Geographic Variations, Peculiarities, and Management of Heart Failure in Sub-Saharan Africa

Okechukwu S Ogah^{1

2

3}, Ejiroghene M Umuerri^{4

5}, Franklin E Obiekwe⁶, Chukwuagoziem S Onuigbo⁷, Boluwatife D Elusiyan⁶, Dimeji A Olawuyi⁶, Christabel I Uche-Orji⁶, Oluwabunmi Ajala⁸, Boma Oyan^{9

10}, Adeola T Adedokun^{11

12}, Olanike A Orimolade⁷, Julius C Mwita¹³, Casmir E Amadi^{14

15}, Dike B Ojji^{11

12}, Mahmoud U Sani^{16

17}, Albertino Damasceno¹⁸, Mayowa O Owolabi^{19

20}, Karen Sliwa²¹

Affiliations

¹ Cardiology Unit, Department of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria. osogah56156@gmail.com.
² Cardiology Unit, Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria. osogah56156@gmail.com.
³ Division of Cardiology, Department of Medicine, University of Ibadan, Oduduwa Road, Ibadan, Oyo State, 200005, Nigeria. osogah56156@gmail.com.
⁴ Cardiology Unit, Department of Medicine, Delta State University, Abraka, Delta State, Nigeria.
⁵ Cardiology Unit, Department of Medicine, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria.
⁶ Alexander Brown Hall, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
⁷ Cardiology Unit, Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria.
⁸ Cardiology Unit, Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
⁹ Cardiology Unit, Department of Medicine, Rivers State University, Port Harcourt, Rivers State, Nigeria.
¹⁰ Cardiology Unit, Department of Medicine, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
¹¹ Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, FCT, Nigeria.
¹² Cardiology Unit, Department of Medicine, University of Abuja, Gwagwalada, Abuja, FCT, Nigeria.
¹³ Cardiology Unit, Department of Medicine, University of Botswana, Gaborone, Botswana.
¹⁴ Cardiology Unit, Department of Medicine, College of Medicine, University of Lagos, Akoka, Lagos, Lagos State, Nigeria.
¹⁵ Cardiology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos, Lagos State, Nigeria.
¹⁶ Cardiology Unit, Department of Medicine, Bayero University, Kano, Kano State, Nigeria.
¹⁷ Cardiology Unit, Department of Medicine, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria.
¹⁸ Cardiology Unit, Department of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
¹⁹ Neurology Unit, Department of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
²⁰ Neurology Unit, Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria.
²¹ Hatter Institute of Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa.

PMID: 41134497
DOI: 10.1007/s11897-025-00712-1

Review

Geographic Variations, Peculiarities, and Management of Heart Failure in Sub-Saharan Africa

Okechukwu S Ogah et al. Curr Heart Fail Rep. 2025.

. 2025 Oct 24;22(1):29.

doi: 10.1007/s11897-025-00712-1.

Authors

Affiliations

¹ Cardiology Unit, Department of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria. osogah56156@gmail.com.
² Cardiology Unit, Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria. osogah56156@gmail.com.
³ Division of Cardiology, Department of Medicine, University of Ibadan, Oduduwa Road, Ibadan, Oyo State, 200005, Nigeria. osogah56156@gmail.com.
⁴ Cardiology Unit, Department of Medicine, Delta State University, Abraka, Delta State, Nigeria.
⁵ Cardiology Unit, Department of Medicine, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria.
⁶ Alexander Brown Hall, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
⁷ Cardiology Unit, Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria.
⁸ Cardiology Unit, Department of Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
⁹ Cardiology Unit, Department of Medicine, Rivers State University, Port Harcourt, Rivers State, Nigeria.
¹⁰ Cardiology Unit, Department of Medicine, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
¹¹ Cardiology Unit, Department of Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, FCT, Nigeria.
¹² Cardiology Unit, Department of Medicine, University of Abuja, Gwagwalada, Abuja, FCT, Nigeria.
¹³ Cardiology Unit, Department of Medicine, University of Botswana, Gaborone, Botswana.
¹⁴ Cardiology Unit, Department of Medicine, College of Medicine, University of Lagos, Akoka, Lagos, Lagos State, Nigeria.
¹⁵ Cardiology Unit, Department of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos, Lagos State, Nigeria.
¹⁶ Cardiology Unit, Department of Medicine, Bayero University, Kano, Kano State, Nigeria.
¹⁷ Cardiology Unit, Department of Medicine, Aminu Kano Teaching Hospital, Kano, Kano State, Nigeria.
¹⁸ Cardiology Unit, Department of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
¹⁹ Neurology Unit, Department of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
²⁰ Neurology Unit, Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria.
²¹ Hatter Institute of Cardiovascular Research in Africa, University of Cape Town, Cape Town, South Africa.

PMID: 41134497
DOI: 10.1007/s11897-025-00712-1

Abstract

Purpose of review: Heart failure is a complex cardiovascular syndrome with diverse etiologies. It is prevalent and has a substantial adverse global health impact. This review focuses on the peculiarities of HF in sub-Saharan Africa.

Findings: Heart failure poses a significant challenge in sub-Saharan Africa, primarily affecting young adults aged 36.5 to 61.5 years. Patients often present with advanced symptoms, exacerbated by socioeconomic factors and other complications. Key risk factors include hypertension, diabetes, chronic kidney disease, and chronic obstructive pulmonary disease, with new challenges arising from obesity, air pollution, and infectious diseases, further complicating treatment approaches. Diagnostic capabilities in sub-Saharan Africa remain limited. Non-adherence to prescribed medications ranges between 23.7% and 74.7%, worsening disease progression and leading to increased rehospitalizations and mortality rates. Moreover, the high costs of guideline-recommended medications, including sodium-glucose cotransporter-2 inhibitors and angiotensin receptor-neprilysin inhibitors, restrict their availability. Additionally, advanced device therapies like implantable cardioverter-defibrillators and cardiac resynchronization therapy are often inaccessible due to their high costs, the scarcity of invasive cardiac laboratories, and a limited number of trained healthcare professionals. Heart failure poses a significant challenge in sub-Saharan Africa, especially among younger adults. Late clinical presentations, compounded by socioeconomic barriers, underscore the urgent need for improved healthcare access and education. Addressing key risk factors, enhancing diagnostics, and ensuring treatment adherence are vital for better management. Additionally, the high costs of advanced medications highlight the necessity for more affordable healthcare solutions to alleviate the burden of heart failure in the region.

Keywords: Africa; Cardiac failure; Epidemiology; Geography; Heart failure; Risk factors.

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Conflict of interest statement

Declarations. Informed Consent and Funding: This article does not contain any studies with human or animal subjects performed by any of the authors. No grant from any funding agency in the public, commercial, or not-for-profit sectors was received for this research. Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors. Competing interests: The authors declare no competing interests.

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Geographic Variations, Peculiarities, and Management of Heart Failure in Sub-Saharan Africa

Affiliations

Geographic Variations, Peculiarities, and Management of Heart Failure in Sub-Saharan Africa

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Miscellaneous