Unraveling the mystery of Cardiovascular Disease and empowering a global fight for health
Imagine a silent epidemic sweeping across the globe, claiming more lives than infectious diseases, maternal and perinatal conditions, and nutritional disorders combined. A group of insidious disorders lies at the heart of this global crisis—cardiovascular disease (CVD). CVD is not just a single condition; it’s a menacing cluster of disorders that strike the heart and blood vessels of the brain, endangering millions of lives worldwide.
The scale of the impact is nothing short of staggering. According to the Centers for Disease Control and Prevention (CDC), CVD stands as the leading cause of death and disability, casting a dark shadow over humanity’s well-being. The harrowing statistics from 2019 alone reveal a heart-wrenching toll of 17.9 million lives claimed by CVDs, representing a daunting 32% of all global deaths.
Among the countless victims, heart attacks and strokes, accounting for a staggering 85% of these fatalities, leave a trail of grief and devastation in their wake. The risk of blood clots and the accumulation of fatty deposits on artery walls intensify, suffocating blood flow to the heart, brain, and various vital organs, causing blood vessels to harden and narrow. Even the blood vessels supplying crucial organs such as the brain, heart, kidneys, and eyes are not spared, falling prey to the relentless grip of these diseases.
Peripheral arterial disease, which strikes the blood vessels that feed our arms and legs, offers a stark example of the insidious nature of CVDs. This isn’t just a distant concern; projections show that by 2030, CVD will mercilessly claim more lives in SSA than infectious diseases, maternal and perinatal conditions, and nutritional disorders combined.
The urgency to address this epidemic cannot be overstated. It’s time to unravel the mysteries surrounding CVDs, empower ourselves with knowledge, and take decisive action to protect the lives and futures of millions worldwide. Join us on this journey to shed light on the hidden battles fought within our hearts and minds, as we strive to conquer this formidable adversary: cardiovascular disease.”
Over 1 million Africans with CVDs die yearly
Over 1 million Africans face a silent and deadly enemy every year – cardiovascular diseases (CVDs). Beyond the staggering numbers lies a profound tragedy, where lives are cut short, dreams remain unfulfilled, and families are left heartbroken. The World Health Organization warns that CVDs are not just a medical issue but a reflection of the major forces shaping our world – globalization, urbanization, and population aging. With CVD-related deaths in sub-Saharan Africa reaching a grim milestone of 1 million in 2019 alone, this epidemic claims 5.4% of all global CVD-related deaths and a staggering 13% of all deaths on the continent.
What’s even more alarming is that these deadly diseases strike silently, often showing no visible symptoms until it’s too late. Heart attacks and strokes, the harbingers of CVDs, account for a heart-wrenching 73% of all CVD deaths in Africa. Imagine lives forever changed in an instant, as a stroke disrupts the blood supply to the brain, leaving essential brain cells to wither away. Prompt treatment is a race against time to prevent severe brain damage and save lives. Equally concerning is hypertension, a deceptively quiet assassin. While simple and affordable treatments exist, the global prevalence of hypertension has skyrocketed to 1.13 billion people in 2015, largely affecting low- and middle-income countries (LMICs).
The stories behind these numbers are not just statistics but personal tragedies. Families lose their loved ones to preventable deaths, leaving behind a void that can never be filled. It’s a stark reminder that CVDs do not discriminate, affecting people of all ages, genders, and backgrounds.
The power to combat this crisis lies within our reach. By knowing our family medical history and modifying lifestyle habits, we can take proactive steps to control risk factors for CVDs. Regular screenings and preventive tests can be the key to early detection, potentially saving countless lives. But, in low- and middle-income countries, governments struggle to muster the capacity, financial resources, and healthcare infrastructure needed to avert risk factors and protect public health.
In the heart of Africa, the South African Heart and Stroke Foundation sheds light on the harsh reality – 30% of the population suffers from some form of CVD, with heart disease surpassing all cancers combined as a leading cause of mortality.
As we uncover the heart-wrenching impact of CVDs on individuals and communities, there has never been a more urgent call for action. Governments, healthcare providers, and communities must come together to prioritize public health and allocate resources to tackle this pressing issue. By investing in prevention, early detection, and accessible healthcare, we can turn the tide against CVDs and pave the way for healthier and brighter futures for millions.
Let us stand united in the face of this formidable adversary, sparing no effort to combat CVDs and create a world where heartbreak and loss are replaced with hope, health, and happiness.
