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Multimorbidity and cardiovascular disease: a perspective on low- and middle-income countries.

Authors
  • Thienemann, Friedrich1, 2, 3
  • Ntusi, Ntobeko A B2
  • Battegay, Edouard1, 4
  • Mueller, Beatrice U1
  • Cheetham, Marcus1, 4
  • 1 Department of Internal Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland. , (Switzerland)
  • 2 Department of Medicine, Faculty of Health Science, University of Cape Town, Cape Town, South Africa. , (South Africa)
  • 3 Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Science, University of Cape Town, Cape Town, South Africa. , (South Africa)
  • 4 University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland. , (Switzerland)
Type
Published Article
Journal
Cardiovascular diagnosis and therapy
Publication Date
Apr 01, 2020
Volume
10
Issue
2
Pages
376–385
Identifiers
DOI: 10.21037/cdt.2019.09.09
PMID: 32420119
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

New and changing patterns of multimorbidity (MM), i.e., multiple concurrent acute or chronic diseases in a person, are emerging in low- and middle-income countries (LMICs). The interplay of underlying population-specific factors and lifestyle habits combined with the colliding epidemics of communicable and non-communicable diseases presents new disease combinations, complexities and risks that are not common in high-income countries (HICs). The complexities and risks include those arising from potentially harmful drug-drug and drug-disease interactions (DDIs), the management of which may be considered as MM in the true sense. A major concern in LMICs is the increasing burden of leading cardiovascular diseases, prevalence of associated risk factors and co-occurrence with other morbidities. New models of MM management and integrated care can respond to the needs of specific multimorbid populations, with some LMICs making substantial progress (e.g., integration of tuberculosis and HIV services in South Africa). But there is a dearth of relevant data on the changing patterns and underlying factors and determinants of MM, the associated complexities and risks of DDIs in MM management, and the barriers to integrated care in LMICs. This requires careful attention. 2020 Cardiovascular Diagnosis and Therapy. All rights reserved.

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