I Asked Google AI About Heart Failure in Haiti--August 2, 2025
Google AI
Why does Haiti have so much congestive heart failure?
Factors contributing to the high prevalence of congestive heart failure in Haiti
Haiti faces a significant burden of congestive heart failure (CHF), particularly early-onset cases, due to a complex interplay of risk factors, healthcare system limitations, and socioeconomic challenges.
Here's a breakdown of the key factors:
1. High prevalence and poor management of hypertension
Hypertension (high blood pressure) is the leading cause of heart failure in Haiti.
A staggering number of Haitians, including young adults, have hypertension.
Despite this high prevalence, only a small percentage of Haitians with hypertension have their blood pressure under control.
2. Socioeconomic factors and their impact on health
Poverty: The vast majority of Haitians live below the poverty line, with limited income and resources.
Food Insecurity: Many struggle to access nutritious foods, relying on less healthy, processed options high in sugar, salt, and oil, which can contribute to hypertension and obesity.
Limited Healthcare Access:
Limited access to diagnostic tools for early detection and management of heart disease.
Many health facilities lack adequate resources, trained personnel, and essential medications.
User Fees and Cost of Care: High out-of-pocket costs for consultations, medications, and transportation create significant barriers to access, particularly for the poorest Haitians.
Geographic Barriers: Rural communities often face long distances to reach health facilities.
Stress and Psychosocial Factors: High levels of stress, social isolation, and depression, frequently linked to poverty and political instability, can negatively impact cardiovascular health.
Environmental Factors: Lead exposure and air pollution are also linked to increased blood pressure and cardiovascular disease risk, according to the National Institutes of Health (NIH).
3. Shifting disease burden and lack of focus on NCDs
Haiti faces a double burden of disease, with infectious diseases historically taking precedence over non-communicable diseases (NCDs) like heart disease.
Despite the increasing prevalence of NCDs, healthcare resources and attention have historically been focused on infectious diseases.
Addressing the problem
There's a critical need for targeted interventions focusing on early prevention and treatment of hypertension and heart failure in Haiti.
Efforts to reduce blood pressure on a population level could significantly decrease cardiovascular disease mortality, according to Think Global Health.
Raising awareness about the importance of reducing salt intake and other lifestyle modifications is crucial.
Investing in strengthening the Haitian healthcare system to improve access to care, essential medicines, and trained personnel is vital.
Addressing underlying socioeconomic determinants of health, such as poverty, food insecurity, and access to clean water and sanitation, is equally important.
This is for informational purposes only. For medical advice or diagnosis, consult a professional. AI responses may include mistakes. Learn more
18 sites
Haiti's Epidemic of Early-Onset Heart Disease
Jun 11, 2024 — Haiti's Epidemic of Early-Onset Heart Disease * In the first population-based study to estimate the number of people living with cardiovascular disease in Haiti...
Think Global Health
Preventing and treating high blood pressure in Haiti - nhlbi, nih
Jun 6, 2023 — Yet, few have resources to control it. * The result, this confluence of risks, has been concerning. Hypertension is the number one risk factor for cardiovascula...
National Institutes of Health (NIH) | (.gov)
The Haiti cardiovascular disease cohort: study protocol for a ...
Nov 1, 2020 — More recently, Haiti's 2017 Demographic Health Survey (DHS) revealed that HTN was the most common CVD risk factor in Haiti with a prevalence of 49% in women and...
National Institutes of Health (NIH) | (.gov)
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What's the typical profile of someone with early-onset heart failure in Haiti?
Typical profile of individuals with early-onset heart failure in Haiti
Research conducted in urban Port-au-Prince, Haiti provides valuable insights into the characteristics of those affected by early-onset heart failure.
Demographics and health
Age: The median age for heart failure patients in Haiti is 57 years old, which is notably younger than in higher-income countries where the median age is around 72. A significant increase in prevalence begins between 30 and 49 years of age, according to the American Heart Association Journals.
Gender: The majority of individuals with heart failure are women, accounting for 68.5% of cases.
Socioeconomic Status: The majority (70.2%) live in extreme poverty, with a reported income of less than $1 USD per day, says ScienceDirect.com. This is considerably higher than 50% of the overall population living in poverty. A staggering 83.9% of heart failure patients live on less than $1 a day compared to those without the condition.
Education Level: A substantial portion (28%) of those with heart failure had no formal schooling, while 26.9% had only a primary education.