Negative public perceptions on the spectrum of cardiovascular disease
In the shadows of cardiovascular disease in Africa lies a troubling reality – negative public perceptions that often prove costly in human lives. The urgency of this crisis calls for public health initiatives that not only increase awareness of heart attack and stroke symptoms but also ensure timely medical care reaches those in need. The statistics published by global nonprofit PATH are alarming, with hypertension prevalence in adults aged 30 to 70 soaring to a staggering 35%, surpassing the global average of 33%. However, the shockingly low 11% control rate for hypertension reflects glaring gaps in awareness, enrollment, and access to optimal treatment across the region.
The knowledge gaps are equally concerning, with limited understanding of maternal cardiovascular health, the prevalence, and balance between congenital and acquired CVD in children, and the spectrum of CVD in adulthood. In Rwanda, where approximately 15% of the population grapples with hypertension, the majority face uncontrolled cases, leading to devastating heart damage. Astonishingly, the Rwanda nationwide NCD STEPwise survey reveals that only 80,000 out of 1 million people with hypertension are enrolled in clinics, exposing a stark disparity between diagnosis and treatment.
The burden of cardiovascular diseases extends far beyond just numbers. For many regions in Africa, cerebrovascular disease, cardiomyopathies, and rheumatic heart disease continue to inflict suffering, especially on vulnerable children in poverty-stricken areas. Rheumatic fever, which wreaks havoc on young lives in developing countries, causes irreversible damage to heart valves and muscle. Shockingly, globally, about 2% of all cardiovascular disease-related deaths are attributed to rheumatic heart disease.
The impact of these negative perceptions goes beyond just untreated conditions. It leads to ignorance of high blood pressure, often left undiagnosed due to the lack of routine measurement. Even when diagnosed, reliable access to healthcare services and life-saving treatment remains a luxury for many, putting lives at risk.
In the face of this daunting crisis, African governments are joining forces to design a ‘roadmap’ for action, seeking to eliminate acute rheumatic fever and eradicate RHD on the continent. The priorities encompass enhanced surveillance, increased access to high-quality medications for prevention, improved reproductive health services for women, and decentralized expertise and technology for managing these conditions.
But this isn’t just a battle for governments; it’s a battle for every heart, every family, and every community. The stories of those affected by negative public perceptions deserve to be heard, and the urgency to take action cannot be overstated. Together, we can break down barriers to awareness, treatment, and care, ensuring that no life is lost to preventable cardiovascular diseases.
The time to rewrite the narrative is now. It’s time to empower communities with knowledge, bridge the gaps in healthcare access, and redefine public perceptions. With united efforts, we can transform hearts, save lives, and create a healthier, more vibrant Africa for generations to come.”
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Poor access to essential medicines, medical interventions, and technological advances
In the heart of Africa, a silent struggle unfolds as millions grapple with cardiovascular diseases, weighed down by the burden of poor access to life-saving medicines, medical interventions, and technological advances. The stark reality is that drug treatment for hypertension, diabetes, and high blood lipids stands as a critical defense against heart attacks and strokes. Yet, the cost of CVDs treatment imposes a heavy economic burden on Sub-Saharan African countries, leaving countless patients undiagnosed and untreated, precariously vulnerable to cardiovascular risks.
The National Library of Medicine (NLM) statistics show the vicious cycle of poverty intertwines with poor health, as 76% of people in SSA endure meager incomes of less than US$2 per day, and 46.5% survive on a mere US$1.08 per day. CVDs management comes at a steep price, with medication costs comprising a substantial portion of the overall expenses. For some, monthly costs hover around US$11.5, while others face a staggering US$44.35, with medication expenses surpassing half of the total cost.
In the midst of these challenges, glimmers of hope emerge through initiatives like the International Forum for Hypertension Control and Prevention in Africa. Efforts are underway to formulate treatment guidelines and identify cardiovascular risk factors. Some African countries have taken strides in conducting epidemiological studies and monitoring programs. However, the road to progress remains fraught with obstacles, from inadequately funded and understaffed health systems to a lack of access to affordable generic drugs and a general lack of awareness about the importance of CVDs prevention.
To break free from this cycle, Africa’s people yearn for education on healthier lifestyles, from weight reduction and smoking cessation to increased physical activity. Empowering individuals with knowledge is a crucial step toward overcoming the barriers that have hindered progress in CVDs prevention.
Diabetes, a relentless foe, joins hands with high blood pressure as a risk factor for CVD, further exacerbating the challenges faced by many in Africa. Astonishingly, 54% of the estimated 24 million people with diabetes in the continent remain undiagnosed, their health and well-being left hanging in the balance, according to the International Diabetes Federation.
