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Invited Commentary
Oct 8, 2012

Hypertension as an Emerging Risk Factor for Acute Heart Failure in Africa: Comment on “The Causes, Treatment, and Outcome of Acute Heart Failure in 1006 Africans From 9 Countries”

Author Affiliations

Author Affiliations: Division of Cardiovascular Medicine, University of Michigan Health System, Ann Arbor (Dr Jamerson); and National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland (Dr Agodoa).

Arch Intern Med. 2012;172(18):1395-1396. doi:10.1001/archinternmed.2012.4491

When we think of the causes of cardiomyopathy in Africa, we tend to think of endemic diseases that are uncommon in the developed world, such as endomyocardial fibrosis, tuberculous pericarditis, and peripartum and idiopathic dilated cardiomyopathy. However, the preceding study shows that assumption to be outdated.1

The authors of the Sub-Saharan Africa Survey of Heart Failure (THESUS-HF) trial characterized the causes and short-term outcomes in 1006 Africans with heart failure from 9 countries in sub-Saharan Africa. The cohort is young (in the fifth to sixth decades of life), and hypertension is the most common cause of their heart failure, without severely reduced systolic function (average ejection fraction of 37%). This pattern of disease has striking parallels with US black patients of African descent. Thus, the work may have global implications for the prevention and treatment of cardiovascular disease.

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