Elsevier

Progress in Cardiovascular Diseases

Volume 56, Issue 3, November–December 2013, Pages 234-239
Progress in Cardiovascular Diseases

The Epidemiology of Cardiovascular Diseases in Sub-Saharan Africa: The Global Burden of Diseases, Injuries and Risk Factors 2010 Study

https://doi.org/10.1016/j.pcad.2013.09.019Get rights and content

Abstract

The epidemiology of cardiovascular diseases in sub-Saharan Africa is unique among world regions, with about half of cardiovascular diseases (CVDs) due to causes other than atherosclerosis. CVD epidemiology data are sparse and of uneven quality in sub-Saharan Africa. Using the available data, the Global Burden of Diseases, Risk Factors, and Injuries (GBD) 2010 Study estimated CVD mortality and burden of disease in sub-Saharan Africa in 1990 and 2010. The leading CVD cause of death and disability in 2010 in sub-Saharan Africa was stroke; the largest relative increases in CVD burden between 1990 and 2010 were in atrial fibrillation and peripheral arterial disease. CVD deaths constituted only 8.8% of all deaths and 3.5% of all disability-adjusted life years (DALYs) in sub-Sahara Africa, less than a quarter of the proportion of deaths and burden attributed to CVD in high income regions. However, CVD deaths in sub-Saharan Africa occur at younger ages on average than in the rest of the world. It remains uncertain if increased urbanization and life expectancy in some parts of sub-Saharan African nations will transition the region to higher CVD burden in future years.

Section snippets

Methods

The core summary measurement of population health in the GBD 2010 Study was disability-adjusted life years (DALYs) in the years 1990 and 2010. DALYs represent the “health gap” between a population’s actual health and an ideal standard. DALYs are composed of years of life lost (YLL) to premature deaths and years lived with non-fatal disease disability (YLD).3 Ten major CVD cause categories were defined based on International Classification of Disease (ICD) classifications: stroke, ischemic heart

Results

Compared with all other world regions, the sub-Saharan Africa region had the smallest proportion of disease burden attributed to CVD in 2010: 8.8% of total deaths, 3.9% of years of life lost, and 3.5% of DALYs (“tree plot” visualization of cause proportions, by region, available at http://viz.healthmetricsandevaluation.org/gbd-compare/). The corresponding CVD proportions for combined high-income regions were 35.7%, 27.2%, and 16.4%. Within sub-Saharan Africa, the Southern region had the highest

Discussion

The epidemiology of CVDs in sub-Saharan Africa is distinct because atherosclerosis causes only about half of CVDs. The GBD 2010 Study estimated that absolute CVD burden has increased in sub-Saharan Africa since 1990, with the largest relative increases in burden being atrial fibrillation and peripheral arterial disease—CVDs occurring most often in the elderly. Cerebrovascular disease, particularly hemorrhagic and other non-ischemic stroke, was the dominant source of CVD burden in the region.

Statement of Conflict of Interest

All authors have no conflicts of interest to report.

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    Statement of Conflict of Interest: see page 238.

    Disclaimer: The views expressed in this article do not necessarily represent the views of the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, or any other government entity.

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