Coronary heart disease and associated risk factors in sub-Saharan Africans

Marijon, Éloi; Trinquart, Ludovic; Jani, Dinesh; Jourdier, H; Garbarz, Eric; Mocumbi, Ana Olga; Celermajer, David S.; Ferreira, Beatriz Moreira Ayub

doi:10.1038/sj.jhh.1002146

Cited by 9 publications

(7 citation statements)

References 11 publications

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“…These risk factors include a history of high blood pressure and diabetes, current or former use of tobacco, a high lipoprotein ApoB/ApoA ratio, abdominal obesity, an unhealthy diet, increased psychosocial stress and physical inactivity. Over the last 5–8 years evidence from several sources indicate that these risk factors are increasing at an alarming rate throughout most of the continent 18 30 31 60–63. Hypertension is the most common risk factor, with recent cross-sectional surveys indicating a prevalence of 19.8–26% in rural communities of Nigeria and Kenya and 23.7–40.1% in urban communities of Tanzania and Namibia64 and other older national prevalence estimates in adults raging between 15 and 20% 65…”

Section: What's New On the Risk Factor Burden And Efforts To Prevent mentioning

confidence: 99%

Recent advances in the epidemiology, outcome, and prevention of myocardial infarction and stroke in sub-Saharan Africa

Ntsekhe

Damasceno

2013

Heart

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The early part of the new millennium witnessed reports of a growing burden of cardiovascular disease in Sub-Saharan Africa (SSA). However the contribution of ischemic heart disease and stroke to this increasing burden relative to that caused by hypertensive heart disease, cardiomyopathy and rheumatic heart disease was not clear. Over the last decade, data from the continent has begun to clarify this issue and suggests three main points. The burden of ischemic heart disease relative to other causes of heart disease remains low particularly in the black Africans majority. Stroke caused predominantly by hypertension is now a major cause of disability and premature death. Third, the burden of risk factors for atherosclerosis is increasing rapidly in most urban and some rural regions. A concerted effort to understand the primary drivers of this increase in cardiac risk factors is required to prevent a future epidemic of atherosclerosis and its sequelae.

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Section: What's New On the Risk Factor Burden And Efforts To Prevent mentioning

confidence: 99%

Recent advances in the epidemiology, outcome, and prevention of myocardial infarction and stroke in sub-Saharan Africa

Ntsekhe

Damasceno

2013

Heart

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“…This difference was not found in men. Marijon et al [27] ascertained, in a small study, that cardiovascular risk factors differed between ethnic groups in Mozambique with hypertension being most prevalent in the African population and this population group having very few other risk factors in comparison to the European and South East Asian groups.…”

Section: Disease Burdenmentioning

confidence: 99%

Non-communicable diseases in Mozambique: risk factors, burden, response and outcomes to date

Silva-Matos

Beran

2012

Globalization and Health

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Mozambique is located on the East Coast of Africa bordering South Africa, Zimbabwe, Zambia, Malawi and Tanzania and is one of the poorest countries in the world. Currently NCDs account for 28% of deaths in Mozambique. Risk factors such as tobacco and alcohol use and poor diet are present in both urban and rural settings. Diseases such as hypertension and diabetes affect large proportions of the population, but people are often unaware of their condition or poorly managed. Data from studies on diabetes highlight the financial burden for NCD management in Mozambique for both the individual and health system. The National Strategic Plan for the prevention and control of NCDs in Mozambique has as its aim to create a positive environment to minimise or eliminate the exposure to risk factors and guarantee access to care. The plan has as its overall objective to reduce exposure to risk factors and morbidity and mortality due to NCDs and has 4 areas of intervention: 1) Prevention and health education with regards to NCDs; 2) Access to quality care, treatment and follow-up; 3) Prevention of disability and premature mortality and 4) Surveillance, research, monitoring and evaluation and advocacy for NCDs. The Ministry of Health developed projects for diabetes and hypertension and used these as key lessons that could then be applied to other NCDs. Mozambique, through political commitment from the Ministry of Health and the dedication of local champions, has been able to garner international support to improve care for people with diabetes and then use this to develop its National Plan for NCDs. Despite this increase in attention resources available do not match the challenge of NCDs in Mozambique. Mozambique’s experience provides a practical example of actions that can be undertaken in a resource poor country to tackle the emerging burden of NCDs.

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“…Studies in Nigeria have suggested that effective treatment of HTN could avert 2 out of 5 deaths caused by that disorder 7 . Marijon and coworkers 8 found that the black African population in Mozambique was unique in comparison to AAs and South Africans, in that it had a higher prevalence of HTN, few cumulated risk factors, and mainly focal proximal single‐vessel lesions. Studies in Tanzanian adults and children revealed the presence of only a few of the known cardiovascular risk factors, with the primary one being smoking 9 .…”

Section: Hypertension As a Risk Factor For Cms In Persons Of African mentioning

confidence: 99%

The Cardiometabolic Syndrome in Persons of the African Diaspora: Challenges and Opportunities

Schuster

Gaillard

Osei

2007

J Cardiometabolic Synd

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Unique genetic traits appear to play a role in the increased rates of hypertension (HTN), glucose dysregulation/diabetes (T2DM), and obesity in persons of African descent. Indeed, with increasing rates of westernization/urbanization and concomitant increases in obesity and T2DM, a similar predisposition to the cardiometabolic syndrome and cardiovascular disease (CVD) can be seen in Africans compared with persons of African descent, with CVD reaching epidemic proportions in many areas of Africa. In addition, the complex relationships of metabolic abnormalities that are unique to individuals of African descent have also been demonstrated in Africans. These include: (1) a dissociation of HTN to insulin resistance; (2) relative favorable lipid profile in the setting of increasing rates of CVD; (3) low levels of visceral adiposity in the setting of obesity and insulin resistance; and (4) a dissociation of insulin sensitivity and adiponectin when compared with Caucasians. Although not well understood, these unique relationships suggest that conventional parameters for CVD do not apply to Africans of persons of African descent.

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Coronary heart disease and associated risk factors in sub-Saharan Africans

Cited by 9 publications

References 11 publications

Recent advances in the epidemiology, outcome, and prevention of myocardial infarction and stroke in sub-Saharan Africa

Recent advances in the epidemiology, outcome, and prevention of myocardial infarction and stroke in sub-Saharan Africa

Non-communicable diseases in Mozambique: risk factors, burden, response and outcomes to date

The Cardiometabolic Syndrome in Persons of the African Diaspora: Challenges and Opportunities

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