Cardiovascular health in Africa has been a subject of medical observation for nearly a century, yet it remains a neglected priority within health agendas. Since Donnison and Lond’s 1929 report on blood pressure in African populations, the continent has undergone an epidemiological transition marked by rising non-communicable diseases. Today, cardiovascular disease (CVD) is a leading cause of mortality in sub-Saharan Africa, with a prevalence that has increased more than 130% between 1990 and 2019. Unlike high-income countries, where early detection, pharmacological advances, and robust prevention programs have driven a steady decline in CVD mortality, Africa continues to face disproportionately high rates of premature deaths. Contributing factors include uncontrolled hypertension, limited access to diagnostics, scarce and centralized cardiology services, and unaffordable essential medicines. These challenges perpetuate economic instability and deepen inequalities, constituting a “silent cardiovascular epidemic.” Future solutions require strategies adapted to African realities rather than direct importation of high-income models. Hypertension control should be the cornerstone, supported by systematic blood pressure monitoring, community-based education, and intersectoral policies promoting healthier lifestyles. Strengthening health systems through training, access to affordable medicines, and basic diagnostic tools is critical. Regional cooperation and international solidarity, modeled on successful infectious disease programs, are equally essential. Moreover, digital health innovations, including mobile health platforms, telemedicine, portable devices, and artificial intelligence, offer cost-effective opportunities to expand access and enhance data-driven decision-making. The African cardiovascular crisis is not a distant threat but a present reality. Closing the gap demands political will, investment, and global partnerships. Just as HIV/AIDS and malaria mobilized unprecedented action, cardiovascular health in Africa must now be recognized as a priority for equity, economic stability, and the right to health.
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