National newspaper wrong on cardiovascular disease deaths in Nigeria

Citing unnamed studies and researchers, a Nigerian daily newspaper attributed rising “sudden and unexplained” deaths in the country to cardiovascular diseases.

The September 2021 report in the Guardian then gave a statistic: “Cardiovascular disease is a significant public health concern responsible for 11 per cent of over two million noncommunicable Disease (NCD) deaths in Nigeria yearly.” 

Is this accurate?  

What is cardiovascular disease?

Africa Check contacted the Guardian for the source of the statistics cited and will update this report when we receive a response.

The World Health Organization (WHO) defines cardiovascular disease as a group of heart and blood vessel disorders. These include coronary heart disease. 

Cardiovascular diseases are noncommunicable, or chronic, diseases. These are usually lengthy and “are the result of a combination of genetic, physiological, environmental and behavioural factors”.

According to the WHO, chronic diseases disproportionately affect people in low- and middle-income countries, where more than three quarters of global deaths from noncommunicable diseases occur.

Cardiovascular disease cause third of chronic disease deaths in Nigeria

The Guardian’s claim was incorrect, Leanne Riley, head of surveillance, monitoring and reporting at the WHO’s noncommunicable diseases department, told Africa Check.

“All deaths in Nigeria only totalled 1.7 million in 2019, so 2 million deaths from noncommunicable diseases is way off,” she said. 

That year, all deaths from noncommunicable diseases in the country were estimated to be 447,767, with 146,627 of those linked to cardiovascular diseases. The agency’s most recent data is from December 2020.

It would have been accurate to say “cardiovascular disease is responsible for 33% or ‘one third’ of nearly half a million noncommunicable disease deaths in Nigeria yearly,” Riley said.

How does WHO calculate these deaths?

Good quality vital registry data was not available in Nigeria, and so mortality or death estimates were calculated using other information, Melanie Cowan told Africa Check. 

She is a technical officer in the surveillance, monitoring and reporting unit in the WHO’s department of noncommunicable diseases.

To estimate noncommunicable diseases deaths, the health agency considered 2018 cancer deaths from Globocan data. Globocan is part of the WHO’s International Agency for Research on Cancer.

It then projected the data “backwards to 2000 and forward to 2019 by cancer site using the time trend from the 2019 Global Burden of Diseases study”, Cowan said.

The global disease study is maintained by the Institute for Health Metrics and Evaluation, an independent global health research centre at the University of Washington in the US.

For other noncommunicable diseases, the WHO estimates drew on the global burden of diseases data for the corresponding causes for the 2000 to 2019 period, she said.

The resulting mortality estimates were then examined by year, age and sex to check if they added up to total deaths. 

Cowan said the estimates came with uncertainty related to data input, processing and modelling, “so the true number of noncommunicable disease deaths could potentially be higher or lower than the reported estimates of 447,767 deaths”.

Diet and lifestyle contribute to cardiovascular disease

Diet and sedentary lifestyles were two key factors contributing to cardiovascular deaths in Nigeria, Oluranti Familoni, a professor of medicine and cardiology at Olabisi Onabanjo University, told Africa Check.

“It is important we watch what we eat. Nigerians seem to be consuming more refined food, high in salt and cholesterol, which is extremely dangerous. We have also become so busy with our jobs and other engagements, which has left us with little or no time for exercise,” he said.

Many cardiovascular diseases are not detected in time as they do not cause major symptoms, Nigerian public health expert Prof Tanimola Akande said. 

“That is why hypertension, for example, is called a silent killer. Cardiovascular diseases when not detected early may easily lead to complications and eventually death. Such deaths may be sudden.”

Low awareness, poverty and poor access to health facilities also significantly affected people’s health-seeking behaviour, Akande told Africa Check.

The high cost of treating these diseases also caused poor adherence to medication, he added. 

Conclusion: Cardiovascular diseases do not account for 11% of more than 2 million deaths in Nigeria

Nigerian daily the Guardian attributed “sudden and unexplained” deaths in the country to cardiovascular diseases.

It said these accounted for 11% of the more than two million deaths from noncommunicable diseases in Nigeria every year. 

The most recent data from the WHO shows all deaths in the country in 2019 were estimated at 447,767. Of these, about a third, or 146,627, were linked to cardiovascular diseases. 

Experts say diet and sedentary lifestyles are among the factors contributing to deaths from these diseases.