Risk factors and associated conditions:
Hypertension: The most common risk factor for heart failure is high blood pressure, or hypertension, affecting 69.9% of those with heart failure. It is significantly higher than in those without the condition. Unfortunately, only a small percentage (13%) of Haitians with hypertension have their blood pressure under control.
Obesity: Individuals with heart failure have a higher rate of obesity, with a median BMI of 28 compared to those without heart failure who have a median BMI of 24. Obesity is present in 37.6% of heart failure patients, which is more than double the rate (16.6%) of those without heart failure.
Renal Dysfunction: Almost a quarter (21.1%) of individuals with heart failure also have kidney problems, which is significantly higher compared to 2.3% in those without heart failure.
Depression and Stress: Heart failure patients have higher rates of moderate-to-severe depression (21.5%) compared to the general population (12.4%). Stress is a recognized risk factor for cardiovascular disease.
Poverty: Individuals living in poverty are more than twice as likely to develop heart failure compared to those in higher income brackets.
Symptoms: The most frequently reported symptoms of heart failure include dyspnea on exertion (86%), orthopnea (72%), and lower extremity edema (67.7%).
Heart Failure Subtype: The majority of heart failure patients in Haiti (71%) have heart failure with preserved ejection fraction, according to the American Heart Association Journals. This suggests a different mechanism than in high-income settings, where heart failure with reduced ejection fraction is more common.
Mortality: The one-year mortality rate for individuals with heart failure in Haiti is significantly high at 6.6%, which is nearly eight times higher than in those without heart failure (0.8%).
Other Risk Factors:
Dyslipidemia (43.8%)
Diabetes (5.6%)
History of alcohol use (16.6%) and tobacco use (8.3%) are also reported.
Food insecurity and poor diet, characterized by a lack of fruits and vegetables, are also associated with the development of heart failure.
High levels of stress.
This profile highlights the devastating impact of early-onset heart failure in Haiti and underscores the urgent need for addressing its social determinants, such as poverty, food insecurity, and lack of access to healthcare, along with effective prevention and treatment strategies for hypertension and related conditions.
This is for informational purposes only. For medical advice or diagnosis, consult a professional. AI responses may include mistakes. Learn more
9 sites
Haiti's Epidemic of Early-Onset Heart Disease
Jun 11, 2024 — They also completed noninvasive tests, including electrocardiograms, which measure the heart's electrical activity, and echocardiograms, ultrasound scans that s...
Think Global Health
Population-Based Epidemiology of Heart Failure in a Low ...
Abstract * Background: Cardiovascular disease disproportionately affects persons living in low- and middle-income countries (LMICs) and heart failure (HF) is th...
National Institutes of Health (NIH) | (.gov)
Preventing and treating high blood pressure in Haiti - nhlbi, nih
Jun 6, 2023 — Yet, few have resources to control it. * The result, this confluence of risks, has been concerning. Hypertension is the number one risk factor for cardiovascula...
National Institutes of Health (NIH) | (.gov)
—
How heart failure with preserved ejection fraction (HFpEF) differs in Haiti
Research highlights significant differences in the prevalence, patient profile, and contributing factors of heart failure with preserved ejection fraction (HFpEF) in Haiti compared to wealthier countries.
1. Higher prevalence and earlier onset
Elevated Prevalence: The age-standardized prevalence of clinical heart failure (HF) in Haiti is 3.2%, which is alarmingly 5-fold higher than previous estimates for low- and middle-income countries and 50% higher than in high-income settings.
Early Onset: HF occurs 2 decades earlier in Haiti than in high-income countries, with the median age of onset being 57 years versus 77 years, respectively. Heart failure with preserved ejection fraction (HFpEF) is the most common type, observed in 71% of HF cases.
2. Predominance of HFpEF
HFpEF as the Most Common Subtype: Studies in Haiti reveal that HFpEF is the most prevalent form of heart failure, affecting a staggering 71% of patients with HF, according to the American Heart Association Journals. This contrasts with high-income countries where heart failure with reduced ejection fraction (HFrEF) is often more common.
3. Associated risk factors and comorbidities
Hypertension as a Primary Driver: Hypertension (high blood pressure) is the leading risk factor for HF in Haiti, yet only a small percentage of hypertensive adults have their blood pressure under control, according to WCM Newsroom.
Obesity and Metabolic Syndrome: Obesity and metabolic syndrome, characterized by a cluster of conditions like high blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels, are also strongly associated with HFpEF in Haiti.
Other Associated Conditions: Chronic kidney disease, depression, and stress are also linked to HF in Haiti.
