Why Ctg leads in heart attack deaths, Barishal tops in heart disease mortality

Highlights:

• Growing pressure of heart patients outpaces health facilities outside Dhaka
• No research on why some regions see more prevalence than others
• Call for minimising risk factors by controlling diabetes, increasing physical activity, avoiding fried and rich foods
• Schools and colleges should enhance physical sports to check child obesity 
• Divisions outside Dhaka need more cath labs, specialists, angiogram facilities
• Upazilas need to have heart emergencies to reduce fatalities
  

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As the number of heart patients has been on the rise across the country, Chattogram division sees higher deaths from heart attacks than any other region. However, deaths from heart diseases are higher in Barishal, according to the Socio-Economic and Demographic Survey 2023 by the Bangladesh Bureau of Statistics (BBS), published in June this year.

While specific research is still ongoing, cardiologists believe that food habit, particularly perceived high consumption of red meat, may be a contributing factor to the higher rates of heart patients in Chattogram. Additionally, in Barishal, late diagnosis and inadequate treatment facilities for heart diseases are often attributed to higher rates of death from heart ailments.

The grim picture comes to the fore as the World Heart Day on 29 September campaigns to motivate countries to develop and support national cardiovascular health action plans. The World Heart Federation sets this year's theme for the day, "Use Heart for Action," as it believes countries attach less priority to heart health and lack effective national policies to contain the killer disease.

The most common types of heart diseases include coronary artery disease, heart arrhythmias, heart failure, heart valve disease, pericardial disease, cardiomyopathy, congenital heart disease etc, according to doctors.

The BBS survey finds heart attacks are the leading cause of death in Bangladesh, accounting for around 19.17% of all deaths.

Following Chattogram, the highest death rates from heart attacks were recorded in Dhaka and Khulna, with 20.85% of deaths in Chattogram attributed to heart attacks and 8.25% due to other heart diseases, as found in the survey.

Dr Ashish Dey, head of the Department of Cardiology at Chittagong Medical College and Hospital (CMCH), told The Business Standard, "Chattogram has more heart patients, but there hasn't been specific research on why this is the case. People here tend to consume a lot of red meat, which increases the risk of heart disease."

He added, "Heart disease is also on the rise due to factors like unhealthy diets, high consumption of fried foods, genetic predispositions, diabetes, smoking, and a lack of physical activity."

With the number of heart patients on the rise, Dr Dey emphasised the need to enhance medical facilities.

"Almost all types of heart treatments are currently available in Chattogram, where government and private hospitals have seven to eight catheterisation laboratories or cath labs. There is one surgical facility in government hospitals and three in private hospitals. However, we need to expand treatment facilities and increase manpower," he added.

Last year, a study was conducted among 107 hospitalised patients in the Cardiology Department of CMCH to assess the risk factors for ischemic heart disease (IHD), heart problems caused by narrowed heart arteries.

The study revealed that the most common risk factor was hypertension (77.6%), followed by diabetes mellitus (53.3%), smoking tobacco (43.9%), a family history of IHD (41.1%), the use of smokeless tobacco (29.0%), and dyslipidemia (28.0%).

Other contributing factors included sleep disturbances (21.5%), a sedentary lifestyle (19.6%), psychosocial stress (19.6%), and obesity (15.9%), as per the study.

Dr Rezwan Rehan, assistant professor in the Department of Cardiology at CMCH, said, "Heart disease is more prevalent in Chattogram due to genetic factors and dietary habits, as people here tend to consume richer foods."

He noted that while there is effective management of heart treatment in Chattogram hospitals, the patient demand is extremely high.

Barishal lacks treatment facilities

According to the BBS survey, in Bangladesh, heart disease is the third leading cause of death, accounting for 10.40% of all fatalities.

Barishal has the highest death rate from heart disease at 12.18%, followed by Rangpur and Mymensingh with 11.78% and 8.25% respectively.

Dr Md Mushfiquzzaman, assistant registrar in the Cardiology Department at Sher-E-Bangla Medical College Hospital in Barishal, told TBS, "Heart disease is often diagnosed late in Barishal. The outdoor service in our cardiology department has been operational for a year and a half, and since its inception, the number of heart patients has significantly increased."

He added, 70-80 patients are admitted daily to the 16-bed cardiology unit. "While we offer echocardiograms and ETT at our hospital, we currently do not have the capacity for angiograms. There is also a shortage of doctors to operate the cath lab," he said, identifying undiagnosed cases of hypothyroidism and diabetes among contributors to the increase of heart disease.

Citing inadequate medical facilities in Barishal, he said the division's lone cath lab at Sher E Bangla MCH remains closed for several months due to shortage of specialist since the clinical and interventional cardiologist was transferred last year. There is no private cath lab in Barishal, requiring heart patients to rush for Dhaka or Khulna for treatment.

Emphasis on reducing risk factors

Doctors emphasise the importance of preventive measures, such as maintaining a healthy lifestyle and proper diet, to reduce the risk of heart diseases, including heart attacks.

Dr Ashish Dey said, "We are seeing heart attack patients as young as 20-22 years old, so prevention should be a primary focus."

He added, "It's essential to manage risk factors, such as controlling diabetes, increasing physical activity, eating healthy foods, and avoiding fried foods."

Additionally, schools and colleges should enhance physical sports programmes, as rising obesity rates among children are increasing their future risk of heart disease, he further said.

Professor Dr Sohel Reza Choudhury, head of the Department of Epidemiology and Research at the National Heart Foundation Hospital and Research Institute, said, "To achieve the SDGs, we need to reduce premature deaths by 30%, with cardiovascular disease being a significant contributor to these deaths. To accomplish this, we must minimise risk factors, ensuring that those who are not yet ill are protected from exposure."

He added, "There should be a system in place to manage emergencies at the upazila level. If emergency medications are administered and patients are then referred to medical colleges at the divisional level, we can significantly reduce heart attack fatalities.