Pulmonary hypertension in low- and middle-income countries with focus on sub-Saharan Africa

Journal article


Anastase Dzudie, Bonaventure Suiru Dzekem, Dike B. Ojji, Andre Pascal Kengne, Ana Olga Mocumbi, Karen Sliwa and Friedrich Thienemann. (2020) Pulmonary hypertension in low- and middle-income countries with focus on sub-Saharan Africa. Cardiovascular Diagnosis & Therapy. 10(2), pp. 316-324. https://doi.org/10.21037/cdt.2019.07.06
AuthorsAnastase Dzudie, Bonaventure Suiru Dzekem, Dike B. Ojji, Andre Pascal Kengne, Ana Olga Mocumbi, Karen Sliwa and Friedrich Thienemann
Abstract

Pulmonary hypertension (PH) is a devastating, progressive disease with increasingly debilitating symptoms and usually shortened overall life expectancy. This article reviews the global epidemiology of PH with focus on low- and middle-income countries (LMICs) and sub-Sahara African in particular. Although left ventricular heart disease is the most common cause globally, the main contributing risk factors in LMICs are chronic infectious diseases especially human immunodeficiency virus (HIV) and schistosomiasis. Other important risk factors of PH are rheumatic heart disease, untreated congenital heart disease (CHD), and sickle cell disease. Despite existing epidemiological data of PH risk factors suggesting a high prevalence in sub-Saharan Africa (SSA), the available literature is limited. International registries in LMICs like the pan African pulmonary hypertension cohort (PAPUCO) study are essential to provide information about the causes, treatment, outcome, and the natural course of PH in Africa and other parts of the world. In addition, there is a need to track diagnostic and management practices in order to develop suitable algorithms to diagnose PH in LMICs.

Keywordspulmonary hypertension (PH); epidemiology; Africa; low- and middle-income countries (LMICs)
Year2020
JournalCardiovascular Diagnosis & Therapy
Journal citation10 (2), pp. 316-324
PublisherAME Publishing Company
ISSN2223-3652
Digital Object Identifier (DOI)https://doi.org/10.21037/cdt.2019.07.06
Scopus EID2-s2.0-85085591925
Open accessPublished as ‘gold’ (paid) open access
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Deposited30 Apr 2021
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Roadmap to achieve 25% hypertension control in Africa by 2025
Dzudie, Anastase, Rayner, Brian, Ojji, Dike, Schutte, Aletta E., Twagirumukiza, Marc, Damasceno, A., Ba, Seringe A., Kane, Abdoul, Kramoh, Euloge, Kacou, Jean B.A., Onwubere, Basden, Cornick, Ruth, Sliwa-Hahnle, Karen, Anisiuba, Benedict, Mocumbi, Ana O., Ogola, Elijah, Awad, Mohamed, Nel, George, Otieno, Harun, ... Mayosi, Bongani. (2017) Roadmap to achieve 25% hypertension control in Africa by 2025. SAMJ South African Medical Journal. 28(4), pp. 262 - 273. https://doi.org/10.5830/CVJA-2017-040
A global view of pulmonary hypertension
Hoeper, Marius, Humbert, Marc, Souza, Rogerio, Idrees, Majdy, Kawut, Steven M., Sliwa-Hahnle, Karen, Jing, Zhi-Cheng and Gibbs, J. Simon. (2016) A global view of pulmonary hypertension. The Lancet Respiratory Medicine. 4(4), pp. 306 - 322. https://doi.org/10.1016/S2213-2600(15)00543-3
Pulmonary hypertension and pregnancy outcomes: data from the Registry Of Pregnancy and Cardiac Disease (ROPAC) of the European Society of Cardiology
Sliwa-Hahnle, Karen, van Hagen, Iris M., Budts, Werner, Swan, Lorna, Sinagra, Gianfranco, Caruana, Maryanne, Blanco, Manuel Vasquez, Wagenaar, Lodewijk J., Johnson, Mark R., Webb, Gary, Hall, Roger and Roos-Hesselink, Jolien W.. (2016) Pulmonary hypertension and pregnancy outcomes: data from the Registry Of Pregnancy and Cardiac Disease (ROPAC) of the European Society of Cardiology. European Journal of Heart Failure. 18(9), pp. 1119 - 1128. https://doi.org/10.1002/ejhf.594
