The commonest forms of heart disease in sub-Saharan Africa are chronic rheumatic heart disease, dilated cardiomyopathy, pulmonary heart disease, infectious forms of heart disease including chronic, constrictive and infective endocarditis, genetic forms of heart disease, and arrhythmias. The consequences of malnutrition, with cardiac manifestations such as beriberi, and the added effects of alcoholism also play a roll.
Hypertension, an important condition, is for the purpose of this article, not considered a primary heart condition. Ischaemic heart disease in this part of the world is at present of little consequence except to the small, westernised white population. It is particularly noteworthy that as a cause of morbidity and mortality, heart disease ranks far below many other diseases of an infectious nature.
The ravages of heart disease are likely to escalate in the next generation(s). The changing demographic picture dictates the way the costly burden of disease should be approached and how funds for research, prevention and therapy can be channelled to best advantage.
This article raises perspectives that in some areas will be contentious, but in general, I am sure will carry consensus. A concerted effort must be made by cardiologists of African countries to arrest the advance of heart disease, and a declaration outlining these strategies, endorsed by the Pan-African Society of Cardiology (PASCAR), is included in this article.