The heart of Africa: succeeding against the odds

by Karen Sliwa
The Lancet – Published Online October 25, 2016

9 pp. 551 kB
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31660-9.pdfcov200h

South Africa and other areas of sub-Saharan Africa have in the past 20 years undergone rapid demographical changes, largely due to urbanisation and changes in lifestyle. This rapid change has led to a marked increase in specific cardiac conditions, such as hypertensive heart disease and coronary artery disease (with the highest prevalence in the middle-aged population), in conjunction with a range of other heart diseases, which are historically common in Africa – eg, rheumatic heart disease, cardiomyopathies, and unoperated congenital heart disease. The short supply of well-equipped screening facilities, late diagnosis, and inadequate care at primary, secondary, and tertiary levels have led to a large burden of patients with poorly treated heart failure.

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