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This study analyzed cardiovascular disease trends from 1990 to 2023, revealing that Western Sub-Saharan Africa (WSSA) has experienced minimal progress compared to global patterns. While global stroke and ischemic heart disease mortality declined by 51.7% and 38.2% respectively, WSSA saw only a 21.8% decline in stroke mortality and actually experienced a 3.3% increase in ischemic heart disease mortality, with a reversal point identified around 2007. High blood pressure was identified as the primary risk factor, while obesity, air pollution, and elevated blood glucose showed the largest increases.
Why it matters
This divergence indicates that despite economic development in Western Sub-Saharan Africa, cardiovascular disease burden is worsening rather than improving, suggesting that current healthcare systems and prevention strategies are inadequate. The findings highlight an urgent need for targeted interventions focused on hypertension control and metabolic risk factor management to prevent widening health disparities.
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⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Background Cardiovascular disease remains the leading cause of death worldwide, yet progress in reducing its burden has not been shared equally across regions. Sub-Saharan Africa has previously been identified as the only world region where age-standardized cardiovascular mortality failed to decline, but long-term, disease-specific trends in Western Sub-Saharan Africa (WSSA) remain poorly characterized. Methods We conducted an ecological trend analysis using Global Burden of Disease (GBD) 2023 data to evaluate age-standardized mortality and disability-adjusted life years (DALYs) for stroke and ischemic heart disease (IHD) in WSSA and globally from 1990 to 2023. Linear and segmented regression assessed long-term trends and breakpoints, risk factor attribution examined six major cardiovascular risk factors, and Pearson correlation evaluated associations between the Socio-demographic Index (SDI) and mortality. Results Global stroke and IHD mortality declined by 51.7% and 38.2%, respectively, between 1990 and 2023. In WSSA, stroke mortality declined by only 21.8%, while IHD mortality increased by 3.3%. Segmented regression identified a breakpoint in IHD mortality around 2007, after which the trend reversed from declining to increasing. High systolic blood pressure was the leading attributable risk factor for both diseases, while obesity, ambient air pollution, and elevated fasting glucose showed the largest relative increases. SDI rose 69.5% in WSSA but correlated strongly only with stroke mortality (r = 0.87), not IHD (r = 0.21). Conclusions WSSA is falling behind global cardiovascular progress, with IHD mortality reversing course despite substantial socioeconomic development. Targeted investment in hypertension control, cardiometabolic risk reduction, and cardiovascular care capacity is urgently needed to prevent this divergence from deepening.