How to Keep Your Heart Beating Strong

By the time you finish reading this sentence, your heart will have beaten three or four times. About 100,000 times by the end of today, and more than 2.5 billion times by the end of an average life. No public holidays, no weekends, no sick days.

It is, frankly, the most loyal organ you own. Most of us treat it worse than our phones.

What your heart actually does, what tends to go wrong (especially for those of us in Nigeria and across Africa), the myths that confuse people the most, and the everyday choices and medications that keep it working; let’s get into it.

A Pump That Never Asks For A Break

The heart is a fist-sized muscle sitting slightly left of centre in your chest. It has four chambers and four valves, and it pushes about 7,500 litres of blood through your body every single day. Spread out the vessels it feeds and you have roughly 96,000 kilometres of pipework, enough to wrap around the equator more than twice [1].

Stranger still, your heart runs on its own electricity. A small cluster of cells in the right atrium, called the sinoatrial node, fires the impulse that tells the heart to beat. That is why a heart, kept oxygenated, can keep beating outside the body. It does not ask the brain for permission [1].

The right side sends blood to the lungs to pick up oxygen. The left side sends that oxygen-rich blood out to the rest of the body. The coronary arteries are the heart’s own private supply lines, feeding the muscle itself. When one of those gets blocked, you have a heart attack.

What Is Going Wrong, And Where

Cardiovascular disease is the leading cause of death in the world. The World Health Organization estimates that around 17.9 million people die from it every year, and more than three-quarters of those deaths now occur in low- and middle-income countries [2]. Africa is no longer a continent of “infectious diseases only.” Heart disease has become one of our biggest killers too.

Hypertension is the chief culprit. A meta-analysis of Nigerian studies put adult hypertension prevalence at roughly 28.9% [3], and more recent urban data suggest the real figure is higher. Across the continent, fewer than one in five people with high blood pressure have it under control. The problem is that hypertension rarely announces itself. People feel fine until the day they don’t, and that day is often a stroke or a heart attack.

Heart failure in our region also looks different from the textbook Western version. Hypertensive heart disease, cardiomyopathies, and rheumatic heart disease drive most cases here, while blocked-artery disease drives most cases in Europe and North America. Sub-Saharan Africa still carries about a quarter of the world’s rheumatic heart disease burden [4], a condition that has nearly vanished in wealthier countries.

There is also a uniquely African statistic worth knowing. Nigeria has the highest reported incidence of peripartum cardiomyopathy in the world, a form of heart failure that strikes women during late pregnancy or the months after delivery. In Kano, the PEACE Registry recorded one case in every 96 deliveries [5]. Many of those women are young, otherwise healthy, and entirely unaware that pregnancy itself can stress the heart.

The Myths That Quietly Kill

A few misconceptions deserve to be retired.

The first is that a heart attack always announces itself with crushing chest pain. It often doesn’t, especially in women. Many women report weeks of unusual fatigue, jaw or upper-back pain, nausea, or shortness of breath before an event, and far too many dismiss these signs as stress or indigestion.

The second is that aspirin every day is good for everyone. The U.S. Preventive Services Task Force changed its position in 2022. Routine low-dose aspirin is no longer recommended for primary prevention in adults aged 60 and above, and is an individualised decision for those between 40 and 59 [6]. If you already have heart disease or have had a stent, that is a different conversation. But please don’t start aspirin based on a friend’s advice.

The third is “cough CPR.” Despite the WhatsApp forwards claiming you can save yourself during a heart attack by coughing rhythmically, the American Heart Association explicitly does not endorse the practice for laypeople [7]. If you think you are having a heart attack, sit down and call for help.

And the fourth: heart disease is not a man’s disease. It is the leading cause of death of women globally, frequently missed because the symptoms look different.

Taking Care Of The Thing

Most of what protects the heart is unglamorous. Move your body for at least 150 minutes a week, and brisk walking counts. Sleep seven to nine hours. Don’t smoke. If you don’t drink, don’t start.

