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(Circulation. 2005;112:3535.)
© 2005 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	RISK FACTORS ASSOCIATED WITH MYOCARDIAL INFARCTION IN AFRICA: THE INTERHEART AFRICA STUDY, by Steyn et al.

 
The data presented by Steyn et al are from the INTERHEART case-control study in 9 sub-Saharan African countries. This study shows, for the first time, what the impact is of modifiable cardiovascular disease (CVD) risk factors on acute myocardial infarctions (AMI). Patients (n=578) were matched to 789 controls. Similar relationships between common CVD risk factors and AMI were found as in the overall INTERHEART study. Modeling of 5 risk factors (smoking, self-reported diabetes and hypertension history, abdominal obesity, and apoB:apoA1 ratio) provided a population-attributable risk of 89.2% for AMI. Four of these risk factors can be determined by taking a medical history and simply measuring the waist and hip circumferences. Contrasting gradients found in socioeconomic class, risk factors, and AMI risk when comparing ethnic subgroups (black, colored, and European/other Africans) suggest different stages of the epidemiological transition. This suggests that AMI will increase in the future in sub-Saharan Africa unless primordial prevention of CVD risk factors occurs, as well as early diagnoses and effective treatment of those with CVD risk factors. See p 3554.

	EPIDEMIOLOGY AND ETIOLOGY OF CARDIOMYOPATHY IN AFRICA, by Sliwa et al.

 
Cardiomyopathy has been known to be endemic in sub-Saharan Africa for nearly a century. The leading causes of heart failure in sub-Saharan Africa are hypertension, valvular heart disease, and cardiomyopathy. This is in contrast to other regions of the world where heart failure is commonly caused by ischemic heart disease. Sliwa and colleagues provide the most comprehensive review to date of what is known about the causes and determinants of heart muscle disease in Africa. . . . [Full Text of this Article]

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