But there is hope on the horizon. Technological advances stand as a beacon of promise, offering transformative treatments for cardiovascular diseases. Patients deserve access to appropriate technology and medication, from basic medicines like aspirin and statins to surgical operations like coronary artery bypass and heart transplantation. Medical devices such as pacemakers and prosthetic valves play a vital role in the fight against CVDs, offering renewed hope for those battling this formidable adversary.
In the tapestry of Africa’s healthcare landscape, the urgent need to bridge the gap in access to essential medicines and technology stands as a rallying cry. By uniting our efforts, we can uplift communities, empower individuals, and build a future where cardiovascular diseases no longer hold sway. Together, let us take strides towards a healthier, heart-strong Africa, where every heartbeat counts, and no one is left behind in the fight for a brighter, healthier tomorrow.”
Targeted policies and investments into cardiovascular disease in Africa
In the face of the daunting cardiovascular disease burden in Africa, a glimmer of hope shines through the transformative power of targeted policies and investments. As the World Health Organization reveals, over three-quarters of CVD deaths ravage low- and middle-income countries, underscoring the urgent need for proactive measures to combat this silent killer.
Health policies that create environments conducive to healthy choices hold the key to empowering individuals to adopt and sustain healthier lifestyles. Simple changes, such as reducing salt in the diet, eating more fruits and vegetables, engaging in regular physical activity, avoiding harmful alcohol use, and cessation of tobacco use, have been proven to significantly reduce the risk of cardiovascular diseases.
In the spirit of collaboration, the African Heart Network (AHN) stands as a beacon of unity, bringing together various cardiovascular societies and national heart foundations with a shared vision: to improve cardiovascular health for all Africans. Aligned with the World Heart Federation’s ambitious ’25 by 25′ global target, the AHN envisions a world where premature deaths caused by CVDs decrease by 25% by the year 2025—a mission underlined by the Sousse’ Declaration of 2018.
Across the continent and beyond, partnerships like the World Heart Federation (WHF) the United Nations, the Non-communicable Disease Alliance (NCD Alliance), Pan African Society of Cardiologists (PASCAR), American Heart Association (AHA), Medtronic Foundation, Heart and Stroke Foundation of South Africa, World Heart Day events, and The Kenyan-Heart Talking Walls project stand as pillars of support, collectively striving to achieve and promote cardiovascular health for all in Africa.
One of the critical risk factors in CVDs is high cholesterol, which can lead to narrowed blood vessels and an increased risk of blood clots. While some therapies may be expensive, many interventions for risk factor control, such as lifestyle changes and generic lipid- and blood pressure-lowering medications, are cost-effective and readily available.
Recognizing the urgency of the situation, WHO Member States adopted a “Global action plan for the prevention and control of NCDs 2013-2020,” targeting a 25% reduction in premature NCD-related deaths by 2025. Key components of this plan are two direct focuses on preventing and controlling CVDs: reducing global prevalence of raised blood pressure by 25% between 2010 and 2025 and ensuring that at least 50% of eligible individuals receive drug therapy and counseling for heart attack and stroke prevention by 2025. Additionally, the plan advocates for an 80% availability of affordable basic technologies and essential medicines, including generics, to treat major NCDs in public and private facilities.
The stakes are high, as approximately 17.8 million deaths worldwide in 2017 were attributed to cardiovascular diseases, representing a staggering 31.8% of all global deaths—a stark 49% increase compared to 1990.
Dietary approaches and physical activity for cardiovascular health
Within the grasp of every individual lies the power to prevent cardiovascular diseases and embark on a journey towards heart-healthy living. The keys to unlocking this potential are simple yet transformative: adopting a healthy diet, quitting smoking, moderating alcohol consumption, and embracing physical activity. By making these lifestyle changes, we can rewrite the narrative of cardiovascular health, preventing a significant number of premature deaths that plague our communities.
Heartbreaking statistics reveal that most cardiovascular disease-related deaths are premature and could be averted through lifestyle modifications. With every bite of nutritious food and each step towards a more active lifestyle, we hold the power to reshape our health destiny. Eating a balanced diet and avoiding harmful habits like smoking and excessive alcohol consumption can save countless lives, reducing CVD-related mortality rates that affect 1 in 3 men and 1 in 5 women.
The impact of behavioral risk factors for heart disease and stroke is profound, manifesting as raised blood pressure, glucose, lipids, and obesity. But the aorta of hope flows within us, offering the chance to strengthen our bodies and shield ourselves from the most common type of aortic disease—an aortic aneurysm. With vigilance, we can recognize the warning signs of this condition, experiencing pain in the chest, back, or abdomen, and seek timely medical attention to prevent potential complications.
