A Professor of Medicine and consultant Cardiologist at the College of Medicine, University of Lagos (UNILAG), Professor Amam Mbakwem has stressed the significance of taking care of one’s heart and understanding the potential risks associated with heart-related conditions.
She gave the charge on Wednesday, July 10, 2024, while delivering the institution’s 20th inaugural lecture in the 2023/2024 academic session titled: It’s your Heart: Guard it with all Diligence – Every heartbeat counts.
Held at the prestigious J. F Ade. Ajayi Auditorium, the event was presided over by the Vice-Chancellor of the University of Lagos, Professor Folasade T. Ogunsola, OON, FAS. It was well attended by notable dignitaries as well as mentors, colleagues, family, friends, mentees and students of the Inaugural Lecturer.
During her lecture, Professor Mbakwem emphasized the importance of heart health and highlighted failure of the heart as a critical issue. According to her, the heart has an immense capacity to cope with stress and injuries but if not properly addressed it will bring about abnormalities, damage or dysfunction.
Using her personal experience as well as graphical statistics to emphasise the impact of heart disease, Professor Mbakwem broke down the topic and provided a clear structure on key aspects of heart health, as well as prevention, and management of heart diseases.
She pointed out that the burden of heart failure continues to rise with an aging population across the globe especially with increased risk factors which are not appropriately controlled like hypertension, diabetes, dyslipidemia, smoking, alcohol consumption and environmental pollution.
Her words “Heart failure (HF) occurs in the middle-aged population in our environment as opposed to the elderly seen in reports from western populations. Our studies and that of our colleagues all around the country have categorically demonstrated that HF occurs a decade to two earlier in Nigeria and Africa compared to the same disease process in the West.”
Highlighting some of her extensive researches, Professor Mbakwem explained that her research findings demonstrated:
- A galloping rise in the frequency of heart failure hospitalization (1590% cumulative increase) over 16years 2001-2017 in LUTH, in tandem with the rise in cardiovascular diseases that lead to heart failure.
- Heart failure occurs in younger people in our environment about a decade or two earlier than in Western populations.
- The commonest risk factor for heart failure in our environment remains hypertension.
- Mortality is high and is increasing, about 19% in the first year and most event will occur within three months of hospitalization.
- About two thirds of our heart failure patients are depressed; 25% have poor quality of life; 50% have psychological pain and 28% have low self-esteem.
- The economic burden is huge and hospitalization for heart failure in Nigeria leads to catastrophic health expenditure and impoverishment up to 60% of our patients who are uninsured.
- A more sensitive NT pro-BNP cut off level for the diagnosis of heart failure in ambulatory care in our environment, 171pg/L vs 125pg/L advised by the manufacturers and the guidelines.
While enumerating her contributions in the cardiovascular health field, Professor Mbakwem delved into the heart condition known as Peripartum Cardiomyopathy (PPCM) which affects women during or shortly after pregnancy. According to her, peripartum cardiomyopathy is a potentially life-threatening condition that can have profound implications for maternal health.
The internationally-acclaimed Cardiologist explained that her work with other collaborators have led to the publication of position and guidance papers on diagnosis, management and counselling on subsequent pregnancies in women with peripartum cardiomyopathy.
At the end of her presentation, Professor Mbakwem made several recommendations to reduce the burden of Cardiovascular Disease (CVD) and its risk factors, as well as improve the well-being of CVD patients. These include:
- Full implementation of the Universal Health Coverage. The out-of-pocket payment for healthcare especially cardiovascular disease has reached catastrophic proportions as defined by World Health Organisation (WHO) and some families have become impoverished trying to pay cardiovascular care.
- There should be a policy to reduce the cost of medications to control the major risk factors like hypertension and diabetes.
- Drug importation should be exempt from import taxes to reduce cost of medications.
- Enabling environment to enable pharmaceutical companies manufacture medications for cardiovascular care locally.
- Empowerment of the primary care facilities for the management of CVDs, CVD risk factors and other NCDs.
- Establishment of regional cardiovascular centres of excellence for quaternary cardiovascular care.
- Improvement of the working conditions of healthcare personnel to stem the current brain drain in the industry.
Professor Mbakwem was born on 6th March, 1957 to the family of late Mr. George Nwawuikwu and Mrs. Justina Afokwalam. She attended the Township School for her primary education and later proceeded to Owerri Girls’ Secondary School for her post-primary education between 1970 and 1974.
After a one-year A-Level programme at Queens College, Yaba, Lagos, she was admitted to study Medicine at the College of Medicine, University of Nigeria, Nsukka where she bagged a Bachelor of Medicine and Surgery (MBBS) Degree in 1981 and subsequently had her Housemanship training at the University of Nigeria Teaching Hospital, Enugu State.
The young medical doctor was mobilised for the mandatory National Youth Service Corps (NYSC) scheme as a medical officer at the Alba Medical Center, Kaduna, from 1982 to 1983. Thereafter, she had her postgraduate training at the Lagos University Teaching Hospital under the auspices of West African College of Physicians and the National Postgraduate Medical College. She passed the membership exams of both colleges and obtained the Fellowship of the West African College of Physicians in 1997.
She undertook further training in Cardiology at the Wolfson Heart Institute, Tel Aviv, Israel in 1999 and also obtained a Fellowship in Medical Education from the Foundation for Advanced International Medical Education and Research (FAIMER) Institute in Philadelphia USA in 2007.
Professor Mbakwem joined the services of the University of Lagos as Lecturer I in the College of Medicine (CMUL) in 1999 and was appointed Professor in 2015. She is the current Head, Department of Medicine; Director of the Medical Education Development Unit, CMUL as well as Chair of Medical Education Committee and Residency Training Programme in the Department of Medicine, CMUL, among others.
She has trained over ten thousand (10,000) medical, dental, and pharmacy students, and has successfully supervised over fifteen (15) fellowship candidates, some of whom have become Associate Professors.
Report: Bayo Salau
Photograph: Ayo Oloyede
