Cardiovascular diseases in Southern Tunisia: current trends and future projections

Cardiovascular diseases (CVD) are a major cause of morbidity and mortality, driven by the epidemiological transition world-wide.

We aimed to describe the epidemiological profile of CVD hospitalizations, to assess their chronological trends and to estimate their future projected trends.

We retrospectively collected data from the regional morbidity registry of the University Hospital of Sfax, Tunisia, between 2003 and 2016. We included patients with ischemic heart disease (IHD), heart failure (HF) and rhythm and conduction disorder (RCD).

The mean age-standardized hospital incidence rate (ASHIR) was 94.8, 20.6 and 14/100000 inhabitants/year for IHD, HF and RCD, respectively. Trends analysis of CVD showed a significant increase in the ASHIR of IHD from 54.3/100000 inhabitants in 2003 to 123/100000 inhabitants in 2016, with an Annual Percentage Change (APC) of 3.59% (95%CI:0.4-6.7%;p<0.001). An upward trend was observed for HF, with ASHIR rising from 8.6/100000 inhabitants in 2003 to 22.6/100000 inhabitants in 2016, with an APC of 8.29% (95%CI:4.1-12;p<0.001). For RCD, no significant change in ASHIR was found. Projections showed that the estimated ASHIR would attend 131 and 36.5/100000 inhabitants for IHD and HF, respectively, while RCD would decline to 19.6/100000 inhabitant in 2026.

IHD and HF were rising at an alarming rate and were expected to continue up to the next 10 years. Therefore, there is an urgent need to emphasize on primordial, primary, and secondary prevention in order to reduce the massive burden of CVD.