Key result
Hypertension is linked to ~4.9-fold higher odds of cardiovascular mortality.
Why the study?
In Zambia, many deaths occur outside health facilities without medical certification, which limits understanding of the true burden and predictors of cardiovascular disease mortality.
What is the burden of cardiovascular disease mortality and which risk factors are associated with CVD-attributed deaths among adult community deaths in Lusaka, Zambia?
Cross-Sectional (n=2,005)
No
What is the burden of cardiovascular disease mortality and which risk factors are associated with CVD-attributed deaths among adult community deaths in Lusaka, Zambia?
Cardiovascular diseases account for over 40% of adult community deaths outside health facilities in Lusaka, Zambia, driven largely by hypertension, preexisting heart disease, and smoking.
Answers are grounded in this paper and cite their sources.
Hypertension history associated with higher CVD death odds in community settings; hypothesis-generating and should not yet change practice.
Introduction Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide and an increasing public health challenge in sub-Saharan Africa. In Zambia, many deaths occur outside health facilities and are not medically certified, limiting understanding of the true burden of CVD mortality. This study assessed the burden of CVD mortality and factors associated with CVD-attributed deaths among adult community deaths undergoing verbal autopsy in Lusaka. Methods We conducted a cross-sectional study using verbal autopsy data for adults aged ≥18 years recorded at the University Teaching Hospital, Lusaka, between January and November 2024. Causes of death were assigned using the InterVA-5 algorithm. The outcome variable was CVD death (stroke, acute cardiac disease, or unspecified cardiac disease). Logistic regression was used to identify factors associated with CVD mortality and estimate adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results Among 2,005 adult community deaths analyzed, 850 (42.4%) were attributed to CVDs. The median age at death was 52 years (IQR: 38–71). Increasing age was associated with higher odds of CVD mortality (AOR=1.01; 95% CI: 1.01–1.02). Individuals with a history of hypertension (AOR=4.90; 95% CI: 3.78–6.37) and heart disease (AOR=3.58; 95% CI: 2.28–5.76) had significantly higher odds of CVD death. Tobacco smoking was also associated with increased odds of CVD mortality (AOR=1.41; 95% CI: 1.06–1.87). Conclusion CVDs accounted for more than two-fifths of adult community deaths in Lusaka, highlighting a substantial and often overlooked burden of mortality occurring outside health facilities. Older age, hypertension, heart disease, and tobacco smoking were significant predictors of CVD mortality. Strengthening community-based screening, prevention, and management of cardiovascular risk factors may reduce premature deaths and support Zambia’s efforts to address the growing burden of non-communicable diseases.
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Ngulube et al. (2026) conducted a cross-sectional in Adult community deaths undergoing verbal autopsy (n=2,005). Cardiovascular risk factors (hypertension, heart disease, tobacco smoking, age) vs. Absence of hypertension, heart disease, or tobacco smoking was evaluated on Cardiovascular disease (CVD) death (stroke, acute cardiac disease, or unspecified cardiac disease) (OR 4.90, 95% CI 3.78-6.37). Hypertension (AOR 4.90; 95% CI 3.78-6.37), heart disease (AOR 3.58), and smoking (AOR 1.41) were strongly associated with CVD mortality, which caused 42.4% of community deaths.
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