4. Sociodemographic factors
Poverty: HFpEF is disproportionately prevalent in the poorest segments of the Haitian population. A study revealed that individuals living in extreme poverty were twice as likely to develop HF compared to those with higher incomes.
Social Vulnerability: Living in socially vulnerable neighborhoods is associated with a higher prevalence of both hypertension and heart failure, with a stronger link observed in young adults and women, according to the National Institutes of Health (NIH).
Gender: The majority of individuals with heart failure in Haiti are women, accounting for 68.5% of cases.
5. Potential contributing factors
Shifting Disease Burden: Haiti faces a growing burden of non-communicable diseases (NCDs) like heart disease, yet healthcare systems historically focused on infectious diseases.
Lack of Control of Risk Factors: Poorly controlled hypertension and high rates of obesity contribute significantly to the development of HFpEF in Haiti.
Environmental Factors: Exposure to heavy metals and air pollution might also play a role in the development and progression of HF, according to Think Global Health.
Addressing HFpEF in Haiti
Focus on Primary Prevention: Early identification and control of hypertension are crucial for preventing the development of HFpEF. WCM Newsroom
Targeted Interventions: Addressing the socioeconomic and environmental factors contributing to cardiovascular disease risk is essential.
Strengthening Healthcare Systems: Improving access to affordable and culturally sensitive care, including diagnostic tools, essential medications, and trained personnel, is vital for early diagnosis and effective management of HFpEF.
Health Literacy and Self-Care: Educating the population on the importance of managing blood pressure, adopting healthier lifestyles, and recognizing early signs of heart failure is also crucial.
17 sites
Population-Based Epidemiology of Heart Failure in a Low ...
Among a population-based cohort of 2981 adults in Haiti, the age-standardized prevalence of clinical HF was 3.2%; 5-fold higher than previous modeling estimates...
American Heart Association Journals
Haiti's Epidemic of Early-Onset Heart Disease
Jun 11, 2024 — "Cardiovascular diseases have become by far the number one cause of death. Our AIDS patients are more likely to die of cardiovascular diseases than HIV-associated...
Think Global Health
Population-Based Epidemiology of Heart Failure in a Low ...
Dec 6, 2022 — What the Study Adds * Among a population-based cohort of 2981 adults in Haiti, the age-standardized prevalence of clinical HF was 3.2%; 5-fold higher than previ...
American Heart Association Journals
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WHAT IS THE TREATMENT FOR HEART FAILURE IN HAITI
Heart failure treatment in Haiti: Challenges and approaches
Haiti, being the poorest country in the Western Hemisphere, faces significant challenges in providing adequate healthcare for heart failure (HF) patients. However, there are ongoing efforts and established protocols to manage the condition.
1. Medications
Available Medications: Loop diuretics (like furosemide) are the most commonly used medications, being widely available and affordable. Other evidence-based therapies, such as ACE inhibitors, beta-blockers, and antiplatelet agents, are also prescribed.
Challenges: The consistent use of guideline-directed medical therapy (GDMT), which includes medications like ACE inhibitors/ARBs/ARNIs, beta-blockers, MRAs, and SGLT2 inhibitors, remains suboptimal in Haiti. Factors contributing to this underutilization include:
Cost and availability of medicines: Despite efforts to promote generics and affordable pricing, access to these medications remains a challenge, particularly in public sector healthcare.
Misconceptions about medication adherence: Some patients might stop taking medications when symptoms improve, falsely believing they are cured. Other misconceptions include the belief that HF medications must be taken with food, which can lead to missed doses due to food insecurity.
Polypill Approach: Researchers are exploring the use of polypills, which combine multiple medications (like blood pressure and cholesterol drugs) into a single pill. This approach could simplify treatment regimens and potentially improve medication adherence and access.
2. Lifestyle modifications and education
Hypertension Management: Controlling high blood pressure is crucial for preventing and treating HF in Haiti, given that it's a primary driver of the condition. Initiatives focus on:
Community-based programs: Community health workers deliver education and support for hypertension management, including regular blood pressure monitoring, lifestyle counseling, and medication delivery.
Primary care guidelines: Specific guidelines are being implemented in clinics to improve hypertension prevention and treatment.
Addressing environmental factors: Researchers are investigating the role of factors like lead exposure and air pollution in hypertension and exploring ways to reduce these exposures.
Dietary Changes: Efforts are underway to educate communities about the impact of high salt intake on blood pressure and promote reducing salt consumption.
