Heart disease is an umbrella term  for a variety of diseases affecting the heart     and obesity can be regarded as one of them.   Forty-four year-old Jongihlanga Dweba from Ntabankulu, near Mount Frere,  in the Eastern Cape, has an obesity problem. He weighed 153 kilograms when he was admitted to Johannesburg’€™s Sunninghill Hospital on the 6th of September. He experienced chest pains, shortness of breath and was unable to walk a considerable distance.

‘€œThis started back in May or, maybe, June this year, and I thought it was just fever.   But even after taking fever medication, the shortness of breath and chest pains did not go away. And, then, I was referred here [Sunninghill Hospital]. My doctors diagnosed me with the condition of pleural effusion’€, says Jongihlanga Dweba.

Congestive heart failure  is the most common cause of pleural effusion.  Pleural effusion  is excess fluid that accumulates in the pleura, the fluid-filled space that surrounds the lungs.  Dweba, had to go through an operation almost immediately after his admission to drain the excess liquid.

‘€œThe operation was done on the 7th of September. And I think it worked because I feel much better and lighter now’€, he says.

In his two weeks’€™ stay at Sunninghill Hospital, he has lost 13 kilograms and now weighs 140 kgs.   As his obesity is a huge risk factor to his health, he is now under a strict eating plan designed by the hospital’€™s dietician. Dweba is well advised to continue with the eating plan when he returns to Ntabankulu.  

‘€œWhere I’€™m from we eat a lot of red meat.   It’€™s going to be difficult to move to a healthy diet that includes eating chicken, fish and lots of vegetables’€, he says.

Dr. Eric Klug, a cardiologist in private practice and executive member of the South African Heart and Stroke Foundation, says, ‘€œwhen we are talking about heart disease, we are talking about the diseases of the heart muscle itself.   We are talking about peripheral vascular disease, coronary artery disease, heart attack.   And you can include in there, high blood pressure, high cholesterol, smoking, obesity and lack of activity’€.

Of all of these conditions, he says heart attacks are a major killer among people who have heart disease.

‘€œHalf of the people that have a heart attack die before they get to the hospital. And the other half do get to the hospital and, maybe, 10% of those will die in hospital.   So, a major way of dying is the heart attack.   Another way of dying is through a stroke. So, a stroke, if it does not disable you, can kill you. And a stroke is related to blood pressure in a strong way’€, says Dr. Klug.

But what causes a heart attack?

‘€œThe heart muscle itself needs nourishment and it gets it from its own tubes, like its own irrigation system. In a so-called Western diet of high fat, high sugar… increasing weight,   less activity and exercise, big tummies, smoking, diabetes and blood pressure… all of that causes narrowing in the tubes. And when those tubes block, then you don’€™t get supply to that piece of steak [heart]. And when it stops working, that’€™s called a heart attack’€, says Dr. Klug.

Dr Klug says heart disease is mostly a lifestyle condition, which makes the majority of it preventable.

‘€œThe number one single biggest threat to cardio-vascular health is smoking. Don’€™t start smoking, and if you are smoking’€¦ stop! The closer one can get to a vegetarian diet… clearly, that’€™s the healthiest. Animal fat is our enemy. Eating meat is an enemy.   Fried chicken and fried foods is our enemy. Avoid red meat and fried foods’€, says Dr. Klug.  

He says it’€™s also important to become physically active to avoid obesity, which can trigger heart problems.

‘€œIf we can just develop an exercise programme… going from nothing to be doing some activity of walking or if you got a bike to ride, swimming, skipping… that makes a huge difference to your cardio-vascular health’€, concludes Dr. Klug.