You never forget your first… heart attack

(AP Photo/Emmanuel Mwiche)

(AP Photo/Emmanuel Mwiche)

Published Feb 28, 2020

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While South Africans go about their days dealing with the stresses of February, from last minute Valentine’s Day plans to a rather comical SONA and impending budget speech, over 350 fellow South Africans will have a heart attack or stroke. Today!

According to the Heart and Stroke Foundation South Africa (HSFSA), approximately 240 people suffer a stroke and another 130 suffer a heart attack in South Africa every single day.

“Africa is witnessing an epidemic of cardiovascular disease (CVD), with staggering morbidity and mortality,” said doctors Zühlke, Sliwa, Naidoo et al in a  medical article last year. “In 2013, an estimated 1 million deaths were attributable to cardiovascular disease in sub-Saharan Africa, constituting 5.5 percent of all cardiovascular disease-related deaths globally and 11.3 percent of all deaths in Africa. Between 1990 and 2013, sub-Saharan Africa was the only geographical region of the world in which the number of cardiovascular disease-related deaths increased.”

The threat that faces over a quarter of the population

This is perhaps not surprising in a country where red meat, alcohol and a diet high in refined carbohydrates and saturated fats – or non-nutritionally dense staples like pap – are the norm. However, it’s hypertension that is the main killer here. According to the  World Health Organisation  a few years ago, 27.4 percent of men and 26.1 percent of women in South Africa had hypertension, although others estimate its closer to one in every three adults and even up to 60 percent of the population.

And every single person suffering from hypertension carries increased risk of having a heart attack or stroke.

However, South Africans, according to an extensive  study done in 21 developed and developing nations worldwide, are less aware of hypertension despite being more at risk.

The good news, physically

Thanks to the march of technology and progress, almost everyone in 2020 is surviving ‘their first’. First heart attack or stroke, that is.

“Decades ago, a heart attack was often deadly, killing up to half of its victims within a few days…Today, more than 90% of people survive myocardial infarction,” says  Harvard University. “Growing use of aspirin, clot-busting drugs, and artery-opening angioplasty in the early stages of a heart attack account for more than half of the reduction in heart attack deaths since 1985, according to an analysis by Stanford researchers.”

The bad news, financially

As Harvard notes, this new surge in heart attack survival has not come without a cost. Medical treatments, time away from work, costly medication and even lengthy or indefinite stretches where sufferers are unable to return to their former lifestyles all mean a hefty financial cost for the quarter of the population at risk of cardiovascular disease.

Just about the only buffer for the average South African without tens or even hundreds of thousands of spare rands is insurance. But there’s a cutting catch-22 there as well, according to MiWayLife CEO Craig Baker.

“South Africans are woefully underinsured, with very few people adequately covered by life insurance if they should suffer a heart attack or stroke. Once they do, they are likely nowadays to survive, luckily. After an expensive recovery, these people are prepared to eat right, exercise and prevent heart disease like they never were before. However, they are still at far higher risk of a secondary episode after their ‘first’ and, with most insurers in the country, they would be uninsurable. Or, at best, the cost of insurance for such high-risk individuals would be ruinous.

“The only real financial chance people have is to be insured before their first cardiovascular episode – something many don’t see the need for until it’s too late.”

The heart of it all

So, what can be done? With the average South African overstretched by expenditure, poor economic growth and tax burdens (for those that are employed) and with insurance seen all too often as a ‘grudge purchase’, it is a tough conversation to have.

“I would advise the average South African get their blood pressure checked and have an honest conversation with a GP about their risk of developing hypertension or cardiovascular problems – then decide for themselves,” says Baker.

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