach Ian Harris unexpectedly discovered that he was at serious risk of a heart attack after undergoing a coronary angiogram.

He had taken several of the young athletes he coached to the Heart Institute of the Caribbean (HIC) for routine check-ups and decided to have one himself. It later revealed that his heart was 50 per cent blocked.

Sharing that he led a very active life, Harris said he was very surprised by his diagnosis, which, if left untreated, could lead to coronary artery disease and cause a heart attack, cardiac arrest, or heart failure.

Realising that he had been walking around unaware of his condition, the now 62-year-old is passionately advocating for the importance of regular heart check-ups.

“It’s crucial that we know, and it’s essential that we get checked,” he emphasised.

Each year, 7,500 Jamaicans experience a heart attack, HIC Chairman Dr Ernest Madu disclosed during a media tour at the facility on Thursday ahead of the annual Masters of Medicine Conference to be held January 18-19, at The Jamaica Pegasus hotel, which will be co-hosted by Yale University.

Of this number, 3,200 are women.

Indicating that many do not survive, Madu stated that cardiovascular disease is the leading cause of death in Jamaica, accounting for 33 to 37 per cent of all fatalities, and that heart disease and stroke together account for more than half of all hospital deaths in the country.

“Heart failure is on the rise. We are beginning to look at heart failure phenotypes that were not previously known, and we believe that a lot of those heart failure cases in Jamaica will be high,” he said.

He estimated that approximately 12,000 Jamaicans – 8,000 men and 4,000 women, primarily aged 55-74 – live with a history of heart attacks.

Expressing concern about the limited number of open-heart surgeries performed annually in Jamaica, Madu pointed out that only around 200 such surgeries take place each year. To address this, he is calling for greater government support for private institutions like the HIC to improve care, particularly in areas such as addressing manpower shortages and facilitating the importation of necessary equipment.

“Private-sector healthcare, public-sector healthcare, they all take care of Jamaicans. So it’s not public versus private,” he said, noting that while mainly private players operate in the tourism sector, the minister bats for the entire industry.

“Heart disease is our problem. Heart disease kills more people than violence,” HIC President Dr Dainia Baugh stated.

Noncommunicable diseases

She noted that Jamaica’s high rate of noncommunicable diseases makes the population even more at risk of developing heart disease. For instance, diabetes affects 11 to 12 per cent of the population, hypertension impacts 30 to 50 per cent of adults, and 11 per cent of adults have high cholesterol. Additionally, 60 per cent of women and 40 per cent of men are either overweight or obese.

Additionally, there is a rising prevalence of overweight or obesity among the youth - 19 per cent of adolescents in Jamaica are considered obese, and 20 per cent of the youth are afflicted with type II diabetes.

Noting the link between some normalised practices such as excessive drinking, smoking, and a diet of excessive carbohydrates, Baugh emphasised the importance of practising a healthy lifestyle, including frequent exercise and proper nutrition, in order to reduce the risk of heart disease.

“I don’t think people really and truly understand what it is that they are doing to contribute to this curve now (increase in cardiovascular disease). That is what is the emergency,” she said.

And while acknowledging that primary healthcare in Jamaica has improved in some areas, she believes that the state of the island’s secondary healthcare system leaves much to be desired, especially when it comes to treating heart issues.

Currently, only the HIC and the University Hospital of the West Indies (UHWI) can provide advanced cardiac diagnosis and treatment, Baugh said. And while the HIC offers 24-hour service, emergency cardiac care is not available at the UHWI all the time, she noted.

Additionally, she said there is a shortage of cardiologists on the island, with only 18 serving the population, most of whom are based in Kingston.

“We know that heart attacks happen most frequently in the early morning hours, but if the staff is not there, prepared to do a diagnostic catheterisation and or to open up the vessel, having a catheter in there is helpful, but it is not answering the problem that we have,” she said.

Madu pointed out that the global standard to operate after a patient has experienced heart blockage and is brought to the hospital is within two hours. He further highlighted that the cardiologists in Jamaica are not locally trained as there are no such programmes available locally.

sashana.small@gleanerjm.com