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Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja, N.W.; Nakagaayi, D.; Aliku, T. et al. Frontiers in Cardiovascular Medicine (2022) CC

In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide. There is currently an epide...miological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade. Unchecked increases in CVD risk factors have contributed to the growing burden of three major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age standardized disability-adjusted life years (DALYs) due to hypertensive heart disease (HHD) were recorded in Africa. The contributory causes of heart failure are changing—whilst HHD and cardiomyopathies still dominate, ischemic heart disease is rapidly becoming a significant contributor, whilst rheumatic heart disease (RHD) has shown a gradual decline. In a continent where health systems are traditionally geared toward addressing communicable diseases, several gaps exist to adequately meet the growing demand imposed by CVDs. Among these, high-quality research to inform interventions, underfunded health systems with high out-of-pocket costs, limited accessibility and affordability of essential medicines, CVD preventive services, and skill shortages. Overall, the African continent progress toward a third reduction in premature mortality come 2030 is lagging behind. More can be done in the arena of effective policy implementation for risk factor reduction and CVD prevention, increasing health financing and focusing on strengthening primary health care services for prevention and treatment of CVDs, whilst ensuring availability and affordability of quality medicines. Further, investing in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on interventions. This review summarizes the current CVD burden, important gaps in cardiovascular medicine in Africa, and further highlights priority areas where efforts could be intensified in the next decade with potential to improve the current rate of progress toward achieving a 33% reduction in CVD mortality. more

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Prevention of Cardiovascular Disease: Guidelines for assessment and management of cardiovascular risk

World Health Organization WHO (2007) C_WHO

Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera... more

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Burden of diabetes mellitus type 2 and its risk factors in Asia from 1990 to 2019: Updates from the 2019 Global Burden of Disease study

Khazaei, Z.; Momenabadi, V.; Badrizadeh, A.; et al. Research Square (2023) CC

The mounting burden of type 2 diabetes is a major concern in healthcare systems worldwide. The purpose of this study is to investigate the trend of type 2 diabetes from 1990 to 2019 in Asia.

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Associations of the built environment with type 2 diabetes in Asia: a systematic review

Aarthi, G.R.; Begum, T. S. M.; Al Moosawi, S.; et al. BMJ Open (2023) CC2

Objectives Our study aimed to systematically review the literature and synthesise findings on potential associations of built environment characteristics with type 2 diabetes (T2D) in Asia.

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Global report on diabetes 1. Diabetes Mellitus – epidemiology. 2. Diabetes Mellitus – prevention and control. 3. Diabetes, Gestational. 4. Chronic Disease

World Health Organization WHO (2016) C_WHO

Diabetes is a serious, chronic disease that occurs either when the pancreas does not produce enough insulin (a hormone that regulates blood sugar, or glucose), or when the body cannot effectively use the insulin it produces. Diabetes is an important public health problem, one of four priority noncom... more

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Global report on diabetes World Health Organization 2016

World Health Organization WHO (2016) C_WHO

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Policy Snapshot: Cholesterol Control and Management in Brazil

World Heart Federation (2015) CC

Worldwide, there are about 17 million deaths due to cardiovascular disease (CVD) each year and at least two or three times as many non-fatal events. Raised cholesterol greatly increases the risks of stroke and heart disease, causing a large health burden across the world. The World Health Organizat... more

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Trend analysis of cardiovascular disease mortality, incidence, and mortality-to-incidence ratio: results from global burden of disease study 2017

Amini, M.; Zayeri, F.; Salehi, M. BioMed Central (2021) CC

Background Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-... more

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HEARTS. Technical package for cardiovascular disease management in primary health care. Access to essential medicines and technology

World Health Organization WHO, et al. (2018) C_WHO

Procurement and supply management activities are fundamental to consistent and reliable access to essential medicines and health products. To reduce the impact of CVD, action needs to be taken to improve prevention, diagnosis, care and management of CVD diseases. Affordable essential medicines and t... more

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HEARTS. Technical package for cardiovascular disease management in primary health care. Team-based care

