Instituto Nacional de Saude, Maputo, Mozambique.
Heart. 2012 Mar;98(6):450-5. doi: 10.1136/heartjnl-2011-301025.
The predominant pattern of cardiovascular diseases in sub-Saharan Africa is that of poverty-related conditions (rheumatic heart valve disease, untreated congenital heart disease, tuberculous pericarditis) and diseases of unclear aetiology with a higher prevalence in this part of the world (peripartum cardiomyopathy, endomyocardial fibrosis). However, the prevalence of the traditional risk factors for cardiovascular diseases such as hypertension and marked obesity is high in a number of sub-Saharan settings, although they vary considerably among countries, urban/rural locations and specific subpopulations. In urban settings, hypertensive heart disease with systolic and diastolic function contributes substantially to morbidity. Awareness of the general public and health workers about the burden of cardiovascular diseases in women must be increased, and risk factor control programmes must be included in the health research agenda on the African continent. Improvement in health services with coordination of maternal health services and non-communicable diseases is also needed. This review focuses on the current knowledge of cardiovascular healthcare of women in sub-Saharan Africa, particularly their propensity for various forms of heart disease, access to healthcare, treatment received within the respective healthcare system, response to therapy and mortality. It highlights the gaps in knowledge and the paucity of data in most of these aspects.
撒哈拉以南非洲地区主要的心血管疾病模式是与贫困相关的疾病(风湿性心脏瓣膜病、未经治疗的先天性心脏病、结核性心包炎)和病因不明的疾病,这些疾病在该地区更为普遍(围产期心肌病、心内膜心肌纤维化)。然而,在撒哈拉以南的一些地区,高血压和明显肥胖等心血管疾病传统危险因素的流行率很高,尽管它们在各国、城乡地区和特定亚人群中差异很大。在城市环境中,高血压性心脏病伴收缩和舒张功能障碍导致发病率显著升高。必须提高公众和卫生工作者对妇女心血管疾病负担的认识,并且必须将危险因素控制方案纳入非洲大陆的卫生研究议程。还需要改善卫生服务,协调孕产妇保健服务和非传染性疾病。本综述重点介绍了撒哈拉以南非洲地区妇女心血管保健的现有知识,特别是她们易患各种形式心脏病、获得医疗保健的机会、在各自医疗保健系统中接受的治疗、对治疗的反应和死亡率。它强调了在这些方面的知识差距和数据匮乏。