# Heart Failure in Africa

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.

## References

1. Mbewu A, Mbanya JC. "Cardiovascular disease." In: Disease and Mortality in Sub-Saharan Africa. 2nd ed. World Bank; 2006.
2. Sliwa K, et al. "Readmission and death after an acute heart failure event." Eur Heart J. 2017;38:1508-1518.
3. ClinicalTrials.gov API v2 Documentation. U.S. National Library of Medicine.

## Note Block

- Type: research
- App: https://mahmood726-cyber.github.io/africa-e156-students/health-disease/dashboards/heart-failure-africa.html
- Code: https://github.com/mahmood726-cyber/africa-e156-students/blob/master/health-disease/code/heart-failure-africa.py
- Data: ClinicalTrials.gov API v2
- Date: 2026-04-05