Talk of the silent killer has many people worried specifically related to sudden deaths. In health though silent killers abound and the anxiety related to their impact on our lives is not one that is easily assuaged. In my own life, over the course of about 5 years the numbers of friends, family members, and old classmates said to have died suddenly without any obvious antecedent illness continues to grow. It appears to me this situation is more common among friends and family living in Ghana and other low and middle income countries, however it is not easy to exclude the impact of my personal bias.
The phenomenon is however not isolated to non-developed world settings though. Overall we are all aging and with age comes chronic diseases and their impact. Other than osteoarthritis which comes with constant reminders as we attempt to engage in vigorous physical activities most diseases of aging are usually silent until they start to cause significant damage to major organs.
The questions that people commonly ask is; “what can one do in such a situation”. Whilst most of the conditions of aging are usually silent they do have recognized signs and symptoms and modern medicine has various ways by which such diseases can be diagnosed by screening and testing even in the absence of symptoms.
On that account even for our so-called ‘silent killers’ none of us needs to fly blind. The diseases and conditions that have been classified into this group may differ but most people would recognize hypertension, heart disease and diabetes among these silent killers. Others do include prostate and ovarian cancer but for the purposes of this post I would exclude these two. I must say though that I addressed the subject of prostate cancer in a prior post.
Hypertension is the most common condition among the common causes of sudden death. This condition affects more than 50% of people of African descent above the age 40 years. I have even seen patients in their 20s with hypertension so screening definitely must start early especially among those who are overweight, obese or have diabetes.
If identified early this condition can be managed appropriately and as such reduce the risk of complications which are usually related to permanent organ damage such as kidney, or heart failure . Poorly controlled hypertension does increase one’s chances of dying of a stroke or heart attack, two common conditions described as silent killers.
Screening for hypertension is fortunately universal, as far as I know no one older than 18 years can escape such a screen on any formal encounter with a health facility that I have ever worked in. I still hear people say they were unaware they were hypertensive. Most people just easily forget unpleasant news especially if it requires them to take an action they are not in a position to take or just do not want to do.
Heart disease sometimes called ischemic heart disease by doctors is definitely the most feared among the silent killers. This condition unfortunately can kill some who are totally unaware of their condition and for some this may be as dramatic as one shearing gripping pain that leads to the grave or an ICU admission. For all intents and purposes this disease once called the widow maker can proudly take the name silent killer without any argument. I would like to however revise the name widow maker to widow and widower maker since in this era of gender equity diseases have also heard our ladies’ cry for equality and are making sure there is equal opportunity to die by sex and gender.
Actually for this condition some believe our ladies have some disadvantages since their symptoms may sometimes be different from what is mostly recognized by physicians and could therefore be misdiagnosed. Nowadays though, all doctors are trained to be aware and be careful when taking care of women so as not to miss what we call atypical signs and symptoms.
The question that may be running through many minds at this time may be so what can a person do? This is one area where prevention can slow things down or make the consequences less tragic. Stopping smoking, sleeping well, low cholesterol diet and exercise are recognized as a means of reducing one risk of dying of heart disease.
We must however recognize that for those of us who have family history of heart attacks or whose cholesterol may be too high we have to be extra careful and may need medications that lowers cholesterol to help us. There are special calculators that have been developed through medical research that your health care professionals can use to advice you about your risk and provide appropriate recommendations.
Today in America and around the world cases of Diabetes are on the increase. This is mostly due to changes in our diet and physical activity. Unfortunately, most of us have motor cars and motorized scooters abound, further reducing our opportunities for non-structured physical activity interspersed within our daily lives. We also have the problem of an over abundance of cheap high calorie foods. The consumption of such foods can rise to a form of addiction for some of us. This can be clearly described as the requirements of a perfect storm for an epidemic of obesity and diabetes and as such our current situation is not a surprise to anyone. Diabetes on its own can lead to heart disease, stroke and is the commonest cause of kidney failure.
The rise in cases of diabetes in the US and worldwide is mostly related to diet and exercise. That means we can turn back the clock on this problem, if we go back to eating more natural foods and avoid processed foods. Every adult above age 45 years and anyone who is overweight or obese needs a test called hemoglobin A1c done at least once a year to screen for Type 2 Diabetes. The normal test should give you a value < 5.7% anything above that is abnormal and if your number is 6.5% or higher you have diabetes and need appropriate treatment
The key take home points I would like to leave with you are below;
- Keep track of your health related numbers, BMI, blood pressure, hemoglobin A1c, and make sure you follow your health professionals recommendations related to these.
- Make sure your diet is diverse and as close to the farm as possible, the less processing of your food the better
- Exercise when you can, ideally just start adding on daily habits that encourage more physical activity. Gym membership is great, but making it a habit to walk to the grocery store or climb the stairs rather than use the elevator would serve most of us better.
- If you smoke quitting is the best thing you can do for both your physical and financial health, smoking robs you double.
Thank you very much for taking the time to read, but your future older self would be thanking you if you follow the simple advice.
Dr. Leonard Sowah is an Internal Medicine Physician in Baltimore, Maryland
In memory of David Nii Allotey Pappoe, MOBA 86. May he Rest In Peace.
Feature Photo – CPR at Maimonides Medical Center in Brooklyn courtesy of Ashley Gilbertson of The New York Times