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Coronary Artery Disease in Nigeria

Blocked heart arteries — rising in Nigeria as diets and stress levels change

Coronary artery disease (CAD) occurs when the arteries supplying the heart muscle with blood become narrowed or blocked by atherosclerosis — a buildup of fat, cholesterol, and inflammatory cells in the artery walls. Historically considered rare in Nigerians, CAD is now rising rapidly, driven by hypertension, diabetes, obesity, changing diets, and stress. It causes angina (chest pain on exertion) and heart attacks.

Signs and Symptoms

✓ Angina: chest tightness, pressure, or pain on exertion that resolves with rest (minutes)
✓ Unstable angina: angina occurring at rest or with increasing frequency and severity
✓ Heart attack: severe central chest pain lasting more than 20 minutes, with sweating, breathlessness, or nausea
✓ Shortness of breath on exertion
✓ In some, especially women and diabetics: atypical symptoms — jaw pain, shoulder pain, nausea, or fatigue without classic chest pain

Risk Factors

When to Seek Help

Chest pain on exertion that resolves with restClassic angina — needs cardiac investigation within 2 weeks. Do not dismiss as 'just stress' or 'indigestion'.
Any chest pain lasting more than 20 minutesPossible heart attack — seek emergency care immediately.
Worsening or resting anginaUnstable angina — urgent hospital admission; may precede heart attack within hours.
Family history + cardiac risk factorsEarly preventive assessment — lipid profile, BP, glucose, and risk calculation should guide preventive treatment.

Tests & Diagnosis

🧪 Resting ECG
May show evidence of old heart attack or ischaemia. Normal ECG does not exclude CAD.
🧪 Exercise stress test (EST)
Walking on a treadmill while the ECG is monitored — looks for ST changes indicating ischaemia. Available at teaching hospital cardiology departments.
🧪 CT coronary angiogram (CTCA)
Non-invasive imaging of coronary arteries — shows plaque burden and degree of stenosis. The most sensitive test for CAD. Available at private radiology centres.
🧪 Conventional coronary angiogram
Invasive catheter test — the gold standard. Shows exact anatomy and guides stenting or bypass surgery decisions.
🧪 Lipid profile
LDL cholesterol is the primary driver of atherosclerosis. Target LDL below 1.8 mmol/L in high-risk patients.
🧪 HbA1c and fasting glucose
Diabetes dramatically accelerates CAD.

Treatment Options

1
Aspirin 75 mg daily
Reduces platelet aggregation and heart attack risk in established CAD. For high-risk primary prevention, discuss with your doctor.
2
Statin therapy
Atorvastatin or rosuvastatin — lower LDL and have anti-inflammatory effects in coronary arteries. Reduce heart attack and death rates by 25–35% in established CAD. Essential for all CAD patients.
3
ACE inhibitor
Reduces cardiac remodelling and second heart attack risk in patients who have had an MI or have heart failure.
4
Beta-blocker
Reduces heart rate and myocardial oxygen demand — used for angina and post-MI.
5
Sublingual GTN (glyceryl trinitrate)
For acute angina attacks — dissolves under the tongue and relieves chest pain within 2–5 minutes. Carry at all times if you have angina.
6
Coronary angioplasty (PCI) with stenting
For significant coronary stenosis — a wire and balloon open the blockage and a metal stent keeps it open. Available at Lagos, Abuja, and Port Harcourt specialist cardiology centres.
7
Coronary artery bypass graft (CABG) surgery
For multivessel or left main stem disease — bypass grafts route blood around blocked arteries. Available at selected Nigerian cardiac surgery units.
8
Lifestyle modification
Smoking cessation, Mediterranean-style diet (vegetables, fish, olive oil, whole grains), regular aerobic exercise, weight loss, and strict BP and glucose control.

Frequently Asked Questions

Is heart disease rare in Nigerians?
It was previously considered less common than in Western populations, but this is changing rapidly. CAD rates are rising in urban Nigerians, particularly those with hypertension, diabetes, and sedentary lifestyles. The 2023 INTERHEART Africa study confirmed that Nigerian risk factor profiles now approach those of high-income countries.
What is the difference between angina and a heart attack?
Angina is reversible chest pain from temporary inadequate blood supply to the heart — it resolves with rest or GTN, and heart muscle is not permanently damaged. A heart attack (myocardial infarction) occurs when blood supply is completely cut off, causing permanent heart muscle death. A heart attack needs emergency treatment within minutes to hours.
Can I prevent a heart attack if I have CAD?
Yes — significantly. Statins, aspirin, blood pressure control, and lifestyle modification reduce second heart attack risk by 50%+. Many people with established CAD live for decades without further events with optimal medical management.
What is cholesterol and why does it matter?
Cholesterol is a waxy fat carried in the blood. LDL ('bad') cholesterol deposits in artery walls forming plaque. HDL ('good') cholesterol removes cholesterol from arteries. Triglycerides are another fat type that worsens atherosclerosis. A lipid profile blood test measures all of these. High LDL is a major modifiable risk factor for heart attack.
Are statins safe?
Yes — statins are among the most studied drugs in medicine. Side effects are uncommon: muscle aches occur in 5–10% (usually mild). Serious muscle breakdown is rare. Slight increase in diabetes risk in those already at risk. The benefit (heart attack prevention) vastly outweighs risk in people with established CAD or high cardiovascular risk.

Related Pages

Chest Pain What Does It MeanCholesterol Guide NigeriaStroke Prevention NigeriaHeart Failure Nigeria Guide

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