I think the dictator ignored the need for early intervention like with a cardiac stent, bed rest and medication. He thought he would live forever. And in the end his own arrogance brought about his demise.
On top of such risky behaviors, he could have felt that he had recovered enough and threw away all precautions his doctors asked him to take.
I was pretty much convinced that he would do himself in a lot earlier than many experts believed, because of those risky behaviors. Many old sick people also have the tendency to recover unexpectedly before their final death.