Cardiovascular Journal of Africa: Vol 28 No 2 (March/April 2017)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 2, March/April 2017 AFRICA 71
From the Editor’s Desk
The gap between clinical practice guidelines and usual clinical
practice is acknowledged to exist worldwide, is seldom measured,
but is considered to be important. In this issue, Ale and Braimoh
(page 72) report on the knowledge of hypertension guidelines
in a large sample of primary care physicians in Nigeria.
Deficiencies in knowledge seemed to translate to deficiencies in
diagnosis and management.
In a cross-sectional study, Ononamadu and colleagues
(page 92) compared the performance of eight anthropometric
indices of obesity: body mass index (BMI), ponderal index,
waist circumference (WC), hip circumference, waist–hip ratio,
waist–height ratio, body adiposity index and conicity index as
correlates and potential predictors of risk for hypertension and
prehypertension in a Nigerian population, and also the possible
effect of combining two or more indices in that regard. In a
related but very different study, Onen (page 86) investigated
anthropometric data from 215 male and 203 female patients
seen in a specialist clinic in Gaborone, Botswana, between
2005 and 2015 to establish appropriate cut-off points for
WC corresponding to a BMI of 30 kg/m2. Relative risks for
cardiometabolic disorders were calculated for different BMIs
and WCs. He proposes new cut-off values, which may be useful
in studies in other sub-Saharan countries.
The importance of studies such as those above is emphasised
by the report from Mwita and co-authors (page 112) on the
clinical characteristics and outcomes of patients admitted to
hospital in Botswana with acute heart failure. The patients
were younger than in similar series in other parts of the world
and had a high short-term mortality rate. Components of
the metabolic syndrome were considered to be important in
causation. Attempts to curb the mortality associated with the
metabolic syndrome require ongoing efforts to identify it and
treat its components in Africa.
Pat Commerford
Editor-in-Chief
Joint PASCAR and Sudan Heart Society African Congress 2017
Khartoum, Sudan
8 to 11 October 2017
“Join us for the next phase in Eradication of Heart Disease
at the confluence of the White and Blue Nile”