Heart disease, once predominantly the preserve of rich countries, is expanding fast in developing economies, although for rather different reasons, a study carried out in South Africa suggests.
Doctors from South Africa and Australia looked at data from 1,593 people who were diagnosed with cardiovascular disease at the Chris Hani Baragwanath Hospital in Soweto, Johannesburg in 2006.
Eight-five percent of them were black Africans, and 59 percent were women. The patients' average age was in the early to mid-fifties, but a quarter were under 40.
The paper said a large number of patients, especially women, were obese, an established risk factor for heart disease.
Factors specific to South Africa were HIV infection and tuberculosis, which worsen certain kinds of heart disease, along with late diagnosis and a tendency to seek hospital care only after consulting a traditional healer had failed.
The study, which appears in next Saturday's The Lancet, is 'relevant to many areas of the world that face similar threats and the emergence of epidemics of heart disease,' a commentary in the journal said.
'In some developing countries, such as India, the epidemiological transition has been more rapid and the speed of transition will vary from country to country depending on the exposure time and competing causes.'