Cardiovascular disease in Africa: Why should we care?

Happy Monday!! This post is to get us all thinking about why cardiovascular disease is actually an issue that needs to be addressed. Quite understandably, there are probably more than a few of us who don’t care and who may not care unless the issue hits close to home or worse still hits us personally. We sure hope this won’t be the case so without further ado, let us jump into it.

In 2012, the World Health Organization published data showing that, 17.5 million people had died from cardiovascular disease-related causes that year. Presently , cardiovascular disease (CVD) is one of four leading non-infectious diseases. The others are diabetes, cancer and respiratory diseases. Together, these diseases accounted for 68% of global deaths (46% of this was due to CVD) in 2012 of which  75%  occurred in low- and middle-income countries. Unfortunately, most of the countries in Africa are among such countries, suffice to say we were significantly affected. For example, there were 323.7, 359.6, 205, 266.5 and 298.3 CVD-related deaths per 100,000 people in Botswana, Democratic Republic of Congo, Kenya, Nigeria and South Africa respectively. If you wish to learn more about WHO statistics on CVD-related deaths specific to your country, please click on the following link: http://apps.who.int/gho/data/node.main.A865CARDIOVASCULAR?lang=en The data shows various trends with some countries showing a decline in the number of CVD-related deaths, others showing a stagnancy and the remaining showing an increase. However, even in the countries showing a decline, the number of deaths are alarming especially given that cardiovascular disease is largely preventable.

So you might be tempted to think “Aren’t HIV,  tuberculosis, malaria,ebola or Lassa more important?” The answer is both yes and no. Yes because they have the potential to cause a higher number of deaths in a shorter  period of time since they are infectious (can be transferred from one person to another directly or through a vector, such as the mosquito in the case of malaria). The answer is however also a resounding no because, while we keep striving to eliminate infectious diseases from our countries and continent, cardiovascular disease is not going to politely stand by and wait for its turn to strike!!! It has been on the rise these past few decades and will continue to do so regardless of our other issues.

The epidemiologic transition model created by Abdel Omran in 1971 aims to describe patterns of health and disease based on determinants such as population growth, infrastructure, medical advances, etc. Although it has been modified through the years, it is widely accepted by renowned public health organizations such as the World Health Organization and has been used to predict the pattern of cardiovascular disease globally. The premise with regards to CVD is that as a country develops, its people live longer because there is a decline in child/infant mortality and infectious disease-related mortality. Bear in mind that typically, chronic diseases like CVD are more apparent in older age. In addition, urbanization becomes more widespread with people moving out of the rural areas to cities and embracing the lifestyle changes that come with such as high-fat diets and reduced physical activity. The combination of adopting a lifestyle laden with such behavioral adaptations and living longer would therefore lead to a shift from mortality being mainly due to infectious diseases to being mainly due to non-infectious chronic diseases like CVD. This has been seen in several countries in the West. In the case of Africa however, it is predicted that rather than have a clear shift, we will be burdened with infectious diseases, non-infectious diseases AND socio-behavioral illnesses concurrently. Already, current research indicates that we are more likely to suffer from cardiovascular disease at a younger age compared to our counterparts in high-income countries.

So back to the original question. Why should we care? We should care because it will indeed be tragic, to wake up some time in the future in an Africa without our current most feared infectious diseases (and the resulting increased life expectancy), only to realize that our people are living longer to be met with the disabling effects of cardiovascular disease.. Worse still will be to wake up with the more likely situation of new infectious diseases in addition to a higher prevalence of cardiovascular disease. There is hope that this will not be the case but to prevent it, we need to not only care and act on an  individual level but also community and country-wide levels.

We hope this post gives you a better idea of why cardiovascular diseases require swift action or gives you more motivation to keep acting against it if you were already aware of its adverse effects.  Subsequent posts will provide you with more information on specific cardiovascular diseases, what is currently being done to address them and steps we can take to improve current efforts and prevent disease.

References:
Jamison DT, Feachem RG, Makgoba MW, et al., editors. Disease and Mortality in Sub-Saharan Africa. 2nd edition. Washington (DC): World Bank; 2006. Chapter 21. Available from: http://www.ncbi.nlm.nih.gov/books/NBK2294/
Omran, Abdel R. “The Epidemiologic Transition: A Theory of the Epidemiology of Population Change.” The Milbank Quarterly 83.4 (2005): 731–757. PMC. Web. 21 Mar. 2016. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690264/
World Health Organization. Global Health Observatory Data Repository: Cardiovascular Diseases, Deaths per 100,000 Data by Country.  Accessed on 20 Mar. 2016. Available from: http://apps.who.int/gho/data/node.main.A865CARDIOVASCULAR?lang=en
World Health Organization. Trade, Policy and Foreign Policy: Health Transition. Accessed on 20 Mar. 2016. Available from: http://www.who.int/trade/glossary/story050/en/
Yusuf, S., Reddy, S., Ounpuu, S. and Anand, S. “Global Burden of Cardiovascular Diseases. Part I: General Considerations, the Epidemiologic Transition, Risk Factors, and Impact of Urbanization.” Circulation. 104 (2001): 2746-2753. Available from: http://circ.ahajournals.org/content/104/22/2746.long
Yusuf, S., Reddy, S., Ounpuu, S. and Anand, S. “Global Burden of Cardiovascular Diseases. Part II: Variations in Cardiovascular Disease by Specific Ethnic Groups and Geographic Regions and Prevention Strategies.” Circulation. 104 (2001): 2855-2864. Available from: http://circ.ahajournals.org/content/104/23/2855.long#content-block
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