article · BMC Cardiovascular Disorders
Recent data on heart failure in Sub-Saharan Africa highlights distinct clinical characteristics and treatment challenges following the release of updated international management guidelines. A review of ten studies covering 2039 adult patients found that hypertensive cardiomyopathy and dilated cardiomyopathy are the leading causes of the condition, while rheumatic heart disease appeared less frequently. Patients regularly experienced complications such as anaemia and electrolyte disturbances, which contributed to adverse health results. Adherence to established clinical guidelines remains poor, exemplified by very low prescription rates for sodium-glucose cotransporter-2 inhibitors. Reported mortality ranged between 3.7 percent and 19 percent, often associated with low blood pressure and chemical imbalances. Furthermore, early hospital readmissions within 8 to 15 days of discharge were frequent, driven largely by patient non-compliance and lifestyle influences. Addressing these gaps requires improved post-discharge follow-up and stricter adherence to care standards.
Heart failure represents a serious health burden in Sub-Saharan Africa, yet patient outcomes remain compromised by low uptake of standard therapies and frequent early hospital readmissions. Understanding regional causes, such as hypertension, alongside common co-occurring complications like anaemia, helps healthcare systems focus their limited resources on targeted clinical pathways and discharge strategies to reduce avoidable deaths.
The findings outline clinical targets for healthcare providers and disease management programmes seeking to reduce readmissions and optimise drug therapy adherence in resource-limited clinics. However, because this review gathers observational clinical data and calls for validated prognostic tools, the work represents early-stage evidence with no direct product or commercial application pathway indicated in the abstract.
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BACKGROUND: Heart failure (HF) in Sub-Saharan Africa (SSA) presents unique challenges, with high prevalence and distinct epidemiological features compared to high-income settings. Despite its burden, recent comprehensive data are lacking, especially amidst recent 2022 AHA/ACC/HFSA guideline release. This scoping review aims to map the literature on HF in SSA, focusing on aetiologies, structural abnormalities, management practices, and outcomes to identify research gaps and inform clinical practice. METHODS: Studies from 2022-2024 published in English or French were included, covering adult patients > 18 years, all study designs except case reports. Studies not reporting any outcomes or focusing solely on one HF subtype were excluded. Literature from all SSA countries was searched using a FACET approach in databases including PubMed, Google Scholar, Cochrane and Scopus. RESULTS: Ten studies, evaluating 2039 patients, were analysed. Dilated cardiomyopathy (DCM), and Hypertensive cardiomyopathy (HCM) emerged as prominent aetiologies. Rheumatic heart disease was reported in only four studies. Common issues included high rates of electrolyte disturbances and anemia, which influenced patient outcomes. Guideline adherence exhibited significant deficiencies, notably with a suboptimal prescription rate of SGLT2 inhibitors (8.3-24.7%). Mortality rates ranged from 3.7% to 19%, linked to factors like low blood pressure and electrolyte imbalances. Hospital stays were variable but significant rehospitalization were common within 8-15 days post discharge and associated with non-compliance and lifestyle factors. CONCLUSION: HCM and DCM are prevalent heart failure aetiologies in SSA. Longitudinal studies are recommended to contextualise aetiological diagnosis and validate prognostic tools amidst limited resources. Enhanced guideline adherence, hypertension control and efficient post-discharge care are essential to reduce morbidity and mortality.
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DOI: 10.1186/s12872-025-04756-y
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