Cardiovascular disease in very low income sub-Saharan Africa: informing the response to an emerging epidemic

Cardiovascular diseases (CVD), including heart attack, stroke and heart failure, are leading causes of death and disability worldwide. This burden is increasingly borne in low-income-countries where access to preventive interventions and health care is limited. Studies in high-income-countries show that CVD is largely preventable. In low-income-sub-Saharan Africa we lack critical basic knowledge of the incidence of non-fatal CVD and risk factors for CVD may be different to high-income-countries. There is an increasing burden of hypertension, adult-onset diabetes and obesity but also risk factors that differ from high-income-countries, such as chronic-infections, malnutrition, poverty and genetics. Using detailed population-based studies in rural and urban Malawi on non-fatal CVD, and across seven African populations on fatal-CVD, I will characterise the types of CVD, identify key drivers, and test risk prediction scores. Findings from this will inform planning of health systems and context relevant, individual and population-level interventions to improve prevention and case management.