3. Surgical interventions (limited)
Cardiac Surgery: Cardiac surgery is very limited in Haiti due to a lack of infrastructure, resources, and trained specialists.
NGO Support: International organizations and NGOs play a vital role in providing occasional surgical interventions, often by sending teams and necessary equipment.
Long-Term Goal: The long-term goal is to build sustainable cardiac centers and training programs within Haiti to provide more accessible and continuous care, according to The Cardiothoracic Surgery Network.
4. Addressing underlying social determinants
Poverty and Social Vulnerability: These factors significantly impact individuals' ability to access and adhere to HF treatment.
Food Insecurity: This can lead to missed medication doses, as patients might mistakenly believe they need to take their medicines with food.
Social Isolation and Lack of Support: These can also negatively affect treatment adherence.
Interventions: Addressing these issues through community programs, patient support networks, and efforts to improve food security are crucial components of holistic HF management.
5. Improving the healthcare system
Strengthening Primary Care: Focus on improving primary care services for early detection, diagnosis, and management of HF and associated risk factors.
Chronic Care Systems: Building robust systems for chronic HF care, including medication access, patient education, and follow-up care, is essential.
Addressing Barriers to Care: Interventions are needed to address issues like transportation costs, long wait times, and perceived disrespectful interactions with healthcare staff, all of which contribute to poor patient experience and treatment adherence.
Leveraging Existing Strengths: Capitalizing on existing social support systems and patients' trust in the healthcare system can facilitate engagement in chronic care, according to the National Institutes of Health (NIH).
Overall, the treatment for heart failure in Haiti involves a multi-pronged approach that extends beyond medication and includes addressing social determinants of health, strengthening the healthcare system, and promoting patient education and adherence.
This is for informational purposes only. For medical advice or diagnosis, consult a professional. AI responses may include mistakes. Learn more
20 sites
Preventing and treating high blood pressure in Haiti - nhlbi, nih
Jun 6, 2023 — The Haiti CVD Cohort researchers have also been studying how combining medication for high blood pressure and cholesterol into one pill, called a polypill, coul...
National Institutes of Health (NIH) | (.gov)
Haiti Study Suggests Early-Onset Heart Failure is Prevalent ...
Apr 29, 2024 — When establishing infrastructure to address cardiovascular diseases in Haiti, “this study suggests that we need to shift focus to early prevention of hypertensi...
WCM Newsroom
Effectiveness of community-based hypertension management ...
Aug 16, 2024 — Abstract. Hypertension is a leading contributor to mortality in low-middle income countries including Haiti, yet only 13% achieve blood pressure (BP) control. W...
National Institutes of Health (NIH) | (.gov)
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How do local beliefs affect heart failure treatment in Haiti?
Influence of local beliefs on heart failure treatment in Haiti
Local beliefs in Haiti, particularly those rooted in spirituality and Vodou, significantly impact patients' perception of illness and their engagement with heart failure (HF) treatment.
1. Spirituality and the healthcare system
God's Role in Healing: Many Haitians hold strong spiritual beliefs, viewing the healthcare system as an extension of God's influence. They often attribute improvements in health to God's will and seek divine help alongside medical care. This can be a facilitator for engagement with healthcare, as patients believe that God supports the health system.
Trust in Healthcare: Positive experiences with acute HF care and a desire to maintain improvements can foster trust in the healthcare system, leading to better engagement with chronic care.
Seeking Divine Intervention: While embracing modern medicine, patients may also seek help from Vodou practitioners (Hougans and Mambos) or engage in traditional healing practices, notes the University of Mississippi | Ole Miss.
2. Beliefs about the causes of illness
Natural vs. Supernatural Illness: Haitians may categorize illnesses as either "natural" (maladi Bondye or God's illness) or "supernatural" (caused by negative spirits or sorcery). If an illness is believed to be natural, patients might be more inclined to seek Western medical treatments.
Incurability of Spirit-related Illnesses: However, a barrier to care is the belief that heart disease caused by mystical and supernatural spirits, like lwa bitasyon (multi-generational spirits), is incurable. This belief can discourage seeking or adhering to conventional treatment for HF. However, patients may not view these spirits as specific barriers to their own personal care experience.
3. Misconceptions and medication adherence
Medication Adherence: A barrier to chronic care includes misconceptions about the importance of medication adherence, particularly the belief that medications are no longer needed when symptoms improve.
Taking Medication with Food: There is a widespread, yet inaccurate, belief that HF medications must be taken with food, which can lead to missed doses due to food insecurity, especially in impoverished settings.
