The term CVD, or cardiovascular disease, refers to a variety of disorders related to cardiac muscle and the blood vessels that supply “the heart, brain and other vital organs.” CVD is the leading cause of death worldwide, killing more than 18.56 million people in 2019. Although many people tend to associate CVD prevalence with high-income regions, CVD in sub-Saharan Africa is also quite common. In 2016, CVD overtook HIV/AIDS as the leading cause of death in this region.
Prevalence of CVD in sub-Saharan Africa
There are nine main risk factors for CVD: “smoking, history of hypertension or diabetes, obesity, unhealthy diet, lack of physical activity, excessive alcohol consumption, raised blood lipids and psychosocial factors.” Psychosocial factors are defined as characteristics that impact an individual on a psychological or social level. Negative psychological factors include stress, anxiety and depression.
Several of these risk factors are common in sub-Saharan Africa and are continuing to increase in prevalence with the rise of urbanization. The region is starting to face high rates of hypertension. In 2016, in the African region, 46% of adults 25 and older had hypertension, a figure that experts expect to climb rapidly. As urbanization in sub-Saharan Africa increases, lifestyle choices diversify — diets change and lifestyles often become more sedentary. These factors all increase the risk of CVD among sub-Saharan Africans, which provides a feasible explanation for the steep increase in this health issue over the past decade.
How Does Poverty Increase the Risk of CVD?
The number of sub-Saharan Africans living in extreme poverty face increased exposure to multiple risk factors for CVD. In 2018, 40% of sub-Saharan Africans endured extreme poverty. Poverty exacerbates negative psychological factors. Researchers from the National Institutes of Health found that those struggling with poverty have “more stress-related brain activity,” which leads to inflammation that increases the risk of CVD. These stress levels link to job insecurity, living in crowded environments and the difficulties one may face in providing for oneself and one’s family.
In addition, people living in poverty have reduced access to adequate preventative health care services. In addition, when sub-Saharan Africans begin to develop diseases that increase their risk of CVD, such as obesity, hypertension and diabetes, they often lack the health care resources to promptly and properly treat these issues. As a result, these health problems often spiral into CVD. CVD can also lead to disability and chronic illness, which impacts the human capital of the nation, leading to a loss of productivity that exacerbates negative psychosocial factors and existing economic instability.
ScienceDirect published a research study in 2013 indicating that child poverty may also increase the risk of developing CVD later in life, in part due to the negative psychosocial factors these children face. In 2017, an estimated 64% of children in sub-Saharan Africa lived in multidimensional poverty. Considering the link between child poverty and CVD, the health impacts of impoverished living conditions are of imperative concern.
Although CVD in sub-Saharan Africa is highly prevalent, there are solutions to reduce the burden of this disease. One initiative working to reduce CVD is the Healthy Heart Africa (HHA) program run by AstraZeneca. The program aims to reduce CVD risk by providing hypertension care. Since its launch in Kenya in 2014, HHA has given training to more than 7,600 health care workers “to provide education and awareness, screening and treatment services for hypertension.” In addition, HHA has supported more than 900 health centers in Africa in supplying “hypertension services” to the public. The program now serves five additional countries — Ethiopia, Tanzania, Ghana, Uganda and Côte d’Ivoire. By 2025, HHA aims to reach 10 million people suffering from high blood pressure across the African continent.
Researchers studying CVD have historically neglected sub-Saharan Africa as an area of interest. Although research in this region is expanding, there is still much to learn about the prevalence and causes of CVD. Increased knowledge of this health issue will aid in developing effective courses of action to reduce the prevalence of CVD in sub-Saharan Africa.
– Aimée Eicher