Risk assessment for pregnancy with cardiac disease - A global perspective
Sliwa-Hahnle, Karen and Anthony, John. (2016) Risk assessment for pregnancy with cardiac disease - A global perspective. European Journal of Heart Failure. 18(5), pp. 534 - 536. https://doi.org/10.1002/ejhf.522
Comparison of the American PPCM registry data with international registries
Hilfiker-Kleiner, Denise, Sliwa-Hahnle, Karen and Bauersachs, J.. (2016) Comparison of the American PPCM registry data with international registries. Journal of the American College of Cardiology. 67(6), pp. 733 - 734. https://doi.org/10.1016/j.jacc.2015.09.112
The heart of Africa: Succeeding against the odds
Sliwa-Hahnle, Karen. (2016) The heart of Africa: Succeeding against the odds. The Lancet. 388(10063), pp. 28 - 36. https://doi.org/10.1016/S0140-6736(16)31660-9
Current management of patients with severe acute peripartum cardiomyopathy: Practical guidance from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy
Bauersachs, Johann, Arrigo, Mattia, Hilfiker-Kleiner, Denise, Veltmann, Christian, Coats, Andrew J. S., Crespo-Leiro, Maria G., de Boer, Rudolf A., van der Meer, Peter, Maack, Christoph, Mouquet, Frederic, Petrie, Mark C., Piepoli, Massimo F., Regitz-Zagrosek, Vera, Schaufelberger, Maria, Seferovic, Petar, Tavazzi, Luigi, Ruschitzka, Frank, Mebazaa, Alexandre and Sliwa-Hahnle, Karen. (2016) Current management of patients with severe acute peripartum cardiomyopathy: Practical guidance from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy. European Journal of Heart Failure. 18(9), pp. 1096 - 1105. https://doi.org/10.1002/ejhf.586
Human immunodeficiency virus-related heart disease
Thienemann, Friedrich, Carrington, Melinda, Sliwa-Hahnle, Karen, Ntsekhe, Mpiko and Stewart, Simon. (2016) Human immunodeficiency virus-related heart disease. In In S. Stewart, K. Sliwa and A. Mocumbi, A. Damasceno and M. Ntsekhe (Ed.). The heart of Africa: Clinical profile of an evolving burden of heart disease in Africa pp. 145 - 154 John Wiley & Sons. https://doi.org/10.1002/9781119097136.ch9
Topic reviews need to be robust
Ntusi, Ntobeko B. A., Kraus, Sarah, Ogunbanjo, Gboyega and Sliwa-Hahnle, Karen. (2016) Topic reviews need to be robust. South African Medical Journal. 106(7), pp. 644 - 645. https://doi.org/10.7196/SAMJ.2016v106i7.10903
Rheumatic heart disease
Stewart, Simon, Carrington, Melinda and Sliwa-Hahnle, Karen. (2016) Rheumatic heart disease. In In S. Stewart, K. Sliwa and A. Mocumbi, A. Damasceno and M. Ntsekhe (Ed.). The heart of Africa: Clinical profile of an evolving burden of heart disease in Africa pp. 121 - 135 John Wiley & Sons. https://doi.org/10.1002/9781119097136.ch7
The causes, treatment, and outcome of pulmonary hypertension in Africa: Insights from the Pan African Pulmonary Hypertension Cohort (PAPUCO) Registry
Thienemann, Friedrich, Dzudie, Anastase, Mocumbi, Ana, Blauwet, Lori, Sani, Mahmoud U., Karaye, Kamilu M., Ogah, Okechukwu, Mbanze, Irina, Mbakwem, Amam, Udo, Patience, Tibazarwa, Kemi, Damasceno, Albertino, Keates, Ashley K., Stewart, Simon and Sliwa-Hahnle, Karen. (2016) The causes, treatment, and outcome of pulmonary hypertension in Africa: Insights from the Pan African Pulmonary Hypertension Cohort (PAPUCO) Registry. International Journal of Cardiology. 221, pp. 205 - 211. https://doi.org/10.1016/j.ijcard.2016.06.242
The African INTERHEART study
Steyn, Krisela and Sliwa-Hahnle, Karen. (2016) The African INTERHEART study. In In S. Stewart, K. Sliwa and A. Mocumbi, A. Damasceno and M. Ntsekhe (Ed.). The heart of Africa: Clinical profile of an evolving burden of heart disease in Africa pp. 1 - 9 John Wiley & Sons.
