The burden of cardiovascular risk factors and consequential cardiovascular diseases has witnessed an increase in SSA due the epidemiological transition SSA is going through. As a result, the burden of cardiovascular diseases such as stroke is rising in SSA and other low income countries. Stroke is a spectacular event that is easily recognizable clinically and usually shares the same risk factors with CHD including hypertension, smoking, diabetes and dyslipidemia. Stroke incidence has been suggested to be on a rise in this context of increasing prevalence of cardiovascular risk factors. On the contrary CHD is considered to be rare. Is it that CHD is actually still rare, underreported, misdiagnosed or underdiagnosed?