15/07/25
Ischemic heart disease, heart failure, stroke: what is the situation in Guyana
Public Health France has published a bulletin on the latest data concerning cardio-chips. He confirms that Guyana remains the second department most affected by cerebral accidents. Heart insufficiency is more frequent there than at the national level, especially in young people, while ischemic heart disease is rarer. The data reveal disparities within the territory. Some of the risk factors are particularly high in Guyana: high blood pressure, diabetes, obesity …
In Guyana, as elsewhere in France, ischemic heart disease, cerebral vascular accidents and cardiac insufficiency, are important causes of morbidity and mortality. Public health France (SPF) has just published a regional bulletin devoted to these pathologies among adults. As at the national level, “they constitute one of the main causes of mortality in those under 65. They are also more frequent than causes of infectious origin, ”underlines SPF. An article on national figures, published in March in the Weekly epidemiological bulletingives interesting elements of comparison.
Prof. Mathieu Nacher and a team of CHU researchers had described this epidemiological transition in an April 2023 article (Read the professional letter of April 28, 2023). Dedicated to a longer period (2001-2021), their study rose that, “overall, everything improves. And quickly!, PR Nacher underlined. Between 2001 and 2017, we see that progress is considerable for strokes, diabetes, traumas, infections. ” But their work showed that “all of this is fragile”. The France Public Health Bulletin is more a photograph, over the period 2020-2023.
Less ischemic heart disease
With 322 hospitalizations per 100,000 inhabitants each year in Guyana, “the proportion of people hospitalized for the management of ischemic heart disease was lower than at the national level (459 per 100,000) between 2021 and 2023”, notes SPF. This figure is standardized on age and sex, which makes it possible to compare the results of Guyana, whose population is younger, with the rest of the territory.
“The proportion of people living with this pathology as well as the deaths caused by it were also lower. In Guyana, 3.7 % of the inhabitants were affected by the pathology in 2022, either that they were newly diagnosed, or that they are already known. At the national level, this proportion was 5.5 %. With 27 deaths on average each year, between 2020 and 2022, its weight is as less as elsewhere. This represents 2.2 % of deaths in Guyana.
Inside the territory, East Guyanese and the savannas are the sectors most affected by ischemic heart disease. But it is in the Cayennaise agglomeration and the savannas that she weighs the most in terms of death. These figures being weak, they are to be handled with caution. Men (8 % prevalence) are more than twice as affected as women (3.4 %). This prevalence climbs from the 65-84 % tranche (one in ten people concerned against 2.3 % among 45-64 year olds).
Heart insufficiency: a larger burden in Guyana, especially in young people
“Unlike ischemic heart disease, heart failure is a more important health burden in Guyana than at national level,” said SPF. The levels of new hospitalizations are however close: 360 per 100,000 inhabitants in Guyana against 344 per 100,000 of national average.
The number of people with heart failure is also higher in us: 3 % of the population is affected against 2.5 % at the national level. Cardiac insufficiency, however, weighs less in terms of death, in Guyana. From 2020 to 2022, 22 deaths were identified on average each year. “One of the explanations would be that people with heart failure in Guyana died from another cause,” said Public Health France.
Inside the territory, the savannas are more affected than the other sectors. Men (3.2 % prevalence) are a little more affected than women (2.9 %). Heart insufficiency also concerns one person over 85 out of five (20.7 %) compared to 7 % in 65-84 year olds.
We also note that the Guyanese are affected much younger than elsewhere in France:
- In Guyana, 18-44 year olds are twice as affected as at the national level: prevalence is 0.2 % here against 0.1 % in whole France;
- There are half more cardiac insufficiency in us than at the national level, both among 45-64 year olds (1.7 % against 1.1 %) than among 65-84 year olds (7 % against 5.1 %);
- The over 85s are less affected in Guyana than at the national level: 20.7 % against 23.7 %.
