Hypertension-related congestive heart failure in west Africa: a framework for global blood pressure control

Postpartum cardiomyopathy with congestive heart failure: A case report

Postpartum cardiomyopathy is a type of heart failure that occurs during late pregnancy or early postpartum without clear causes. It poses significant health risks. Recognition and management are crucial for better outcomes. We describe a case of a 23-year-old Ugandan woman who developed heart failure symptoms 1 month after giving birth. Physical examination revealed signs of congestive heart failure. Chest X-ray showed cardiomegaly, leading to a diagnosis of postpartum cardiomyopathy based on clinical criteria. Treatment involved diuretics, beta-blockers, angiotensin receptor blockers, SGLT2 inhibitors, and bromocriptine. This case underscores the importance of considering postpartum cardiomyopathy in the postpartum period. Prompt diagnosis and comprehensive management through a multidisciplinary approach can improve patient outcomes. Further research is needed to deepen our understanding of this condition.

Controlling hypertension and reducing its associated morbidity and mortality in the Caribbean: implications of race and ethnicity

Cardiovascular diseases and stroke, especially hypertension, represent a significant global disease burden for both morbidity and mortality, with a disproportionately higher impact in vulnerable low- to middle-income countries. International initiatives such as the Centers for Disease and Prevention and the Pan American Health Organization Standardized Hypertension Treatment Project have been developed to address this burden on the Caribbean and Latin America populations. The disparity in disease burden observed in low- to middle-income countries is explained, in part, by differences in disease risks for different racial and ethnic groups with high blood pressure more prevalent and hypertension-related morbidity significantly higher in men and women of African heritage. In addition to the race and ethnic differences in indicators of socioeconomic status, access to care and health service delivery, the physiologic mechanism of high blood pressure including salt-sensitivity, may also play a significant role in the disparities in hypertension and hypertension-related outcomes. This article focuses on potential racial and ethnic differences in influences on the pathophysiology of hypertension in the Caribbean region of the world. The identification of such differences may be used in the development of population hypertension control strategies and treatment approach that address the excess disease burden in these populations. The consideration of strategies, such as salt reduction and hypertension awareness and treatment, are particularly relevant to the high-risk Caribbean region.

Improved Blood Pressure Control to Reduce Cardiovascular Disease Morbidity and Mortality: The Standardized Hypertension Treatment and Prevention Project

Hypertension is the leading remediable risk factor for cardiovascular disease, affecting more than 1 billion people worldwide, and is responsible for more than 10 million preventable deaths globally each year. While hypertension can be successfully diagnosed and treated, only one in seven persons with hypertension have controlled blood pressure. To meet the challenge of improving the control of hypertension, particularly in low- and middle-income countries, the authors developed the Standardized Hypertension Treatment and Prevention Project, which involves a health systems-strengthening approach that advocates for standardized hypertension management using evidence-based interventions. These interventions include the use of standardized treatment protocols, a core set of medications along with improved procurement mechanisms to increase the availability and affordability of these medications, registries for cohort monitoring and evaluation, patient empowerment, team-based care (task shifting), and community engagement. With political will and strong partnerships, this approach provides the groundwork to reduce high blood pressure and cardiovascular disease-related morbidity and mortality.