Africa hosts 167 heart failure trials compared to 2,499 in the United States — a 15-fold disparity. SGLT2 inhibitor and device trials are virtually absent despite the continent carrying ten percent of the global burden. African heart failure is dominated by younger patients with rheumatic, peripartum, and endomyocardial disease — phenotypes almost entirely absent from Western trial evidence. Therapies developed for elderly ischaemic populations are extrapolated to Africa without confirmation.
The Evidence 138 words · target 156
In global cardiology, does the distribution of heart failure trials reflect the distinct burden carried by Africa? This audit queried ClinicalTrials.gov for heart failure trials across Africa (167), the United States (2,499), and Europe (2,527) through March 2026. Investigators reported the inter-continental volume ratio as the primary estimand for research equity in cardiovascular medicine. Africa hosted 167 heart failure trials versus 2,499 in the United States, a 15x disparity despite carrying approximately ten percent of global burden. SGLT2 inhibitor and device trials were near-absent in Africa, while peripartum cardiomyopathy had only 4 trials despite Nigeria having the highest global incidence. These findings expose a fundamental evidence gap where therapies validated in elderly ischaemic populations are extrapolated to younger African patients without confirmation. Interpretation is limited by reliance on one public registry which may undercount locally funded cardiovascular studies.
Sentence Structure
Question
In global cardiology, does the distribution of heart failure trials reflect the distinct burden carried by Africa?
Dataset
This audit queried ClinicalTrials.gov for heart failure trials across Africa (167), the United States (2,499), and Europe (2,527) through March 2026.
Method
Investigators reported the inter-continental volume ratio as the primary estimand for research equity in cardiovascular medicine.
Primary Result
Africa hosted 167 heart failure trials versus 2,499 in the United States, a 15x disparity despite carrying approximately ten percent of global burden.
Robustness
SGLT2 inhibitor and device trials were near-absent in Africa, while peripartum cardiomyopathy had only 4 trials despite Nigeria having the highest global incidence.
Interpretation
These findings expose a fundamental evidence gap where therapies validated in elderly ischaemic populations are extrapolated to younger African patients without confirmation.
Boundary
Interpretation is limited by reliance on one public registry which may undercount locally funded cardiovascular studies.