Strokes at the origin of 6 % of deaths; An unfavorable dynamic in the west
The weight of cerebral vascular accidents in Guyana has been described for a long time. They are responsible for 6 % of deaths. Guyana is the second department where they cause the most hospitalizations. The annual impact (364 hospitalizations per 100,000 inhabitants) is unusual with the national average (231 per 100,000). In 2022, 2,951 people living in Guyana had already made a stroke. This represents 1.7 % of the population in gross figures, due to the youth of the Guyanese population. With a structure of age and sex comparable to the rest of France, this prevalence would be 3.3 %, much more than the national average (2 %).
All the Guyana sectors are affected, but “West Guyanese seems more particularly in an unfavorable dynamic concerning this pathology”. The figures “suggest a recent progression of strokes in this sector while demography increases,” said SPF. Among those over 85, one in six (16.7 %) has already made a stroke. It is twice as much as in 65-84 year olds (8.2 %) and eight times more than in 45-64 year olds (2.1 %).
Many risk factors in Guyana
“The significant weight of cardio-none diseases is largely linked to the high prevalence of their risk factors,” explains Public Health France. In addition to non-modifiable risk factors such as gender and age, the main risk factors for cardio-necusal diseases are smoking, unbalanced diet, physical inactivity, sedentary lifestyle, overweight, obesity, diabetes, hypertension, dyslipidemia, alcohol consumption and sleep disorders. Chronic kidney disease, drug use, depression, hypertensive disorders of pregnancy, hormone -dependent diseases and environmental factors, such as air pollution, have also been identified as risk factors for cardiovascular disease. »»
Some of these risk factors are particularly present in Guyana and higher than at the national level:
- High blood pressure affects 23 % of the population;
- Diabetes, 12 %;
- Obesity, 16 % of men and 25 % of women.
If the consumption of alcohol and tobacco is less with us, food is often less varied than elsewhere. Another factor that weighs unfavorably for these pathologies.
Pr Jocelyn Imoi, head of the CHU cardiology department: “The weight to pay for heart failure is higher in Guyana”
All these figures do not surprise Professor Jocelyn Inmo, head of the CHU cardiology department. “Regarding ischemic heart disease and the resulting mortality, what we observe corresponds to what we already knew: it is much lower in the Antilles-Guyana than in France. Three or four elements can explain this already old observation:
- “Tabalic consumption has always been extremely low in the Antilles-Guyana;
- “Obesity and diabetes are very high but not to the point of reversing balance. So you shouldn’t sing Cocorico;
- “The Antilles are what is called a blue area, that is to say an area with many centenarians. It may be the same observation when the population of Guyana aged. But if these centenarians suffer from ischemic cardiopathies, they make as much infarction as the general population, are as diabetic and as hypertensive. One day, we will understand;
- Finally, there may be an antillo-Guyanese paradox linked to food or something that could be a protective factor vis-à-vis ischemic heart disease, despite our disastrous obesity and diabetes rates. We have not yet clearly explained it, ”he admits.
As for theheart failure“All the epidemiological indicators were in the red worldwide, twenty years ago, recalls Pr Imo. We were told an epidemic of cardiovascular disease. Around 2015-2017, it was found that the epidemic arrived and it was a surge. Until then, all cardiologists had made a little heart failure. From now on, it has become a major field of the specialty, with specialists who do only. This is due to the aging of the population, which gives time to risk factors to cause heart failure. In Martinique, heart failure is a geriatrician disease. In Guyana, there are probably very local reasons that make risk factors different from what they are elsewhere. This produces a weight to pay more important than it should be. These figures correspond to our observations. The fact that heart failure affects more young people is a reality that we share on a daily basis with our colleagues from Martinique, Guadeloupe and Guyana. We have a very special illness in the Antilles-Guyana, which makes it reaching younger and more numerous subjects. »»
“With the AVCwe explode the counters, deplores Pr Imoi. We know why: hypertension and other risk factors. The situation becomes disastrous in the Antilles, mainly because the population ages. We are better in charge of coronary pathology; Patients live longer and make stroke. In Guyana, this weight of strokes is not an effect of aging but the weight of high blood pressure. The disease is frequent, serious and we pay the price. Guyana takes the same direction as the Antilles but the engines are different and therefore the care must be completely different. In Guyana, you have to work in coronary insufficiency. For strokes, we must resume the business at the base, work on our knowledge of high blood pressure. »»
