Strategies for heart disease in sub-Saharan Africa.

The commonest forms of heart disease in sub-Saharan Africa are chronic rheumatic heart disease, dilated cardiomyopathy, pulmonary heart disease, infectious forms of heart disease including chronic, constrictive and infective endocarditis, genetic forms of heart disease and arrhythmias. Malnutrition, with cardiac manifestations such as beriberi, and alcoholism also play a part. Ischaemic heart disease in sub-Saharan Africa at present affects mainly the small, Westernised white population. Heart disease is a less important cause of morbidity and mortality than many other infectious diseases but is likely to escalate in the next generation(s). The changing demographic picture dictates the way in which funds for research, prevention and treatment must be channelled to best advantage. A concerted effort must be made by cardiologists of African countries to arrest the advance of heart disease, and a declaration outlining these strategies has been endorsed by the Pan-African Society of Cardiology (PASCAR).