Cardiovascular Journal of Africa: Vol 29 No 6 (November/December 2018)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 29, No 6, November/December 2018 350 AFRICA
targeted for intensive BP control, LVH screening and management
interventions that promote left ventricular remodelling.
Limitations and strengths
Several limitations must be borne in mind in this study. Firstly,
this was a cross-sectional study and the associations found
are not causal in nature. Secondly, there was the potential for
social desirability bias, recall bias and reliance on self-reports,
all of which could have resulted in information bias and
possible misclassification. Thirdly, a substantial proportion of
patients in the research setting were referred from other clinics
for uncontrolled hypertension, which could have resulted in
selection bias. Fourthly, only CV risk factors relevant to PHC
were investigated and exclusion of some investigations, such as
echocardiogram, could have underestimated CV risks such as
LVH. Lastly, the study setting had an under-representation of
coloured and Asian ethnic groups and the study findings may
therefore not be representative of the overall South African
population.
Most studies on CV risk factors in South Africa have been
community or hospital based. One of the strengths of this study
includes that it is one of the few studies that focused on CV risks
among patients with hypertension in PHC. It also uncovered
a high prevalence of co-existing CV risks among patients with
hypertension in a peri-urban setting and highlights the substantial
risk of CVD in South African PHC. Based on its findings, the
study indicates that the PHC level of care must play a significant
role in curbing the epidemic of CVD in South Africa.
Conclusion
This study shows that the prevalence of CV risk factors among
patients with hypertension in South African PHC is high,
reflecting the clustering of CV risk factors and a high CVD
risk in this population. While urgent preventative interventions
are needed to address this enormous risk, such interventions
must take cognisance of the sociodemographic disparities in
prevalence of CV risk factors in South Africa.
We thank Ms Nthate Mochaba and Thandeka Bhayi for their work as
research assistants, and the entire staff of Johan Heyns Community Health
Centre for their support and co-operation. We are grateful to Dr A Kalain for
his assistance with data analysis.
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