Preventing cardiovascular disease (CVD): Interview with Professor René Baragou, Head of Cardiology at Sylvanus Olympio University Hospital

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Extract from the article: In Togo, recent population studies reveal that 30% of adults suffer from high blood pressure, 7.3% from diabetes and 15% from obesity. CVD is responsible for increasing hospital admissions. The key to reversing the trend is prevention. Professor René

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« It is characterised by chest pains, coughing on exertion, shortness of breath on exertion... »

In Togo, recent population studies reveal that 30% of adults suffer from high blood pressure, 7.3% from diabetes and 15% from obesity. CVD is responsible for increasing hospital admissions. The key to reversing the trend is prevention. Professor René Baragou, Head of Cardiology at the University Hospital of Sylvanus Olympio and President of the Société de Cardiologie du Togo (SOCART), gives his advice on how to improve prevention.

Santé-Education: Are there any early warning signs of cardiovascular disease?

Pr René Baragou: We need to distinguish between two groups. On the one hand, there are those who don't know it but who are at risk.These are the asymptomatic.This includes people who smoke, have a strong hereditary factor, are overweight or obese, have high blood pressure or diabetes.On the other hand, there are those who have symptoms. This is characterised by chest pains, coughing on exertion, shortness of breath first on exertion, then on the slightest exertion and finally at rest. Men over 40 and women over 50 who fall into one of these two groups should be concerned.

Is it possible to reduce the risks?

For people who are at risk, it is important to control these risks as much as possible.This means not smoking, eating a low-fat diet with more vegetables and being physically active, such as walking or taking the stairs rather than the lift.You don't need to run a marathon; a daily walk of around thirty minutes is enough.You should also consult a cardiologist once a year to detect any coronary problems.

For symptomatic people, the advice is the same: avoid smoking and eat better. As for physical activity, before resuming it, you should consult a cardiologist to prevent a heart attack.

What are the main types of heart disease that can occur?

Firstly, there is ischaemic heart disease, which accounts for around 60% of hospital admissions.It can range from simple angina pectoris to heart attack and concerns everything to do with the supply of blood to the heart via the coronary arteries.Then there is valvular heart disease.This is a problem with the heart valves, which are either malformed, shrinking or becoming insufficient. The two main symptoms are breathlessness and palpitations.Then there is cardiomyopathy, which affects the heart muscles. The heart is a muscle that can sometimes become deficient and lose its effectiveness, leading to heart failure. Heart muscle disease can be idiopathic, meaning that the causes are not identified, or secondary, in the case of myocarditis.There can also be congenital heart disease, which is a malformation in children that is treated very early in life but will make them more fragile.

How is cardiovascular disease screened?

It starts with a clinical examination, an electrocardiogram and a cardiac ultrasound which, even if they are imperfect, help to orientate the diagnosis and visualise any valvular or myocardial anomalies or infarctions.

Other, more sensitive tests, such as a stress test or myocardial scintigraphy, will help refine the diagnosis and, if necessary, suggest that the patient have his coronary arteries examined by coronary angiography, an examination that shows the arteries of the heart and any atherosclerotic lesions.

Can I do sport if I have a cardiovascular disease?

It depends on the pathology; there are several grades.If the problem is a narrowing of the valves, it can be treated and you can return to a normal life once the problem has been resolved.On the other hand, if you have a heart attack - and a quarter of patients develop coronary heart disease through a heart attack - then the heart is defective.Depending on the seriousness of the condition, major exertion may be prohibited, or even the slightest exertion or even flying may be forbidden.The most important thing is to avoid a heart attack.

Interview by Abel OZIH