CARDIOVASCULAR JOURNAL OF AFRICA • Volume 35, No 1, January – April 2024 6 AFRICA Conclusion There is a paucity of PCI-capable facilities in Nigeria, with only 12 operational facilities, mostly in the private health sector. There needs to be a significant investment by the government and other stakeholders in Nigeria to increase the access to cardiac catherisation, given the increasing burden of ischaemic heart disease and the paradigm shift from communicable to non-communicable diseases. We thank Ayodeji Olorunda for proofreading the manuscript. References 1. Kakou-Guikahue M, N’Guetta R, Anzouan-Kacou J, Kramoh E, N’Dori R, Ba S, et al. Optimizing the management of acute coronary syndromes in sub-Saharan Africa: A statement from the AFRICARDIO 2015 Consensus Team. Arch Cardiovasc Dis 2016; 109(6–7): 376–383. 2. Stassen W, Wallis L, Lambert C, Castren M, Kurland L. Percutaneous coronary intervention still not accessible for many South Africans. Afr J Emerg Med 2017; 7(3): 105–107. 3. Isezuo S, Sani M, Talle A, Johnson A, Adeoye A, Ulgen M, et al. Registry for Acute Coronary Events in Nigeria (RACE‐Nigeria): Clinical characterization, management, and outcome. J Am Heart Assoc 2022; 11(1). 4. Stassen W, Wallis L, Castren M, Vincent-Lambert C, Kurland L. A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt. Afr J Emerg Med 2019; 9(3): 145–149. 5. O’Gara P, Kushner F, Ascheim D, Casey D, Chung M, de Lemos J, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. Circulation 2013; 127(4). 6. Kimeu R, Kariuki C. Assessment of the management of acute myocardial infarction patients and their outcomes at the Nairobi Hospital from January 2007 to June 2009. Cardiovasc J Afr 2016; 27(4): 218–221. 7. Johnson A, Falase B, Ajose I, Onabowale Y. A cross-sectional study of stand-alone percutaneous coronary intervention in a Nigerian cardiac catheterization laboratory. BMC Cardiovasc Disord 2014; 14(1). 8. National Bureau of Statistics. Demographic Statistics Bulletin 2020. https://nigerianstat.gov.ng/elibrary (accessed 2 February 2022). 9. Magdy A, Shawky A, Mohanad A, Shaheen S. Egypt: coronary and structural heart interventions from 2010 to 2015. EuroIntervention 2017; 13(Z): Z21–Z24. 10. Langabeer J, Henry T, Kereiakes D, DelliFraine J, Emert J, Wang Z, et al. Growth in percutaneous coronary intervention capacity relative to population and disease prevalence. J Am Heart Assoc 2013; 2(6). 11. United States Census Bureau. Census Bureau Projects US Population of 312.8 Million on New Year’s Day. https://www.census.gov/newsroom/ releases/archives/population/cb11-219.html (accessed 17 February 2022). 12. Adedinsewo D, Omole O, Oluleye O, Ajuyah I, Kusumoto F. Arrhythmia care in Africa. J Int Cardiac Electrophysiol 2018; 56(2): 127–135. 13. Hagopian A, Thompson M, Fordyce M, Johnson K, Hart L. The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain. Human Res Health 2004; 2(1). Wake-up call for governments as studies flag high risk of ultra processed foods Experts say the dangers posed by the increasing and alarming global consumption of ultra-processed food – raised blood pressure levels, heart disease and strokes – is threatening a ‘tidal wave of harm’ and should serve as a wake-up call for governments worldwide. In the UK and US, more than half of the average diet now comprises ultra-processed food (UPF) such as cereals, protein bars, fizzy drinks, instant meals and fast foods. For some, especially people who are younger, poorer or from disadvantaged areas, a diet of as much as 80% UPF is typical. Two large studies presented at the world’s largest heart conference showed the devastating impact UPF has on cardiovascular health, reports The Guardian. The first study, which tracked 10 000 women for 15 years, found that those with the highest proportion of UPF in their diet were 39% more likely to develop high blood pressure than those with the lowest. This was the case even after academics adjusted for the effect of salt, sugar and fat. High blood pressure, or hypertension, increases the risk of serious heart conditions including heart disease, peripheral arterial disease, aortic aneurysms, kidney disease and vascular dementia. The second study, a gold-standard meta-analysis of more than 325 000 men and women, showed those who ate the most UPF were 24%more likely to have cardiovascular events including heart attacks, strokes and angina. Increasing daily UPF consumption in calorie intake by 10% was associated with a 6% increased risk of heart disease. And those with UPF making up less than 15% of their diet were least at risk of any heart problems, found the research led by the Fourth Military Medical University in Xi’an, China. The findings were revealed at the annual meeting of the European Society of Cardiology in Amsterdam, where thousands of the world’s leading heart doctors, scientists and researchers were briefed on the studies. The results prompted calls from experts for urgent action. UPF are products that have gone through multiple processes during manufacturing, and are usually high in salt and sugar and may contain additives and preservatives. Often, they are low in fibre and lacking the nutrients present in fresh or minimally processed foods, such as fresh fruit and vegetables, plain yoghurt and homemade bread. Previous studies have linked eating high levels of UPF with a range of health problems including obesity, type 2 diabetes and cancer. One of the researchers behind the first study, Anushriya Pant, of the University of Sydney, said many people were unaware that food they assume is healthy, such as shopbought sandwiches, wraps, soups and low-fat yoghurts, were in fact UPF. Women typically eat more UPF than men, she said, but added that more research was needed to establish whether this was driven by the marketing of ultra-processed diet and low-fat foods at women. Dr Chris van Tulleken, one of the world’s leading UPF experts and author of the book Ultra Processed People, said: ‘The findings of these new papers are entirely consistent with a large and growing body of work showing that increasing consumption of UPF is associated with an increased risk of cardiovascular disease.’ Van Tulleken called for black warning labels to be added to UPF packaging, as is already the case in Chile and Mexico, and said there should be a clampdown on marketing of UPF, and in particular adverts aimed at children. Source: MedicalBrief 2023
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