4. Importance of cultural sensitivity
Building Trust: Healthcare providers who demonstrate respect for traditional health beliefs may elicit more trust and cooperation from Haitian patients and their families. Rejecting these beliefs could result in mistrust and non-adherence to recommended treatments.
Integrating Beliefs: Future interventions to improve HF care should address these misconceptions and leverage local spiritual beliefs to promote patient engagement.
In summary, local beliefs, particularly those concerning the causes of illness and the role of spirituality, can act as both facilitators and barriers to heart failure treatment in Haiti. Addressing these beliefs with cultural sensitivity and integrating them into healthcare strategies is crucial for improving patient outcomes.
9 sites
Heart Failure Care Facilitators and Barriers in Rural Haiti
Sep 25, 2024 — Community domain: spiritual beliefs * Facilitators: support from God, God supports the health system. Many patients described how their spirituality influences ...
Annals of Global Health
Heart Failure Care Facilitators and Barriers in Rural Haiti
Sep 25, 2024 — regarding the clinic experience. A barrier to healthcare was the belief that heart disease caused by mystical and supernatural spirits is incurable. Conclusions...
Annals of Global Health
Heart Failure Care Facilitators and Barriers in Rural Haiti
Participants expressed strong spiritual beliefs, with the view that the healthcare system is an extension of God's influence. Barriers to chronic care included m...
National Institutes of Health (NIH) | (.gov)
—
What other misconceptions affect heart failure treatment adherence in Haiti?
Other misconceptions affecting heart failure treatment adherence in Haiti
Beyond the cultural beliefs discussed earlier, several other misconceptions significantly impact heart failure (HF) treatment adherence in Haiti:
1. Perceived incurability of heart disease
Some patients may believe that heart disease, particularly if attributed to mystical or supernatural causes like lwa bitasyon, is incurable.
This belief can lead to a sense of fatalism and discourage individuals from seeking or adhering to conventional medical treatment, as they might feel that their efforts are futile if the condition is destined to be incurable.
2. Misconceptions about medication adherence
Symptoms Improvement: A significant barrier to adherence is the misconception that medications are only needed when symptoms are present.
When symptoms improve, patients might stop taking their medications, not realizing that continuing medication is crucial for long-term management and preventing symptom recurrence.
Need for Food with Medication: Many patients mistakenly believe that HF medications must be taken with food. Given the high prevalence of food insecurity in Haiti, this misconception can lead to missed doses when food is unavailable.
3. Lack of understanding of disease management
Self-care Challenges: Patients may struggle with self-care activities, including remembering to attend follow-up appointments and taking daily medications as prescribed.
This can stem from a lack of understanding of the importance of these activities for long-term HF management.
Complex Regimens: HF patients often have complex medication regimens, with multiple medications to be taken at different times of the day. This complexity, combined with a lack of understanding, can contribute to unintentional non-adherence, notes the National Institutes of Health (NIH).
4. Negative perceptions of the healthcare system
Clinic Experience: Some patients express low satisfaction with their clinic experiences, citing long wait times, perceived disrespect from staff, and difficulty understanding the order of care.
Trust and Communication: While some patients express trust in the healthcare system, negative experiences and communication barriers can erode this trust, potentially hindering adherence to treatment plans.
These misconceptions highlight the need for tailored, culturally sensitive interventions that go beyond simply providing medication. Educating patients about the chronic nature of HF, addressing specific misunderstandings about medication adherence, improving the patient experience within the healthcare system, and leveraging existing social support networks are crucial steps towards enhancing treatment adherence and improving HF outcomes in Haiti.
9 sites
Heart Failure Care Facilitators and Barriers in Rural Haiti
Sep 25, 2024 — Participants expressedstrong spiritual beliefs, with the view that the healthcare system is an extension of God's influence. Barriers to chronic care included m...
Annals of Global Health
Heart Failure Care Facilitators and Barriers in Rural Haiti
Participants expressed strong spiritual beliefs, with the view that the healthcare system is an extension of God's influence. Barriers to chronic care included m...
National Institutes of Health (NIH) | (.gov)
Factors Influencing Medication Adherence in Heart Failure Patients ...
Dec 18, 2024 — Non‐WHO categories. Intentional and unintentional non‐adherence. A total of 52 (71%) and 49 (67%) participants, respectively, answered the open‐ended questions ...
National Institutes of Health (NIH) | (.gov)
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John A. Carroll, MD
www.haitianhearts.org