Cardiovascular disease the leading cause of death in SA

After HIV/Aids, cardiovascular disease (CVD) is the leading cause of death in South Africa, with one in three people over 25 suffering from hypertension (high blood pressure), making the early diagnosis and management of the disease so important.
Nicole Jennings, spokesperson for Pharma Dynamics – South Africa’s leading provider of cardiovascular medicine – says non-adherence to prescribed medicine regimens is a pervasive medical problem, costing many people their health and the healthcare system billions of rands.

“While there is much room for improvement, addressing medication non-adherence is a complex issue that requires a multifaceted approach.” She cites cost, complex regimes, forgetfulness, lack of understanding, and psychological factors as common reasons heart patients may not take their hypertensive medication. “Not taking medication as prescribed can have serious consequences, especially regarding cardiovascular diseases. “Non-adherence also increases the risk of hospitalisation by 10–40 per cent and the mortality risk by 50–80 per cent. Other consequences may also include:

Increased risk of heart events: Failure to take heart medicine as prescribed can significantly increase the risk of heart-related events like heart attacks, strokes, and unstable angina. Doctors often prescribe medications like angiotensin-converting enzymes (ACE inhibitors), antiplatelet drugs, beta-blockers and anticoagulants to prevent these events.

Worsening of heart disease: Doctors typically prescribe cardiovascular medications to manage and stabilise heart diseases like hypertension, heart failure and arrhythmias.

Hospitalisation: Medication non-adherence can cause exacerbated heart conditions, which may require hospitalisation. Heart failure patients, for example, may experience fluid buildup in the lungs (pulmonary oedema) or other complications that need urgent medical attention.

Reduced quality of life: Uncontrolled heart disease can lead to symptoms like chest pain, shortness of breath, fatigue, and decreased exercise tolerance. These symptoms can significantly reduce a person’s quality of life and ability to perform daily activities.

Increased healthcare costs: Non-adherence can result in more frequent doctor visits, hospitalisations and additional medical interventions, leading to higher healthcare costs for individuals and the healthcare system.

Complications in other organs: CVD can impact other organs and systems in the body. For example, untreated hypertension can damage the kidneys, eyes, and blood vessels. Non-adherence can exacerbate these complications.

Increased mortality risk: Ultimately, non-adherence to heart medications can increase the risk of premature death, especially in cases of severe heart disease. Jennings says healthcare providers play a crucial role in educating patients about the importance of their medications, discussing potential side effects and concerns, simplifying regimens when possible and exploring cost-effective options. “As the country’s leading provider of heart medicine, we have a robust strategy to bring more cost-effective combination therapies to the local market. Lessening the pill burden for patients who need to take two or more types of medication daily is one way to improve adherence.

“It’s important to note that while medication adherence is a critical factor, other lifestyle changes and risk factor management (like diet, exercise, stopping smoking, limiting alcohol intake) also play a crucial role in reducing hospitalisations in heart patients. Therefore, a comprehensive approach to heart disease management is essential,” she says.