Cardiovascular Disease Burden and Associated Risk Factors among Adults with Type 2 Diabetes Mellitus in Sub-Saharan Africa: A Narrative Review
Abstract:
Cardiovascular
disease (CVD) is the leading cause of morbidity and mortality among individuals
with type 2 diabetes mellitus (T2DM) globally, and its burden is increasing
rapidly in sub-Saharan Africa due to rising diabetes prevalence, population
ageing, urbanization, and constrained health systems. This narrative review
synthesizes evidence on the prevalence of CVD and associated risk factors among
adults with T2DM in sub-Saharan Africa. A structured literature search was
conducted across PubMed/MEDLINE, Scopus, Google Scholar, and African Journals
Online, covering English-language publications from January 2000 to December
2025. Following screening and eligibility assessment, 42 studies were included
and synthesized descriptively. The reviewed literature indicates that CVD is a
common complication among adults with T2DM in sub-Saharan Africa, with reported
prevalence ranging from approximately 20% to over 50%, depending on study
setting and methodology. Hypertension-related CVD was the most frequently
reported manifestation, followed by stroke, heart failure, and coronary artery
disease. Increasing age, longer duration of diabetes, hypertension, poor
glycemic control, dyslipidaemia, obesity, and adverse lifestyle behaviors
emerged consistently as major cardiovascular risk factors. In addition, health
system weaknesses—such as limited access to care, inadequate screening and
diagnostic capacity, medication stock-outs, and fragmented chronic disease
services—together with socioeconomic disadvantage, were recurrently associated
with poor cardiovascular outcomes. Overall, the evidence highlights a
substantial and growing cardiovascular burden among patients with T2DM in
sub-Saharan Africa, driven by a convergence of modifiable clinical risk factors
and structural health system and socioeconomic challenges. Strengthening
integrated diabetes and cardiovascular care, improving access to essential
services, and addressing underlying social determinants of health are critical
priorities for reducing cardiovascular morbidity and mortality in this
population.
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