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By Professor Shahryar Sheikh, President of the World Heart Federation.

Heart disease and stroke is the world’s number one killer, causing 17.5 million deaths each year or more than one death every two seconds, and 80 per cent of the victims are from low- and middle-income countries. Not enough of us are aware of how much our own lifestyle and heritage could be contributing to our risk of developing heart disease and stroke. The theme of this year’s World Heart Day is encouraging people to “Know Your Risk” and take the appropriate action to control it.

World Heart Day was established in 2000 by the World Heart Federation as a global initiative to increase public awareness of the threat of heart disease and stroke and the importance of healthy lifestyles so that children, adolescents and adults all over the world can live better, longer.

The annual events are run by World Heart Federation member organizations in 100 countries on all continents and attract tens of thousands of participants each year. Activities on the day include health checks, walks, runs, jump rope, fitness sessions, public talks, stage shows, scientific forums, exhibitions, concerts and sports tournaments.

The World Heart Federation, a non-governmental organization based in Geneva, Switzerland, is committed to helping the global population achieve a longer and better life through prevention and control of heart disease and stroke, with a particular focus on low- and middle-income countries. Members of the World Heart Federation include 196 societies of cardiology and heart foundations from over 100 countries.

Heart disease and stroke is responsible for as many deaths worldwide as HIV/AIDS, tuberculosis, malaria and diabetes plus all forms of cancer and chronic respiratory disease combined. But the good news is that heart disease is largely preventable and there are simple, affordable steps that can be taken to reduce the major risk factors.

The message of World Heart Day is a positive one and emphasizes the importance of a heart-healthy lifestyle to leading a better, longer life. Each year World Heart Day focuses on a specific theme. This year’s campaign, encouraging people to “Know Your Risk!”, is aimed at helping people to find out what they can do to reduce their risk.

Particular emphasis for this year’s World Heart Day is being placed on high blood pressure, or hypertension, the most significant risk factor for stroke and an important one for heart disease. High blood pressure can cause damage to the body every day that it is too high and it affects more than a billion people, or one in four adults, worldwide.

High blood pressure normally goes undetected, but it is straightforward for a healthcare professional to identify and is usually easy to control with simple lifestyle changes and/or medication. The key to avoiding high blood pressure is to understand the disease better; hence the appeal for everyone to “Know Your Risk!”

The dominant risk factors for heart disease and stroke are divided into modifiable factors (ie things we can do something about like high blood pressure, elevated blood lipids, tobacco smoking, obesity and lack of exercise) and non-modifiable risk factors (such as age, gender and genetic predisposition) to which we must adapt our lifestyles accordingly.

There is a vast public misperception and disproportional lack of attention on heart disease, stroke and hypertension in relation to more sensational health issues. As a result people tend to overestimate the number of deaths from rarer and infrequent risks while underestimating those from more common causes such as heart disease and stroke.

Visiting your health-care professional for a heart health check is more important than you think and you can take immediate action to improve your heart health. Visit your health-care professional to check the health of your heart, including your blood pressure, and no matter what your risk level is adopt a healthy lifestyle including a good diet, no tobacco exposure and more than 30 minutes a day of physical activity. Above all, “Know Your Risk!” so you can have a heart for life.

Statistic about Africa, mainly Western african countries such as Senegal

- In 2001, the World Health Report reported that CVD alone accounted for 9.2% of the total deaths in Africa in 2000 compared with 8.15% in 1990

- It should also be noted that the average age of death from CVD is at least 10 years younger in low-income settings than in developed countries, thus hitting adults in their most productive years. For example, in South Africa, 41% of deaths due to CVD occur in adults between 35 and 64 years old, compared to 12% in the United States

- The WHO has reported that the number of disability adjusted life years lost to CVD in sub-Saharan Africa rose from 5.3 million for men and 6.3 million for women in 1990 to 6.5 million and 6.9 million in 2000, and could rise to 8.1 million and 7.9 million in 2010.

- This situation is notably due to the increase in CVD risk factors in the population, likely linked to rapid changes in lifestyles:

Tobacco represents an important risk factor for CVD in Africa due to the prevalence of smoking on the continent, particularly among males: 50% of males in Namibia smoke. 40% to 49% of the male population in Tanzania and South Africa, and 30% to 39% in Zambia and Zimbabwe, smoke.

- Among CVD risk factors, the primary cause of CVD is hypertension, which displays a clear upward trend. According to the WHO, more than 20 million people have hypertension in Africa, with a prevalence ranging from 25% to 35% in adults aged 25-64 years[1]. For comparison purposes, 24.5 million people (adults and children) in Africa live with HIV/AIDS according to the 2006 UNAIDS report. Although these figures come from different sources, they give an idea of the increasing hypertension epidemics.

- a recent study in Ghana has shown that the prevalence of hypertension in urban Accra reached 27.3%

- The Colombia Earth Institute and the Millennium Villages Project analyzed hypertension prevalence in three rural villages in Rwanda, Malawi and Tanzania, and found out that 22.8%, 15.9% and 26.8% respectively of the inhabitants were affected

- A study performed in 2004 in 12 villages in Ashanti, Ghana, showed the hypertension prevalence to be of 28.7% overall

- In Senegal, 13% of women and 9% of men die of CVD (WHO 2002). 21.9% of females between 15 and 49 suffer from overweight or obesity (WHO 2003).

- In Ghana, 13.5% of men and 17.7% of women die from CVD (WHO 2002)

- In Guinea 12.3% of women and 9.7% of men die of CVD (WHO 2002) and 14.3% of women between 15 and 49 suffer from overweight or obesity (WHO 2005)

With the collaboration of Cristina BROCH