Acute coronary syndromes in low- and middle-income countries: Moving forward
Benjamin Seligman1, Rajesh Vedanthan2, Valentin Fuster3
1School of Medicine and Department of Biology, Stanford University, Stanford, CA, USA.
Insights
Cardiovascular disease is the top cause of death globally, especially in low- and middle-income countries (LMICs). These nations face growing burdens from lifestyle changes and inadequate healthcare systems to manage acute coronary syndromes.
Area of Science:
- Public Health
- Epidemiology
- Global Health
Background:
- Cardiovascular disease (CVD) is the leading global cause of mortality, with acute coronary syndromes (ACS) being a major contributor, particularly in low- and middle-income countries (LMICs).
- Deaths from ACS in LMICs occur at younger ages compared to high-income countries, leading to significant socioeconomic consequences, including loss of breadwinners and catastrophic medical debt.
Discussion:
- The increasing prevalence of CVD in LMICs is linked to the epidemiologic transition, characterized by rising incomes, adoption of unhealthy diets, sedentary lifestyles, and increased substance use.
- Healthcare systems in many LMICs are ill-equipped to handle the growing CVD burden due to insufficient access to facilities, medications, transportation challenges, and low public awareness of ACS symptoms and the need for urgent care.
Key Insights:
- ACS mortality in LMICs disproportionately affects younger populations, resulting in profound economic hardship for affected families.
- Inadequate healthcare infrastructure and limited public health awareness exacerbate the impact of CVD in LMICs.
- The global rise in non-communicable diseases, driven by lifestyle changes, presents a growing challenge for healthcare systems worldwide.
Outlook:
- Addressing the escalating CVD crisis in LMICs requires strengthening healthcare systems, improving access to preventive and acute care services, and implementing public health initiatives to promote healthier lifestyles.
- International collaboration and targeted interventions are crucial to mitigate the growing burden of cardiovascular disease in LMICs and reduce premature mortality.
Abstract:
Cardiovascular disease remains the leading cause of death worldwide, particularly in low- and middle-income countries (LMICs), with substantial mortality from acute coronary syndromes. These deaths, when compared against high-income countries, occur at younger ages, and, beyond the lives lost, often result in economic privation for families deprived of a breadwinner and indebted by the oftentimes catastrophic cost of inpatient medical care. This burden will likely grow in scale in the years ahead as more countries pass through the epidemiologic transition. Billions around the world are beginning to experience the comforts that even modestly increased incomes can provide, including diets high in fats and sugars, more sedentary lifestyles, and tobacco and alcohol use and abuse. Health care systems in many of these countries are ill-equipped to prevent the harms caused by these lifestyles, as well as treat the acute coronary syndromes that result from them-including insufficient access to appropriate facilities and medications, difficulties with transport, and low awareness of the symptoms and need for emergent evaluation.
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