Coronary heart disease in black Africans: an overview.

Coronary heart disease is still rare representing only 6% of all cardiovascular diseases in black Africans despite its increased incidence in recent years. Myocardial infarction in black Africans shows similar characteristics as those seen in patients aged under 40 years in the west, particularly regarding the frequency of infarction as the first manifestation of the disease, low prevalence of coronary artery stenosis and relatively common finding of normal coronary arteriography. Risk factor profile is the same as in western countries, but the haemoglobin S or C trait could be a unique one. The long-term outcome of infarction is severe and influenced by myocardial sequelae of imprecise origin; delayed hospitalisation; absence of thrombolysis and angioplasty; and socio-economic and literacy problems.