CORONARY HEART-DISEASE - OUTLOOK FOR AFRICA

In Africa, coronary heart disease (CHD) is near absent in rural areas, and very uncommon in urban centres, where many Africans are in an adv anced stage of transition. Among town dwellers intakes of food, especi ally fat, have risen and intakes of fibre-containing foods have fallen . Mean serum cholesterol level is almost double that of rural populati ons living traditionally. Obesity in females has risen enormously. Pre valence of hypertension exceeds that in the white population. The same applies to the practice of smoking in males, but not in females. The level of physical activity has fallen generally. With these increases in risk factors we can expect urban Africans to attain the high mortal ity rate for CHD now experienced by Afro-Americans. Prevention by urgi ng reversion to previous life-style behaviour is a non-starter. Howeve r, as long as Africa remains impoverished, a major rise in CHD is unli kely.