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An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective

Rhonda BeLue1, Titilayo A Okoror2, Juliet Iwelunmor3, Kelly D Taylor4, Arnold N Degboe1, Charles Agyemang5* and Gbenga Ogedegbe6

Author Affiliations

1 Department of Health Policy and Administration, 604 Ford Building, The Pennsylvania State University, University Park, PA, USA

2 Department of Health and Kinesiology, Purdue University, Lambert Fieldhouse, West Lafeyette, Indiana, USA

3 Department of Biobehavioral Health, The Pennsylvania State University, 315 Health and Human Development East, University Park, PA, USA

4 Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, 50 Beale St, San Francisco, California, USA

5 Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, Amsterdam, the Netherlands

6 Department of Medicine, New York University, New York, USA

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Globalization and Health 2009, 5:10  doi:10.1186/1744-8603-5-10

Published: 22 September 2009



Sub-Saharan African (SSA) countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD). This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems.


The purpose of this paper is to explore the socio-cultural context of CVD risk prevention and treatment in sub-Saharan Africa. We discuss risk factors specific to the SSA context, including poverty, urbanization, developing healthcare systems, traditional healing, lifestyle and socio-cultural factors.


We conducted a search on African Journals On-Line, Medline, PubMed, and PsycINFO databases using combinations of the key country/geographic terms, disease and risk factor specific terms such as "diabetes and Congo" and "hypertension and Nigeria". Research articles on clinical trials were excluded from this overview. Contrarily, articles that reported prevalence and incidence data on CVD risk and/or articles that report on CVD risk-related beliefs and behaviors were included. Both qualitative and quantitative articles were included.


The epidemic of CVD in SSA is driven by multiple factors working collectively. Lifestyle factors such as diet, exercise and smoking contribute to the increasing rates of CVD in SSA. Some lifestyle factors are considered gendered in that some are salient for women and others for men. For instance, obesity is a predominant risk factor for women compared to men, but smoking still remains mostly a risk factor for men. Additionally, structural and system level issues such as lack of infrastructure for healthcare, urbanization, poverty and lack of government programs also drive this epidemic and hampers proper prevention, surveillance and treatment efforts.


Using an African-centered cultural framework, the PEN3 model, we explore future directions and efforts to address the epidemic of CVD risk in SSA.