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The tip of the iceberg in the sub-Saharan Africa: unraveling the real world in the diagnosis and treatment of heart failure
  1. Luis E Rohde1,2,
  2. Andréia Biolo1,2
  1. 1 Advanced Heart Failure Program, Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
  2. 2 Department of Internal Medicine and Post-Graduate Program in Cardiology, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
  1. Correspondence to Dr Luis E Rohde, Cardiovascular Division, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos 2350, Sala 2061, Porto Alegre 90035-903, Brazil; rohde.le{at}gmail.com

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A pivotal publication of the Global Heart Failure Awareness Programme in 20141 calls for an integrated international effort to make heart failure a health priority in every country across the globe. Ensuring equity of care for all patients by delivering timely access to diagnostic services and treatment of heart failure is one of the key aspects highlighted by this initiative. Several recent reports clearly demonstrate, however, that there is still significant regional variability in several facets of the diagnosis and management of heart failure across different parts of the world.2 Moreover, healthcare system organisation and resource use also vary greatly, producing major constrains to patients’ care, particularly in low-income to middle-income countries.

There is a growing body of international data evaluating patients with heart failure outside North America and Europe, mostly in the acute setting or in tertiary care referral facilities. The Sub-Saharan Africa Survey of Heart Failure (THESUS-HF) was pioneer to prospectively evaluate clinical characteristics, patterns of treatment and short-term outcomes of patients with acute decompensated heart failure admitted to university hospitals in nine African countries.3 THESUS-HF investigators demonstrated that heart failure affected African patients at an early age, was caused mostly by hypertension and had low rates of beta-blockers prescription at discharge. Rates of …

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