Guided by the World Health Organization’s wisdom, we understand that most cardiovascular diseases are preventable, and the power lies in addressing behavioral risk factors head-on. Inspired by the success stories of projects like RESOLVE and the WHO Global Hearts initiatives, African stakeholders are poised to redefine cardiovascular health. These crucial interventions emphasize improved hypertension management, reduced salt intake, and tobacco cessation, steering individuals towards a path of well-being.
Amidst the challenges we face, stress management emerges as a potent weapon in our arsenal, mitigating the risk factors for CVDs. The healing power of stress relief techniques can pave the way for healthier hearts and happier lives, showcasing the interconnectedness of mental and cardiovascular health.
As we embark on this journey, we must recognize that every small step towards a 10% reduction in mortality from ischemic heart disease and stroke in low- and middle-income countries between 2011 and 2025 amounts to a remarkable US$377 billion reduction in economic losses. Information based on a study by the National Library of Medicine highlighted that these transformative changes are not only vital for individual well-being but also for the prosperity of our nations. Behind every statistic lies a story of triumph—a life saved, a heart healed, a family reunited. Together, let us seize the potential within us to prevent cardiovascular diseases, rewrite our health destinies, and create a future where heart-healthy living is within reach for all.
Progress in the global fight against non-communicable diseases
Amidst the shadow of cardiovascular diseases, a glimmer of hope emerges from the progress made in the global fight against non-communicable diseases (NCDs). As the leading non-communicable disease, cardiovascular diseases continue to cast a long shadow over Africa, where they account for a staggering 73.4% of global deaths and 80% of all premature deaths each year. The rising tide of premature deaths from CVDs is a wake-up call for action, compelling leaders worldwide to commit to the strategic objectives of the global action plan for the prevention and control of NCDs.
A new beacon of change is rising on the horizon, with the regional strategy for NCDs, PEN-PLUS, guiding the way for countries to strengthen their health systems effectively. This roadmap, developed in collaboration with African health ministers by WHO, standardizes programs to address chronic and severe NCDs, including cardiovascular diseases. PEN-PLUS equips primary health care to prevent NCDs, detect them early, provide appropriate management, and ensure prompt referral. Already, this powerful package is making strides in Liberia, Sierra Leone, Cameroon, Nigeria, Burkina Faso, Benin, the Democratic Republic of Congo, Malawi, Uganda, Kenya, Tanzania, Ethiopia, Zambia, Zimbabwe, Mozambique, and Rwanda.
As governments march forward with ongoing health system reforms, a crucial milestone is reached by including cardiovascular disease management interventions in universal health coverage packages. This significant step marks a united effort to alleviate the burden of cardiovascular diseases. In the spirit of global cooperation, the US CDC, WHO, and other partners joined forces to launch the Global Hearts Initiative, anchored by the HEARTS technical package. This initiative empowers primary health care with evidence-based tools and practices to improve hypertension control, saving lives through early detection and prompt care.
Success stories emerge from the transformational power of partnerships. Rwanda stands tall as a shining example, with AstraZeneca, PATH, the Ministry of Health, and the Rwanda Biomedical Centre coming together to champion the Healthy Heart Africa program. This program paves the way for improved access to hypertension screening and care, leaving no heart behind in the quest for better health.
Emphasizing evidence-based approaches, the World Health Organization is diligently increasing the availability of normative guidance for the management of acute coronary syndrome and stroke, fortifying the frontline of care for cardiovascular diseases.
By pooling efforts and implementing hypertension programs at the primary care level, 18 countries have showcased efficient and cost-effective solutions to reduce the prevalence of coronary heart disease and stroke. The power of CVDs’ prevention in Africa lies in identifying health advocates, effective leadership, and a coalition of professional groups. The fruits of reduced CVD mortality rates ripple beyond health outcomes, as increased life expectancy enables individuals to contribute to the economy for longer, maximizing gross domestic product per capita growth.
In the heart of this global fight against NCDs, hope beats stronger than ever. The progress achieved so far bears witness to the transformative potential of collective action and strategic interventions. As we stand united in this journey, let us forge ahead, leaving no life untouched, no heart unguarded, and no opportunity for a healthier future unseized. Together, we can paint a brighter tomorrow where cardiovascular diseases no longer claim lives prematurely, and every heartbeat is a testament to the triumph of global health efforts.
This feature appeared in the June 2022 issue of Healthcare Middle East & Africa. You can read this and the entire magazine HERE
