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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 29, No 6, November/December 2018
AFRICA
347
diabetes. Women on the other hand, were more likely to
report using snuff and being obese. Black participants were
significantly more likely to report snuff use compared to other
racial groups, but less likely to report cigarette smoking, family
history of hypercholesterolaemia, family history of fatal CV
event and having hypercholesterolaemia. Compared to those in
employment, pensioners were significantly more likely to report
being physically inactive. Educational level and marital status did
not correlate with any CV risk factor.
Discussion
This study found that the prevalence of other CV risk factors
among patients with hypertension was high. In addition, there
were significant sociodemographic differences in the prevalence
of each CV risk factor, and for each CV risk factor, the
prevalence found in this study was higher than previously
published in population-based studies in South Africa.
24-27
These
findings have clinical and policy implications in that they suggest
the presence of a high inherent risk of CVD among patients
Table 2. Prevalence of cardiovascular risk factors
Variable (
n
=
328)
% (
n
)
Mean BP, mmHg
Systolic (SD)
139.0 (20.9)
Diastolic (SD)
84.3 (12.57)
BP controlled to target
60.7 (199)
Tobacco use
Current smoker
11.9 (39)
Second-hand smoker
16.0 (47)
Current snuffer
19.5 (64)
Alcohol use
Current alcohol use
28.0 (92)
Physical activity
Active
26.8 (88)
Inactive
73.2 (240)
Clinical risk factors
Diabetes mellitus
30.2 (99)
Elevated cholesterol
26.5 (87)
Family history of hypercholesterolaemia
5.2 (17)
Family history of fatal CV event (among females
< 65 years and males < 55 years)
14.9 (49)
Left ventricular hypertrophy, %
5.2 (17)
Anthropometric measures
Mean weight (kg)
85.4
Mean BMI (kg/m
2
)
33.7
Increased waist circumference (> 88 cm for
women, > 102 cm for men)
80.8 (265)
Table 4. Cardiovascular risk factors and gender
Risk factors
Female
(
n
=
260)
Male
(
n
=
68)
Total
(
n
=
328)
p
-value
Alcohol use,
n
(%)
56 (21.5) 36 (53.4)
92 (28)
0.0000
Cigarette smoking,
n
(%)
19 (7.3)
20 (29.4)
39 (11.9)
0.0000
Snuff use,
n
(%)
63 (19.2)
1 (1.5)
64 (19.5)
0.0000
Exposure to smoking,
n
(%)
43 (16.5)
4 (5.9)
47 (14.3)
0.08832
Physical inactivity,
n
(%)
182 (70)
58 (85.3)
240 (73.2)
0.0221
Diabetes mellitus,
n
(%)
71 (27.3) 28 (41.2)
99 (30.2)
0.0322
High cholesterol,
n
(%)
70 (26.9) 17 (25)
87 (26.5)
0.3784
Family history of cholesterol,
n
(%)
14 (5.4)
3 (4.4)
17 (5.2)
0.1626
Fatal CV event,
n
(%)
34 (13)
15 (22)
49 (15)
0.4332
BMI ≥ 30 kg/m
2
,
n
(%)
190 (73)
26 (38.2)
216 (65.8)
0.0000
Waist circumference,
n
(%)
236 (90.8) 29 (42.6)
265 (80.8)
0.0529
Left ventricular hypertrophy,
n
