Predominance of heart failure in the heart of Soweto study cohort: Emerging challenges for urban African communities

Simon Stewart, David Wilkinson, Craig Hansen, Vinesh Vaghela, Robert Mvungi, John McMurray, Karen Sliwa

Research output: Contribution to journalArticle

110 Citations (Scopus)

Abstract

There is a paucity of data to describe the clinical characteristics of heart failure (HF) in urban African communities in epidemiological transition. Methods and Results - Chris Hani Baragwanath Hospital services the 1.1 million black African community of Soweto. South Africa. Of 1960 cases of HF and related cardiomyopathies in 2006, we prospectively collected detailed demographic and clinical data from all 844 de novo presentations (43%). Mean age was 55 ± 16 years, and women (479 [57%]) and black Africans (739 [88%]) predominated. Most (761 [90%]) had ≥1 cardiovascular risk. Mean left ventricular ejection fraction was 45 ± 18%. Overall, 180 patients (23%) had isolated diastolic dysfunction, 234 (28%) tricuspid regurgitation, 121 (14%) isolated right HF, and 100 (12%) mitral regurgitation. The most common diagnoses were hypertensive HF (281 [33%]), idiopathic dilated cardiomyopathy (237 [28%]), and, surprisingly, right HF (225 [27%]). Black Africans had less ischemic cardiomyopathy (adjusted odds ratio, 0.12; 95% CI, 0.07 to 0.20) but more idiopathic and other causes of cardiomyopathy (adjusted odds ratio, 4.80; 95% CI, 2.57 to 8.93). Concurrent renal dysfunction, anemia, and atrial fibrillation were found in 172 (25%), 72 (10%), and 53 (6.3%) cases, respectively. Conclusions - These contemporary data highlight the multiple challenges of preventing and managing an increasing and complex burden of HF in urban Africa. In addition to tackling antecedent hypertension, a predominance of young women and a large component of right HF predicate the development of tailored therapeutic strategies.

LanguageEnglish
Pages2360-2367
Number of pages8
JournalCirculation
Volume118
Issue number23
DOIs
Publication statusPublished - 2 Dec 2008

Keywords

  • Africa
  • Epidemiological transition
  • Epidemiology
  • Heart failure
  • Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Stewart, S., Wilkinson, D., Hansen, C., Vaghela, V., Mvungi, R., McMurray, J., & Sliwa, K. (2008). Predominance of heart failure in the heart of Soweto study cohort: Emerging challenges for urban African communities. Circulation, 118(23), 2360-2367. https://doi.org/10.1161/CIRCULATIONAHA.108.786244
Stewart, Simon ; Wilkinson, David ; Hansen, Craig ; Vaghela, Vinesh ; Mvungi, Robert ; McMurray, John ; Sliwa, Karen. / Predominance of heart failure in the heart of Soweto study cohort : Emerging challenges for urban African communities. In: Circulation. 2008 ; Vol. 118, No. 23. pp. 2360-2367.
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Stewart, S, Wilkinson, D, Hansen, C, Vaghela, V, Mvungi, R, McMurray, J & Sliwa, K 2008, 'Predominance of heart failure in the heart of Soweto study cohort: Emerging challenges for urban African communities', Circulation, vol. 118, no. 23, pp. 2360-2367. https://doi.org/10.1161/CIRCULATIONAHA.108.786244

Predominance of heart failure in the heart of Soweto study cohort : Emerging challenges for urban African communities. / Stewart, Simon; Wilkinson, David; Hansen, Craig; Vaghela, Vinesh; Mvungi, Robert; McMurray, John; Sliwa, Karen.

In: Circulation, Vol. 118, No. 23, 02.12.2008, p. 2360-2367.

Research output: Contribution to journalArticle

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AU - Stewart, Simon

AU - Wilkinson, David

AU - Hansen, Craig

AU - Vaghela, Vinesh

AU - Mvungi, Robert

AU - McMurray, John

AU - Sliwa, Karen

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KW - Africa

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