Bi treatment with hydralazine/nitrates vs. placebo in Africans admitted with acute HEart Failure (BA-HEF)
Sliwa-Hahnle, Karen, Damasceno, Albertino, Davidson, Beth A., Mayosi, Bongani, Sani, Mahmoud U., Ogah, Okechukwu, Mondo, Charles, Ojji, Dike, Dzudie, Anastase, Kouam, Charles Kouam, Yonga, Gerald, Ba, Serigne Abdou, Ogola, Elijah, Edwards, Christopher, Milo, Olga and Cotter, Gad. (2016) Bi treatment with hydralazine/nitrates vs. placebo in Africans admitted with acute HEart Failure (BA-HEF). European Journal of Heart Failure. 18(10), pp. 1248 - 1258. https://doi.org/10.1002/ejhf.581
Late maternal deaths: A neglected responsibility
Sliwa-Hahnle, Karen and Anthony, John. (2016) Late maternal deaths: A neglected responsibility. The Lancet. 387(10033), pp. 2072 - 2073. https://doi.org/10.1016/S0140-6736(16)30391-9
Ten-year coronary artery disease risk in 1571 newly presenting hypertensive black subjects
Ojji, Dike, Stewart, Simon, Atherton, John J., Ajayi, Samuel, Mamven, Manmak H., Ngabea, Murtala, Ojji, O. and Sliwa-Hahnle, Karen. (2016) Ten-year coronary artery disease risk in 1571 newly presenting hypertensive black subjects. Journal of Community Medicine & Health Education (online). 6(3), pp. 1 - 5. https://doi.org/10.4172/2161-0711.1000442
Cord blood samples: A less explored tool in early diagnosis of neonatal cardiovascular disease
Sliwa-Hahnle, Karen and Hilfiker-Kleiner, Denise. (2015) Cord blood samples: A less explored tool in early diagnosis of neonatal cardiovascular disease. Journal of the American College of Cardiology. 66(8), pp. 940 - 942. https://doi.org/10.1016/j.jacc.2015.07.001
Heart failure in the developing world
Sliwa-Hahnle, Karen and Stewart, Simon. (2014) Heart failure in the developing world. In In D. L. Mann and G. Michael Felker (Ed.). Heart Failure: A Companion to Braunwald's Heart Disease pp. 410 - 419 Elsevier.
Pathophysiology and epidemiology of peripartum cardiomyopathy
Hilfiker-Kleiner, Denise and Sliwa-Hahnle, Karen. (2014) Pathophysiology and epidemiology of peripartum cardiomyopathy. Nature Reviews Cardiology. 11(6), pp. 364 - 370. https://doi.org/10.1038/nrcardio.2014.37
Is all heart failure the same around the globe?
Sliwa-Hahnle, Karen. (2013) Is all heart failure the same around the globe? European Heart Journal. 34(40), pp. 3091 - 3092. https://doi.org/10.1093/eurheartj/eht385
Acute heart failure: Is it peripartum cardiomyopathy or not?
Bachelier-Walenta, Katrin, Hilfiker-Kleiner, Denise and Sliwa-Hahnle, Karen. (2013) Acute heart failure: Is it peripartum cardiomyopathy or not? Obstetric Medicine. 6(1), pp. 42 - 44. https://doi.org/10.1258/OM.2012.120042
Sex and gender differences in cardiovascular disease
Sliwa-Hahnle, Karen. (2012) Sex and gender differences in cardiovascular disease. European Heart Journal. 33(11), pp. 1298 - 1299. https://doi.org/10.1093/eurheartj/ehs103