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AFRICA
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CVJAFRICA • Volume 26, No 2, H3Africa Supplement, March/April 2015
In SSA, the age-adjusted mortality from CVD has not
declined, and the regional burden of CVD is rising, albeit
modestly, largely due to population growth, aging and the
epidemiological transition. To address this challenge in SSA and
the persistent impact of CVD and other NCDs in developed
nations, we need revolutionary ideas or targets. It is in this regard
that we recognise the endothelium, which plays a remarkable role
in health and disease. Its relevance to CVD warrants increased
awareness and appreciation in public health and practice. It
is now understood that socio-ecological and bio-behavioural
drivers converge to affect various types of CVD and NCD
via endothelial dysfunction. Furthermore, the varied response
to these risk-factor exposures suggests a more complicated
relationship with the underlying mechanisms for endothelial
dysfunction.
Targeted efforts to understand the genomic and epigenetic
mechanisms underpinning eNOS uncoupling may help explain
the differential response to disease drivers and perhaps provide
robust targets for CVD prevention and treatment. This concept
requires the type of resources and framework for collaboration
offered by the H3Africa platform. In the interim however,
widespread dissemination, adoption and implementation of
proven interventions for the prevention and control of CVD risk
factors that are also affordable and acceptable in the SSA context
are strongly encouraged.
The views expressed in this article are those of the authors and do not neces-
sarily represent the views of the National Heart, Lung, and Blood Institute,
National Institutes of Health, or the US Department of Health and Human
Services.
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