A study on pulmonary hypertension in low- and middle-income countries, with a focus on sub-Saharan Africa, has found that in South Africa, the conditions accounted for 31% of total cardiovascular deaths, with medical specialists saying the condition can also result from being overweight, smoking and using narcotics like cocaine and methamphetamine.
Pulmonary hypertension is different from hypertension in that it occurs only in the lungs, affecting not only breathing, but also overall cardiac health, they said.
Dr Gerald Maarman from the Centre for Cardio-Metabolic Research in Africa at Stellenbosch University says that, according to researchers, the prevalence of pulmonary hypertension in Africa can range from 10% to 68%.
Reasons for these high mortality rates, said the study, included lack of access to healthcare, infrastructure and equipment to diagnose the illness, as well as the unavailability of specific treatment, reports News24.
Moustafa Kamel, medical affairs director of Janssen pharmaceutical companies for Johnson & Johnson, said pulmonary hypertension can affect the entire body, and that there five groups of the illness, including pulmonary arterial hypertension, a serious progressive disease with no cure, and which can lead to heart failure and early death.
“Pulmonary arterial hypertension affects the arteries, the lungs and the heart. It causes the walls of the pulmonary arteries to become thick and stiff, narrowing the space through which blood can flow, increasing pulmonary blood pressure.”
Consequently, the heart works harder to pump blood to the lungs, which in turn, causes blood pressure to rise significantly. Excessive cardiac workout caused by pulmonary hypertension can result in the heart enlarging, tiring and, eventually, failing.
Kamel says pulmonary hypertension is hereditary in some instances, but can also be caused by environmental and lifestyle factors.
“People with a family history of pulmonary hypertension should be particularly aware of their risks, but evidence shows that obesity, smoking and taking recreational drugs that are stimulants can bring it about, too. Existing medical conditions like kidney disease can also cause pulmonary hypertension. Living at a high altitude, work and related environmental stress and pressures could also become triggers,” he says.
Pulmonary hypertension may affect one in every 100 people worldwide, translating to between 50m and 70m people already living with the illness. In people over 65, the ratio of pulmonary hypertension incidence thins out to one in 10.
Study details
Pulmonary hypertension in developing countries: Limiting factors in time to diagnosis, specialised medications and contextualised recommendations
G J G Maarman
Published in African Journal of Thoracic & Critical Care Medicine on 5 March 2022
Abstract
Pulmonary hypertension (PH) is a fatal disease with no cure. Combination therapy that includes several specialised medications can improve survival and quality of life. However, there are many challenges, and these include a lack of effective screening tools, misdiagnosis and late diagnosis, a lack of awareness among clinicians and patients, expensive PH medication and the unavailability of these medications in many developing countries. Based on the literature, this paper provides helpful approaches and ‘out of the box’ ideas to try to surmount these challenges. We make the following recommendations: develop better (contextually fitting) screening tools, investigate novel therapeutics or novel drug targets, implement incentivised and accredited training for clinicians and implement awareness campaigns (by using traditional and social media and promoting awareness at healthcare or educational institutions). Other recommendations include greater advocacy that engages public and private funders, combine scarce skills and networks of social sciences and implementation sciences and invite nonprofit organisations to the fight against PH in conjunction with researchers. Furthermore, the implementation of breathlessness clinics in rural areas can be helpful, as well as the investigation of the biomarker potential of genetic mutations or unique gene signatures of patients during research. We hope that healthcare professionals, researchers, scientists and regulatory authorities or research bodies, can use our recommendations in a practical setting, especially in developing countries where resources are limited and the healthcare burden is high.
News24 article – A killer disease stalks Africa: Pulmonary hypertension (Open access)
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