The global cardiovascular diseases risk pattern in a peri-urban working-class community in South Africa. The Mamre
Krisela Steyn1, Naomi S Levitt, Margaret Hoffman
1Chronic Diseases of Lifestyle Unit, Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa. ksteyn@mrc.ac.za
Insights
Cardiovascular disease (CVD) risk is high in a South African community, with age and gender being key factors. Easily measured variables may help predict CVD risk in resource-limited settings.
Area of Science:
- Public Health
- Epidemiology
- Cardiology
Background:
- Cardiovascular disease (CVD) poses a significant global health challenge.
- Understanding CVD risk factors in diverse populations is crucial for targeted interventions.
- Peri-urban communities often face unique health burdens.
Purpose of the Study:
- To assess CVD risk factors and their global burden in a working-class community near Cape Town.
- To identify easily measurable variables associated with global CVD risk scores.
- To explore alternatives to biochemical estimates for CVD risk assessment.
Main Methods:
- A population-based sample of 976 adults (≥15 years) in Mamre was studied.
- Data collected included demographics, lifestyle factors (smoking, activity, alcohol), and clinical measurements (BP, anthropometry, lipids, glucose).
- Global CVD risk was calculated using Framingham risk equations, age-standardized to the South African census.
Main Results:
- The 10-year CVD event probability was 5.2% for men and 4.2% for women; over 30% and 25% for those ≥55 years, respectively.
- Prevalence of hypertension was 22% (men) and 16% (women); smoking was high (62% men, 44% women); diabetes was 6% (men) and 5% (women).
- Easily measured factors explained 40.3% of the global CVD risk score variation, including medical history, physical activity, weight, height, and waist circumference.
Conclusions:
- The Mamre population faces a high 10-year risk of CVD events.
- Age and gender are primary determinants of global CVD risk.
- Findings support developing a CVD risk score using accessible measures for resource-limited regions.
Objectives:
To describe the cardiovascular disease (CVD) risk factors and the global burden of CVD risk in a peri-urban, working-class community of Mamre near Cape Town. To identify additional variables in the data set associated with the global CVD risk factor score. The latter was calculated using the major CVD risk factors in formulas derived from the Framingham global CVD risk calculations. Such variables could possibly be used for global CVD risk calculations, instead of depending on biochemical estimates for these calculations.
Methods:
In a random population-based sample of 976 people aged 15 years and older, data on demography, smoking, physical activity, and alcohol use were collected. Blood pressure (BP), anthropometry, levels of serum glucose and lipids, and low-density lipoprotein cholesterol (LDL) particle sizes were also determined. These data allowed calculation of the global CVD risk profile with the Framingham study's formula. The data are age-standardized to the colored (mixed ancestry) population according to the 1996 South African census.
Results:
The global CVD risk score suggested that men and women had a 5.2% and 4.2% probability, respectively, of having a CVD event in the next 10 years, while for those 55 years of age and older, the probability increased to more than 30% and 25%, respectively. Hypertension was found in 22% of men and 16% of women. Sixty-two percent of the men and 44% of the women smoked cigarettes, while 6% and 5% had diabetes, respectively. Hypercholesterolemia was present in 47% of men, and 46% of women. Small-dense LDL particles were present in 26% of men and 14% of women. A number of easily measured CVD risk factors could explain 40.3% of the variation of the global CVD risk score. These include aspects of the medical history provided by the patient, the inverse of the amount of physical activity and weight measurements, as well as height, and waist circumference.
Conclusions:
The people in Mamre have a high probability of suffering a CVD event in the next 10 years. Age and gender are the primary contributors to the global CVD risk score. The findings suggest the possibility of developing a global CVD risk score based on easily measured CVD risk factors for use in developing countries with limited resources.
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