Cardiovascular and Vascular Disease in the Tropics Including Ischaemic Heart Disease, Stroke, and Hypertension

Cardiovascular diseases (CVDs) are the leading causes of death and disability across the world, including high CVD burdens in tropical countries. Ischemic heart disease (IHD), stroke, and hypertension are among the major contributors to overall CVD mortality and morbidity. Therefore, this chapter provides an overview of the key aspects in the pathogenesis, diagnosis and treatment of these conditions. Other forms of CVD relevant to tropical countries (e.g., rheumatic heart diseases, heart failure secondary to so-called non-ischemic “tropical cardiomyopathies”, endomyocardial fibrosis and congenital heart disease) are also discussed but in less detail. CVDs share several “classical” modifiable risk factors with other non-communicable diseases (NCDs). These include tobacco use, poor diet, physical inactivity, obesity, and excessive alcohol use. Other determinants include various environmental, social and physiological risk factors (e.g., age, sex, socio-economic status, air pollution, metal pollution, built environment). For CVD prevention strategies, population-wide and individual approaches should be combined. Implementation must be context-specific by recognising the socio-cultural, environmental and demographic differences and considering potential differences in disease patterns, risk factor profiles, and available resources across settings.