Of the 5434 registered deaths in the UAE in 2000, 1381 were due to cardiovascular diseases making it the primary

cause of death in the country. As in previous years, the pattern of CVD mortality during the year 2000 is characterized by: Acute myocardial infarction ( heart attack) is the most frequent cause of CVD deaths accounting for 28 per cent of these deaths in 2000. It is followed by cerebrovascular disease (16.2 per cent), hypertensive disease (13.0 per cent) and ischemic heart disease (12.3 per cent). With the exception of acute rheumatic fever, more CVD deaths are reported among males than females across all age groups. Over 90 per cent of CVD deaths occur over the age of 45 years. The commonest cancers causing death globally are lung cancer claiming 2.1 per cent of all deaths followed by stomach cancer (1.4 per cent) and colorectal cancer (0.9 per cent) (World Health Organization, The World Health Report 2000).

The prevalence and incidence of stroke in Sub-Saharan Africa have increased over the last half century, due principally to increased life expectancy and changes in environmental determinants and risk factors. The majority of cerebrovascular accidents (CVAs) occur in young and middle-aged people and are related to hypertension. Hypertension is highly prevalent in Sub-Saharan Africa and is often undetected or poorly controlled. This may be the explanation for the high proportion of hemorrhagic CVAs, whereas in developed countries most CVAs occur in older people and are thrombotic in etiology. This has been confirmed by clinical, radiological, and postmortem diagnostic methods. Overall, CVAs account for 7 percent of deaths in South Africa (Statistics South Africa 1996).

Hypertension At the beginning of the twentieth century, high blood pressure was virtually nonexistent among indigenous Kenyans (Lore 1993) and Ugandans (Hutt 1990), but the reason may have been the lack of screening programs and access to care. From about 1975, high blood pressure became established in Cameroon, Cte d'Ivoire, Democratic Republic of Congo, Ghana, Kenya, Nigeria, and Uganda. As in developed countries, consumption of salt and alcohol, psychological stress, obesity, physical inactivity, and other dietary factors are thought to have played an important etiologic role in the genesis of primary hypertension in genetically predisposed individuals. Nevertheless, communities still exist in the Democratic Republic of Congo, Kenya, Nigeria, and the Kalahari Desert in which blood pressure is low and does not seem to rise with age. Rural-to-urban migration coupled with acculturation and modernization trends have some relation to the development of high blood pressure as observed in Kenyan and Ghanaian epidemiologic studies o prevalent is hypertension today in Sub-Saharan Africa that hypertensive heart disease might in fact be the most common form of CVD in Africa. Hypertension is a risk factor for both stroke and IHD (Bradshaw et al. 2003). Left ventricular hypertrophy, congestive heart failure, and stroke are common in Africans with hypertension. There is little published information on formal programs addressing awareness, treatment,

and control. Local, regional, and national surveys are required to provide epidemiological data necessary for informed decision making and policy setting on when and whom to treat in Africa (Kapuku, Mensah, and Cooper 1998;van der Sande et al. 2001).

Sad to say, the Filipino government has neglected heart health in its agenda. The Department of Health's (DoH) Cardiovascular disease program, with its flagship Bantay Presyon or Hypertension Program, has been going on since 1994, but there is little evidence that this program is effective (2). It is ironic that, since 1994, deaths from heart disease are still increasing, yet the budget for heart disease is steadily decreasing, from US$1,262,019 in 1995, down to about US$38,462 for the year 2002. Poor patients, seen at the rural health centers, are only given one-week supply of heart medications and asked to buy the rest.