Every week, a name crops up on social media of a young professional, a student, a seemingly fit person who collapsed and never woke up.

What was once spoken of in hushed tones is now a growing public concern, raising questions about why sudden deaths are becoming more visible across the country.

According to the Vital Statistics report by the Kenya National Bureau of Statistics (KNBS), non-communicable diseases accounted for 61.7 percent of all deaths in 2023, up from 52.4 percent the previous year, a burden that includes cardiovascular conditions.

This marks a sharp rise from a decade ago, when NCDs accounted for less than a third of all deaths.

“The increase reflects changing lifestyles, longer life expectancy, and improved control of infectious diseases, which have shifted the country’s disease burden towards chronic conditions,” the report noted.

Meanwhile, health facility records show at least 7,478 deaths in 2024 were linked to heart-related conditions, while cardiac arrest has consistently ranked among the top causes of hospital deaths between 2020 and 2024.

“The burden will continue rising if urgent action is not taken,” the ministry added. “Urbanisation, population changes and lifestyle shifts are key drivers,” said the Ministry of Health.

Clinicians say many of these deaths present as sudden collapses, often in people with no known history of illness.

“We are seeing more cases of people collapsing suddenly and dying,” said Daniel Nduiga, a cardiologist and heart rhythm specialist at Heart Rythm Medical Centre.

“The answer to whether these incidents are actually increasing or simply more visible is likely a combination of both. In an interconnected world, such events are publicised widely and quickly.”

Evidence shows that most sudden collapses stem from three acute events.

“The direct causes are fatal heart attacks, fatal cardiac arrhythmia, and stroke. These are all fuelled by hypertension, diabetes, and high cholesterol,” Dr Nduiga said.

Autopsy findings from studies conducted by the University of Nairobi revealed that heart attacks were the leading cause of cardiovascular deaths in Kenya, followed by cardiomyopathy, brain haemorrhage, and pulmonary thromboembolism.

“These deaths occur largely among men and people below 50 years,” the report noted, “pointing to a growing impact on the working-age population.”

However, by the time many patients reach the hospital, the damage is already done.

Read: Chronic diseases are now top cause of death in Kenya

“Many patients arrive after collapsing at home or work, with little or no prior diagnosis,” said Dr Esther Itemi, a consultant cardiologist in Nairobi.

“This places additional strain on emergency services, which are forced to manage complications that could have been prevented through early detection and routine care.”

Dr Nduiga added that in many cases, deaths classified as sudden are actually the result of undiagnosed conditions.

“The underlying disease was there long before the collapse. “Without regular screening, patients may live for years with high blood pressure or heart disease without knowing,” he said. “They only seek care when complications occur.”

Doctors attribute the rising burden largely to untreated risk factors, particularly hypertension.

“Nearly one in four adults has high blood pressure, yet more than half have never been tested, and most of those diagnosed are not on treatment or have not achieved control,” Dr Nduiga explained.

The Ministry of Health acknowledges gaps in early detection and consistent care.

“Many patients only present at advanced stages,” it said. “This has forced higher-level facilities to manage preventable complications, highlighting weaknesses in primary care coverage.”

In response, the ministry said it is scaling up screening for hypertension and diabetes at the primary care level.

“Non-communicable diseases have also been prioritised under universal health coverage reforms, with a focus on early diagnosis and long-term management.

Implementation remains uneven, particularly in rural areas where diagnostic services are limited,” it said.

According to Dr Nduiga, heart disease rarely announces itself. Instead, it builds quietly, over years, until the body can no longer cope.

“Unfortunately, many people miss the warning signs such as fatigue, dizziness, shortness of breath, and an awareness of their own heartbeat. Elevated blood pressure, leg swelling, headache, and low energy are early indicators that all is not well,” explained Dr Nduiga.

"Chest pain during activity and palpitations require urgent evaluation. Delays often lead to fatal outcomes,” added Dr Itemi.

The pattern is also shifting by age, with cardiologists reporting more patients in their 30s and 40s than they saw a decade ago.

“Our young people are engaging in high-risk behaviour, including smoking, excessive alcohol intake, and illicit drug use. Sedentary lifestyles and poor diet are also fuelling hypertension, diabetes, and high cholesterol,” said Dr Nduiga.

Surveys indicate that a significant proportion of adults now carry multiple NCD risk factors. Among men aged 18 to 69, smoking remains widespread, increasing cardiovascular risk even among those in their 20s and 30s.

Similarly, urbanisation has accelerated these trends, with more Kenyans adopting sedentary routines and consuming processed foods high in salt and fat.

Environmental factors also play a role. “The widespread use of biomass fuels for cooking exposes millions to air pollution, which is linked to heart disease, hypertension, and stroke,” said Dr Nduiga.

Clinicians further note that the Covid-19 pandemic resulted in missed screenings, interrupted treatment, and delayed diagnoses, leaving many patients at higher risk.

Despite the high risk, experts say that most cardiovascular deaths are preventable; however, the infrastructure to prevent them is not consistently in place.

“Access to routine screening and follow-up care remains uneven. Basic services such as blood pressure checks, blood sugar monitoring, and heart tests are not consistently available at primary care facilities,” said Dr Itemi.

Adults are urged to regularly monitor blood pressure, cholesterol, body mass index, and blood sugar.

“Any symptoms such as chest pain, palpitations, unexplained shortness of breath, persistent dizziness, or leg swelling should prompt immediate evaluation,” said Dr Nduiga.

Lifestyle changes are equally important. “Reduced intake of processed foods, increased physical activity, avoiding tobacco, moderating alcohol, and managing stress are essential preventive measures,” he added.

Dr Nduiga noted that public perception remains a barrier, as many people consider sudden death as accidental, failing to see the connection between their lifestyle and these diseases.

“We need to change knowledge, attitudes, and health-seeking behaviour,” he said.

“This is a public health crisis, especially given the poor access to quality healthcare for the majority of our population. What is urgently needed is education, community mobilisation, and greater investment in access to care,” he added.

→ lowoko@ke.nationmedia.com

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