title: Heart Failure in Africa, Asia, the Middle East and South America: The INTER-CHF study.
abstract: BACKGROUND
  There are few data on heart failure (HF) patients from Africa, Asia, the Middle East and South America.
  
  
  METHODS
  INTER-CHF is a prospective study that enrolled HF patients in 108 centers in 16 countries from 2012 to 2014. Consecutive ambulatory or hospitalized adult patients with HF were enrolled. Baseline data were recorded on sociodemographics, clinical characteristics, HF etiology and treatments. Age- and sex-adjusted results are reported.
  
  
  RESULTS
  We recruited 5813 HF patients: mean(SE) age=59(0.2)years, 39% female, 65% outpatients, 31% from rural areas, 26% with HF with preserved ejection fraction, with 1294 from Africa, 2661 from Asia, 1000 from the Middle-East, and 858 from South America. Participants from Africa-closely followed by Asians-were younger, had lower literacy levels, and were less likely to have health or medication insurance or be on beta-blockers compared with participants from other regions, but were most likely to be in NYHA class IV. Participants from South America were older, had higher insurance and literacy levels, and, along with Middle Eastern participants, were more likely to be on beta-blockers, but had the lowest proportion in NYHA IV. Ischemic heart disease was the most common HF etiology in all regions except Africa where hypertensive heart disease was most common.
  
  
  CONCLUSIONS
  INTER-CHF describes significant regional variability in socioeconomic and clinical factors, etiologies and treatments in HF patients from Africa, Asia, the Middle East and South America. Opportunities exist for improvement in health/medication insurance rates and proportions of patients on beta blockers, particularly in Africa and Asia.
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Canada. Electronic address: hisham.dokainish@phri.ca.
authors.forename: Hisham
authors.initials: H
authors.lastname: Dokainish
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Canada.
authors.forename: Koon
authors.initials: K
authors.lastname: Teo
authors.affiliation: Cardiovascular Institute and Fuwai Hospital, Peking Union Medical College, Beijing, China; Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhu
authors.affiliation: All India Institute of Medical Science, New Delhi, India.
authors.forename: Ambuj
authors.initials: A
authors.lastname: Roy
authors.affiliation: King Fahad Cardiac Center, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Khalid F
authors.initials: KF
authors.lastname: AlHabib
authors.affiliation: AlShaab Teaching Hospital, Khartoum, Sudan.
authors.forename: Ahmed
authors.initials: A
authors.lastname: ElSayed
authors.affiliation: University of the Philippines, Manila, Philippines.
authors.forename: Lia
authors.initials: L
authors.lastname: Palileo-Villaneuva
authors.affiliation: Fundacion Oftalmologica de Santander, (FOSCAL) and Medical School, Universidad de Santander (UDES), Bucaramanga, Colombia.
authors.forename: Patricio
authors.initials: P
authors.lastname: Lopez-Jaramillo
authors.affiliation: Bayero University, Kano, Nigeria; Aminu Kano Teaching Hospital, Kano, Nigeria.
authors.forename: Kamilu
authors.initials: K
authors.lastname: Karaye
authors.affiliation: UiTM Selayang, Selangor University, Cheras, Malaysia; UCSI University, Cheras, Malaysia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Yusoff
authors.affiliation: ECLA Foundation, Instituto Cardiovascular de Rosario, Argentina.
authors.forename: Andres
authors.initials: A
authors.lastname: Orlandini
authors.affiliation: Hatter Institute for Cardiovascular Research in Africa, SAMRC, Faculty of Health Sciences, University of Cape Town, South Africa.
authors.forename: Karen
authors.initials: K
authors.lastname: Sliwa
authors.affiliation: Mulago National Referral Hospital, Kampala, Uganda.
authors.forename: Charles
authors.initials: C
authors.lastname: Mondo
authors.affiliation: Universidad de La Frontera, Temuco, Chile.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lanas
authors.affiliation: Centre for Chronic Disease Control, New Delhi, India.
authors.forename: Dorairaj
authors.initials: D
authors.lastname: Prabhakaran
authors.affiliation: Hamad Medical Center, Doha, Qatar.
authors.forename: Amr
authors.initials: A
authors.lastname: Badr
authors.affiliation: Aswan Heart Centre, Aswan, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elmaghawry
authors.affiliation: Eduardo Mondlane University, Maputo, Mozambique.
authors.forename: Albertino
authors.initials: A
authors.lastname: Damasceno
authors.affiliation: Department of Cardiovascular Medicine, Muhimbili National Hospital, Dar es Salaam, Tanzania.
authors.forename: Kemi
authors.initials: K
authors.lastname: Tibazarwa
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Canada.
authors.forename: Emilie
authors.initials: E
authors.lastname: Belley-Cote
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Canada.
authors.forename: Kumar
authors.initials: K
authors.lastname: Balasubramanian
authors.affiliation: Hamad Medical Center, Doha, Qatar; Aswan Heart Centre, Aswan, Egypt.
authors.forename: Magdi H
authors.initials: MH
authors.lastname: Yacoub
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Huffman
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Harkness
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Canada.
authors.forename: Alex
authors.initials: A
authors.lastname: Grinvalds
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: McKelvie
authors.affiliation: Population Health Research Institute, McMaster University, Hamilton, Canada.
authors.forename: Salim
authors.initials: S
authors.lastname: Yusuf
mesh_terms: D000349:Africa / Q000453:epidemiology; D000368:Aged; D001208:Asia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D038622:Internationality; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D011446:Prospective Studies; D013020:South America / Q000453:epidemiology
keywords: Epidemiology; Global health; Heart failure; Registry