Background-Cardiovascular disease, the major cause of mortality and morbidity in modern societies, is set to overtake infectious diseases in the developing world as the most common cause of death. The increasing prevalence of major and emerging cardiovascular risk factors accounts for the growing burden of cardiovascular disease in the world. Diabetes in all its forms is one of the main cardiovascular risk factors. Two of 3 diabetic patients will die as a result of cardiovascular complications, and approximately 30% of patients treated in cardiovascular intensive care units have diabetes. Methods and Results-This review on the cardiovascular complications of diabetes in sub-Saharan Africa is a bibliographical MEDLINE search of published data over the past 2 decades. Diabetes-related cardiovascular disease complications are considered to be rare in Africa but are on the rise and are regularly associated with classic cardiovascular risk factors. Coronary heart disease may affect 5% to 8% of type 2 diabetic patients and cardiomyopathy, up to 50% of all patients. Close to 15% of patients with stroke have diabetes, and up to 5% of diabetic patients present with cerebrovascular accidents at diagnosis. Peripheral vascular disease prevalence varies across sites from 4% to 28%. Conclusions-It is obvious that diabetes mellitus and related cardiovascular complications are gaining more importance in sub-Saharan Africa. The relative contribution of putative risk factors is not well defined, and further research is therefore needed.

Objectives: To determine the sociodemographic associations of obesity in Ghana. Design: A cross-sectional descriptive study was conducted on a sample of 6300 adults aged 25 years and over who were selected by random cluster sampling. Setting: Two urban (high-class and low-class suburbs) and a rural community in Accra, Ghana. Subjects and methods: In total, 4731 (1857 males, 2874 females) subjects participated. Demographic data were obtained by a questionnaire and height and weight were determined with subjects in light clothing and without shoes. Results: The overall crude prevalence of overweight and obesity was 23.4 and 14.1%, respectively. The rates of overweight (27.1 vs. 17.5%) and obesity (20.2 vs. 4.6%) were higher in females than males. Obesity increased with age up to 64 years. There were more overweight and obesity in the urban high-class residents compared with the low-class residents and in urban than rural subjects. Overweight and obesity were highest among the Akan and Ga tribes and relatively low among Ewes. Subjects with tertiary education had the highest prevalence of obesity (18.8%) compared with less literate and illiterate subjects (12.5-13.8%). Subjects whose jobs were of a sedentary nature had higher levels of obesity (15%) than subjects whose jobs involved heavy physical activity (10%). Subjects who did not engage in leisure-time physical activity were more obese than those who had three or more sessions of leisure-time physical activity per week (15.3 vs. 13.5%). Conclusions: Overweight and obesity are common among residents in the Accra area. Older age, female gender, urban, high-class residence, sedentary occupation and tertiary education were associated with higher levels of obesity. Policies and programmes that promote healthy lifestyles may prove beneficial.

The incidence of type 2 diabetes is growing rapidly, not only in developed countries but also worldwide. We chose to study type 2 diabetes in West Africa, where diabetes is less common than in the U.