Cardiovascular Risk Reduction Diabetes Sub-Saharan Africa: What should

Cardiovascular Risk Reduction in Diabetes in Sub-Saharan Africa: What should the Priorities be in the Absence of Global Risk Evaluation Tools?

Submit a Paper

Libertas Analytics

Download Paper

Send to Endnote

1358 Article Views

Authors: Andre Pascal Kengne, Alfred Kongnyu Njamnshi and Jean Claude Mbanya

Publication Date: 09 Feb 2008

Journal: Clinical Medicine Insights: Cardiology Clinical Medicine: Cardiology 2008:2 25-31

CMIcar
journal

82,545 Article Views

2,778,338 Libertas Article Views

More Statistics

Abstract Andre Pascal Kengne^1,2, Alfred Kongnyu Njamnshi^3a and Jean Claude Mbanya^1,3b

¹The George Institute for International Health, University of Sydney, Sydney Australia, ²The Health of Population in Transition Research Group, Yaounde—Cameroon. ³Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1; and ^3a – The Neurology and ^3b - Endocrinology Departments, Yaoundé Central Hospital, Yaoundé, Cameroon.

Abstract

Background: The growing burden of type 2 diabetes in Sub-Saharan Africa (SSA) and related cardiovascular complications call for vigorous actions into prevention. Comprehensive cardiovascular risk evaluation is important for the success of such actions.

Methods: We have reviewed 3 currently existing sets of recommendations for cardiovascular prevention in diabetes in SSA. Distribution of major risk factors and patterns of reported cardiovascular outcomes are used to suggest orientations for cardiovascular prevention in diabetes in this region. Papers and reports published over the period 1990 to 2007 were used.

Results: Existing guidelines share some similarities, but also have areas of inconsistencies. They are generally adaptations of existing guidelines, focused more on individual risk factors, and are not usually backed-up by local evidence. They all have a projection on blood pressure lowering. This focus is supported by the high prevalence of hypertension among people with diabetes in SSA. Blood pressure and tobacco smoking are the modifiable risk factors accessible to evaluation and interventions on a wide scale in SSA. Appropriate blood pressure control will have a major impact on stroke (the commonest cardiovascular disease) through a reduction of the cerebrovascular risk, and to a lesser extent on coronary heart disease and total deaths in diabetes in this region.

Conclusions: In the absence of global risk evaluation tools, the use of blood pressure lowering as a primary focus of cardiovascular prevention strategies is relevant for SSA. However, there is a need to set-up diabetes and stroke registers to monitor outcomes and generate tools for accurate risk prediction and management in diabetes in this region.

Post a Comment

x close

Discussion Add A Comment

Posted by Balarabe Sani Garko - 11:33,March 28, 2008

“Hi, Excellent work, the other problem though may be that alot of people in SSA donot even have the privilege of access to quality health care, BP reduction is a good indicator, but we have a large population of hypertensives whose BP has been so mismanaged that the myocardium can't raise any pressure, this was reported from Nigeria in the early 80's by Falase and others, it appears that now the problem is more. Patient education is again a big problem, where attending health care workers donot give adequate time for patient education if at all. There is a need for a large scale study i SSA to look at the behaviour patterns of BP among hypertensives over time, and to assess the quality of care given to hypertensives in SSA. Balarabe Sani Garko MBBS, MPH, FWACP Dept of Medicine/cardiology ABU Teaching Hospital, Zaria Nigeria”

share on