(%)
10 (3.8)
7 (10.3) 17/328 (5.2) 0.07153
Table 3. Cardiovascular risk factors by age group
Age group, years
Risk factor
20–39
(
n
=
15)
40–59
(
n
=
168)
60–79
(
n
=
140)
≥ 80
(
n
=
5)
Total
(
n
=
328)
p
-value
Alcohol use,
n
(%) 9 (60) 44 (26.2) 38 (27.10) 1 (20) 92 (28.04) 0.037*
Cigarette smok-
ing,
n
(%)
2 (13.33) 22 (13.1) 15 (10.71) 0 (0) 39 (11.89) 0.7173
Snuff use,
n
(%)
5 (33.33) 36 (21.4) 22 (15.7) 1 (20) 64 (19.5) 0.1962
Exposure to
smoking,
n
(%)
0 (0.0) 31 (18.5) 13 (9.3) 3 (60) 47 (14.3) 0.0015*
Physical inactiv-
ity,
n
(%)
11 (73.3) 105 (62.5) 119 (85) 5 (100) 240 (73.2) 0.0001
Type 2 diabetes,
n
(%)
3 (20.0) 50 (29.8) 44 (31.4) 2 (40) 99 (30.2) 0.7809
Hypercholesterol-
aemia,
n
(%)
7 (46.6) 37 (22) 41 (29.3) 2 (40) 87 (26.5) 0.4379
Family history of
hypercholesterol-
aemia,
n
(%)
2 (13.3) 11 (6.5)
4 (2.8) 0 (0.0) 17 (5.2) 0.2184
Fatal CV event,
n
(%)
Female
2 (13.3) 18 (10.7) 13 (9.3) 1 (20) 34 (10.4) 0.8400
Male
1 (6.6)
4 (2.4)
10 (7.1) 0 (0.0) 15 (4.6) 0.2252
BMI ≥ 30 kg/m
2
,
n
(%)
9 (60) 118 (70.2) 87 (62.1) 2 (40) 216 (65.8) 0.4945
Waist circumference,
n
(%)
Female
10 (83.3) 130 (91)
91 (91) 5 (100) 236 (90.7) 0.7765
Male
1 (6.6)
8 (4.8)
20 (14.3) 0 (0.0) 29 (42.6) 0.4484
Left ventricular
hypertrophy,
n
(%)
0 (0.0)
9 (5.3)
7 (5)
1 (20) 17 (5.2) 0.3137
*p-values include very small numbers in the extreme age groups to be statistically
reliable.
Table 5. Cardiovascular risk factors and race
Risk factors
Asian
(
n
=
1)
Black
(
n
=
282)
Coloured
(
n
=
3)
White
(
n
=
42)
Total
(
n
=
328)
p
-value
Alcohol use,
n
(%)
0 (0.0) 73 (26)
2 (66.6) 17 (40.5) 92 (24.2) 0.0717
Cigarette smok-
ing,
n
(%)
0 (0.0) 24 (8.5)
0 (0.0) 15 (35.7) 39 (11.9) 0.0000*
Snuff use,
n
(%)
0 (0.0) 63 (22.3) 1 (33)
0 (0.0)
64 (19.5) 0.0081*
Exposure to
smoking,
n
(%)
0 (0.0) 38 (13.5) 0 (0.0)
9 (21.4) 47 (12.6) 0.0866
Physical inactiv-
ity,
n
(%)
1 (100) 203 (72)
3 (100) 33 (78.6) 240 (73.2) 0.5292
Diabetes melli-
tus,
n
(%)
1 (100) 87 (30.1) 2 (66.6) 9 (21.4) 99 (30.2) 0.122
High cholesterol,
n
(%)
1 (100) 63 (22.3) 1 (33)
22 (52.4) 87 (26.5) 0.0079*
Family history
of cholesterol,
n
(%)
1 (100)
5 (1.8)
1 (33)
10 (24)
17 (5.2) 0.0000*
Fatal CV event,
n
(%)
49 (15)
Female
0 (0.0) 24 (8.5)
0 (0.0) 10 (24)
34 (69.4) 0.0215
Male
0 (0.0)
7 (2.5)
0 (0.0)
8 (19)
15 (30.6) 0.0000
BMI,
n
(%)
1 (100) 192 (68.1) 2 (66.7) 21 (50) 216 (65.8) 0.8794
Waist circumference,
n
(%)
265 (80.8)
Female
1 (100) 203 (72)
1 (33)
31 (73.8) 236 (90.8) 0.3502
Male
0 (0.0) 23 (8.1)
1 (33)
5 (12)
29 (8.8) 0.2968
Left ventricular
hypertrophy,
n
(%)
0 (0.0) 16 (5.7)
0 (0.0)
1 (2.4)
17 (5.2) 0.7213
*p-value includes very small numbers of Asian and coloured participants to be
statistically reliable. These two races with the white race were allocated as other
race in the logistic regression (Table 6).