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Risk factors for coronary heart disease in the Indians of Durban
Y K Seedat1, F G Mayet, S Khan
1Department of Medicine, University of Natal, Durban.
Insights
Coronary heart disease (CHD) is epidemic in South African Indians. A survey found 15.3% prevalence, with diabetes and high cholesterol as key risk factors, necessitating urgent primary prevention programs.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Coronary heart disease (CHD) poses a significant global health challenge, particularly among migrant Indian populations.
- In South Africa, CHD among Indians has reached epidemic proportions, highlighting a critical public health concern.
Purpose of the Study:
- To determine the prevalence of coronary heart disease (CHD) in the Indian population of Durban, South Africa.
- To identify known risk factors associated with CHD in this demographic group.
Main Methods:
- A field survey was conducted among 778 Indian subjects aged 15-69 years in metropolitan Durban.
- Data collection included medical history, risk factor assessment (cholesterol, triglycerides, diabetes, smoking, etc.), and resting electrocardiogram (ECG) abnormalities.
Main Results:
- A CHD history was reported by 15.3% of subjects (13.4% adjusted).
- Key risk factors identified were hypercholesterolemia, hypertriglyceridemia, and diabetes mellitus, strongly associated with CHD.
- 52% (45.5% adjusted) had at least one major risk factor (Level A), and 68% (61.9% adjusted) had Level B risk factors. Resting ECG abnormalities were found in 47.6% (48.2% adjusted).
Conclusions:
- The high prevalence and significant risk factors for CHD in migrant Indians in Durban underscore the severity of the issue.
- Immediate and intensive primary prevention programs targeting CHD risk factors are crucial for this population.
Abstract:
Coronary heart disease (CHD) is a major problem in migrant Indians throughout the world. In South Africa it has reached 'epidemic' proportions. A field survey was conducted among Indians in the metropolitan area of Durban to determine the prevalence and known risk factors for CHD. In a study of 778 subjects aged 15-69 years (408 men), 15.3% (sex and age adjusted 13.4%) had a history of CHD. The important risk factors in men were hypercholesterolaemia, hypertriglyceridaemia, diabetes, and smoking, and in women diabetes, hypercholesterolaemia, and hypertriglyceridaemia. The minor risk factors were hyperuricaemia, sedentary occupation, obesity in women and a positive family history of CHD. A study of the major risk factors leading to CHD showed that 52% (sex and age adjusted 45.5%) had at least one major risk factor at the higher (level A) and 68% (sex and age adjusted 61.9%) at the lower (level B) risk levels. Diabetes mellitus was strongly associated with a positive history of CHD. In 47.6% (sex and age adjusted 48.2%) of the total group resting ECG abnormalities were found that could be coded. Because of the severe nature of CHD in the migrant Indian, an immediate and intensive programme of primary prevention of CHD risk factors should be instituted.