World Health Organization WHO, et al. (2018) C_WHO

Many low-resource settings have a shortage of physicians and health workers. (1) In order to provide patient-centred continuous care more effectively, primary care systems can include team-based care strategies in their clinic workflows and protocols. Team-based care uses multidisciplinary teams (wh... more

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HEARTS. Technical package for cardiovascular disease management in primary health care. Systems of Monitoring

World Health Organization WHO, et al. (2018) C_WHO

Monitoring is a crucial element in any successful programme. It is important to know if health care facilities – and ultimately countries – are meeting the agreed goals and objectives for preventing and managing cardiovascular diseases (CVD). Monitoring is the on-going collection, management ...and use of information to assess whether an activity or programme is proceeding according to plan and/ or achieving defined targets. Not all outcomes of interest can be monitored. Clear outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met. To allow progress to be monitored, this module provides a set of indicators on CVD management. Agreeing on a set of indicators allows countries to compare progress in CVD management and treatment across different districts or subnational jurisdictions, as well as at a facility level, identify where performance can be improved, and track trends in implementation over time. Monitoring these indicators also helps identify problems that may be encountered so that implementation efforts can be redirected. This module starts from the collection of data at facility level, which is then “transferred up” the system: facility-level data are aggregated at subnational level to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys. Implementing a monitoring system requires action at many levels. At national and subnational levels, staff can determine how best to integrate data elements into existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS). In the facility setting, personnel must be aware of what data are needed. Sample data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools more

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Ambient air pollution and non-communicable respiratory illness in sub-Saharan Africa: a systematic review of the literature

Glenn, B. E.; Espira, L. M.; Larson, M. C.; Larson, P. S. BMC (2022) CC2

Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa’s rapid pace of urbanization, economic expansion, and population growt... more

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World Heart Federation Roadmap on Atrial Fibrillation – A 2020 Update

Freedman, B.; Hindricks, G.; Banerjee, A. Global Heart (2021) CC

The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death... more

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The Global Burden of Disease Study at 30 years

Murray, C.J.L. nature medicine (2022) CC

The Global Burden of Disease Study (GBD) began 30 years ago with the goal of providing timely, valid and relevant assessments of critical health outcomes. Over this period, the GBD has become progressively more granular. The latest iteration provides assessments of thousands of outcomes for diseases... more

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Public knowledge of cardiovascular disease and response to acute cardiac events in three municipalities in Brazil

Bartlett, E. S.; Flor, L.S.; Souto Medeiros, D. et al. Open Heart (2020) CC

Objective: To conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness and training in three underserved communities in Brazil. Metho... more

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A Roadmap on the Prevention of Cardiovascular Disease Among People Living With Diabetes

Mitchell, S.; Malanda, B.; Damasceno, A. et al. World Heart Federation (2019) CC

In 2014, the World Heart Federation (WHF) launched an initiative to develop a series of Roadmaps [1e6]. Their aim is to identify potential roadblocks on the pathway to effective prevention, detection, and management of cardiovascular disease (CVD), along with evidence-based solutions to overcome... more

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Environmental Determinants of Cardiovascular Disease

Bhatnagar, A. Circulation Research (2018) CC

Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultu... more

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The Mexico Declaration: Improving Circulatory Health for All People

World Heart Federation (2016) CC

The Mexico Declaration for Circulatory Health brings together global health organizations committed to improving circulatory health and reducing deaths and disability from heart disease and stroke around the world. These diseases presently represent the biggest health burden world-wide, accounting ... more

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HEARTS. Tool for the development of a consensus protocol for treatment of hypertension

World Health Organization WHO, et al. (2018) C_WHO

Technical package for cardiovascular disease management in primary health care.

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HEARTS. Technical package for cardiovascular disease management in primary health care. Implementation Guide

World Health Organization WHO, et al. (2018) C_WHO

HEARTS provides a set of locally adaptable tools for strengthening the management of CVD in primary health care. HEARTS is designed to enhance implementation of WHO PEN by providing: • operational guidance on further integrating CVD management • technical guidance on evaluating the impact of... more