When people hear of heart disease, many imagine it as something that strikes suddenly in old age, often without warning. But doctors are increasingly sounding the alarm: ischaemic heart disease (IHD) is showing up in younger and seemingly healthier Kenyans more than ever before.
Dr George Otieno, a consultant physician and cardiologist at AIC Kijabe Hospital, says this condition develops quietly over the years.
“It’s called a ‘silent’ disease because most people don’t realise something is wrong until a crisis happens,” he says.
IHD occurs when blood vessels that supply the heart (the coronary arteries) narrow or block, depriving the heart of oxygen and nutrients.
As a result, the heart struggles and, in some cases, stops altogether.
“If you ever feel unusual chest discomfort while exercising, don’t assume it’s just stress; get checked,” Dr Otieno advises.
Like most lifestyle-related illnesses, the causes of IHD are a combination of variables, including daily choices on food intake and physical activity.
However, some risks are out of our control, such as being male, having a family history of early heart disease, growing older (above 50 for men and 60 for women), or even one’s genetic background. But the bigger culprits, Dr Otieno emphasises, are modifiable. These include smoking, uncontrolled high blood pressure, diabetes and lack of exercise.
“These factors collude over the years to damage blood vessels, increase inflammation, and allow fat deposits to accumulate,” he says.
One of the most dangerous things about IHD is how quietly it develops. Early warning signs are often dismissed: “People may feel vague fatigue, mild chest discomfort, especially during exertion, or unusual shortness of breath,” says Dr Otieno.
“At first, the discomfort comes only with exercise, but as the blockage worsens, even small activities can trigger it. Sometimes, there are no warnings, then one day, they get a crushing chest pain.”
This, he notes, is why taking seemingly minor symptoms seriously could save lives. While the condition is more common as people age, lifestyle changes are reshaping this pattern.
“It used to be something we diagnosed mostly in people over 50,” says Dr Otieno.
“But now we’re seeing patients in their 30s and 40s. Westernised diets, rising obesity and high cholesterol are major contributors. Autoimmune conditions and connective tissue diseases are also linked to younger women developing IHD.”
IHD symptoms may be triggered by cold seasons, heavy exertion, especially during exercise and high-pressure corporate lifestyles.
“Corporate stress is a big one. People lose time for exercise, eat poorly, sleep less and live in a constant state of tension. That combination weakens blood vessels, and sets the stage for a heart attack,” Dr Otieno explains.
Beyond health risks, the financial implications are quite costly. Dr Otieno notes a single heart attack diagnosis costs between Sh130,000 and Sh150,000. Treating a blocked artery may cost as much as Sh350,000 per artery, and often involves ICU care and months of recovery. In some cases, the patients may need lifelong medication to manage the condition.
Traditionally, men have been more affected by ischemic heart disease than women. According to Dr Otieno, men still make up the majority, with about 20 percent higher prevalence. But women are catching up, and the way they present symptoms is often very different.
“Men usually show the classic signs: severe chest pain radiating to the arm or jaw, sweating, palpitations or even collapse,” he says.
“Women and diabetic patients, may present with vague symptoms like fatigue, heartburn, or mild discomfort. These typical signs are often dismissed, which is dangerous.”
So what preventive measures can people, especially those who are most vulnerable to the disease, take? According to Dr Otieno, the most effective strategies are surprisingly simple, but they require consistency.
“The key is making small but consistent changes. Walk more, use the stairs, take short breaks from long sitting hours, and choose healthier meals instead of stress-driven junk food. Find ways to relax, whether it’s meditation, prayer, or simply disconnecting for a while.”
Routine medical checks are critical. An annual screening for blood pressure, cholesterol, and diabetes helps catch silent risks early.
“Stress management, reducing alcohol, and moderating caffeine intake are good,” he adds, “but the real game changers are exercise, quitting smoking, and controlling blood pressure and cholesterol.”
In some cultures, sudden death is still explained as witchcraft or curses, as most patients are hesitant to open up. Others believe only the obese or the elderly get heart disease. Both are myths.
“We’re seeing heart attacks in people with normal body weight and in much younger patients,” says Dr Otieno. “The earlier one adopts healthy habits, the stronger the protective effect later in life.”