Food matters more than most people accept. The Mediterranean and DASH eating patterns, heavy on vegetables, beans, fish, whole grains, nuts, and olive oil, and light on red meat and refined carbs, consistently come out on top in cardiovascular research. The good news is that traditional African cooking is closer to this ideal than any fast food chain will ever be. Efo riro, edikang ikong, beans, ogbono, fish, plantain, garden eggs, and pawpaw all earn their place. The trouble is what we add. Too much palm oil and deep frying. Too many bouillon cubes. Cutting back on stock cubes and salt alone can drop blood pressure meaningfully within weeks.

Get your numbers checked. Blood pressure, fasting glucose, and a lipid panel at least once a year, and more often if you are over 40 or have a family history. If you are not sure where to start, you can chat with Afiya, our AI health companion on WhatsApp, in over 50 languages.

Medication Management, And The Prescription Nobody Fills

For many people, lifestyle alone is not enough. The right medication, taken consistently, is what keeps the heart out of trouble.

Blood pressure is usually controlled with one or more of a handful of drug classes. ACE inhibitors (angiotensin-converting enzyme inhibitors) such as lisinopril and ramipril relax blood vessels but sometimes cause a dry cough. Angiotensin receptor blockers like losartan and telmisartan do a similar job without the cough. Calcium channel blockers like amlodipine and nifedipine are particularly effective in patients of African descent and are often a sensible first choice. Beta-blockers, including bisoprolol, carvedilol, and metoprolol, slow the heart and protect it after a heart attack. Diuretics such as hydrochlorothiazide and furosemide help the body shed extra fluid.

For cholesterol, statins are the foundation. Atorvastatin, rosuvastatin, and simvastatin lower LDL (the “bad” cholesterol) and have decades of evidence behind them. Ezetimibe is sometimes added when statins alone are not enough.

People with established heart disease or atrial fibrillation often need antiplatelets like low-dose aspirin or clopidogrel, or anticoagulants such as warfarin, rivaroxaban, and apixaban, to prevent clots. Heart failure care has changed substantially in recent years. The 2022 ACC/AHA guidelines now recommend four foundational drug classes for most patients with reduced ejection fraction [8]: an ARNI like sacubitril/valsartan, a beta-blocker, a mineralocorticoid receptor antagonist such as spironolactone, and an SGLT2 inhibitor like dapagliflozin or empagliflozin.

Supportive options have a smaller role but are worth understanding. Prescription-grade omega-3 (icosapent ethyl) reduced major cardiovascular events by 25% in high-risk patients in the REDUCE-IT trial [9]. Coenzyme Q10 may ease statin-related muscle aches. Plant sterols can lower LDL by about 10%. Routine multivitamins, vitamin E, and red yeast rice do not earn their keep, and red yeast rice in particular has quality-control concerns.

Here is the part most people miss. Buying the medication is not the hard part. Taking it every day, for years, is. WHO estimates that in chronic conditions, only about half of patients take their medication as prescribed. In hypertension, that translates directly into strokes that did not have to happen. This is the gap HubPharm Africa was built to close, with chronic-care medication delivery, refill reminders, and pharmacist support so that no patient runs out of the drugs keeping them alive. You can browse and refill your heart medications here.

When To Stop Reading And Call For Help

Call for emergency help if you experience persistent chest pressure, pain spreading to the jaw or arm, sudden shortness of breath, cold sweats, or unexplained fainting. For a suspected stroke, remember FAST: Face drooping, Arm weakness, Speech difficulty, Time to act fast.

Your heart will keep beating in the background whether you treat it well or not. Give it a little attention back.

Author

Kelvin is a Physiology graduate from the prestigious University of Ilorin, with a background spanning health science, therapy, and health communications. As Content creation Lead at HubPharm Africa, he brings a science-informed perspective to making health information accessible, accurate, and engaging. You can share your perspectives and/or feedback with Kelvin at kelvin@hubpharmafrica.com