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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 1, January/February 2019
20
AFRICA
non-communicable diseases and their risk factors in the general
population in South Africa in 2012.
19
SANHANES-1 noted a
lower rate of self-reported diabetes in black African participants
than with Asian (13.6%) and white (6.9%) participants, and
similar or lower levels of obesity and hypertension compared
with other ethnic groups. However, SANHANES-1 was a
general population study, whereas this study examined a highly
selected population receiving LMT.
Changes in the political system have now made access to cities
possible for black South Africans, and many have migrated from
rural to urban areas. This has likely resulted in a greater adoption
of a sedentary lifestyle and increased consumption of refined
Table 3. Demographics, presenting characteristics and medical history of the study population overall and by ethnicity
Total
(
n
=
396)
Ethnicity
Asian
(
n
=
98)
Black African
(
n
=
96)
Caucasian/European
(
n
=
144)
Other
(
n
=
58)
Demographics
Age (years), mean (SD)
60.0 (10.2)
61.5 (8.9)
57.3 (9.9)
61.4 (10.9)
58.5 (10.2)
Men,
n
(%)
223 (56.3)
54 (55.1)
34 (35.4)
104 (72.2)
31 (53.4)
Residence location,
n
(%)
Urban/suburban
367 (92.7)
98 (100.0)
88 (91.7)
124 (86.1)
57 (98.3)
Rural
29 (7.3)
0 (0.0)
8 (8.3)
20 (13.9)
1 (1.7)
Educational level,
n
or
n
/
n
(%)
Illiterate
7/391 (1.8)
0 (0.0)
7/95 (7.4)
0 (0.0)
0 (0.0)
Primary
67/391 (17.1)
13 (13.3)
33/95 (34.7)
1 (0.7)
20 (37.0)
Secondary
197/391 (50.4)
60 (61.2)
32/95 (33.7)
80 (55.6)
25 (46.3)
University/higher
120/391 (30.7)
25 (25.5)
23/95 (24.2)
63 (43.8)
9 (16.7)
Private health insurance,
n
(%)
Yes
279 (70.5)
79 (77.6)
48 (50.0)
134 (93.1)
21 (36.2)
No
117 (29.5)
22 (22.4)
48 (50.0)
10 (6.9)
37 (63.8)
Insurance includes drug reimbursement,
n
or
n
/
n
(%)
301/368 (81.8)
55/96 (57.3)
74/79 (93.7)
131/140 (93.6)
41/53 (77.4)
Employment status,
n
(%)
Full time
159 (40.2)
31 (31.6)
44 (45.8)
69 (47.9)
15 (25.9)
Part time
13 (3.3)
3 (3.1)
3 (3.1)
4 (2.8)
3 (5.2)
Not employed/retired
224 (56.6)
64 (65.3)
49 (51.0)
71 (49.3)
40 (69.0)
CVD risk level,
n
(%)
Low
1 (0.3)
0 (0.0)
0 (0.0)
1 (0.7)
0 (0.0)
Moderate
7 (1.8)
2 (2.0)
1 (1.0)
4 (2.8)
0 (0.0)
High
123 (31.1)
34 (34.7)
46 (47.9)
26 (18.1)
17 (29.3)
Very high
223 (56.3)
59 (60.2)
32 (33.3)
94 (65.3)
38 (65.5)
Not assessable
a
42 (10.6)
3 (3.1)
17 (17.7)
19 (13.2)
3 (5.2)
Presenting characteristics
BMI,
n
/
n
(%)
25 to
<
30 kg/m
2
145/395 (36.7)
47 (48.0)
27 (28.1)
51 (35.4)
20/57 (35.1)
≥
30 kg/m
2
199/395 (50.4)
32 (32.7)
61 (63.5)
78 (54.2)
28/57 (49.1)
Metabolic syndrome (ATP III),
n/n
(%)
205/380 (53.9)
52/91 (57.1)
56/92 (60.9)
64/140 (45.7)
33/57 (57.9)
Physical inactivity,
b
n
(%)
227 (57.3)
65 (66.3)
63 (65.6)
64 (44.4)
35 (60.3)
Current smoker,
c
n or
n/n
(%)
53 (13.4)
15 (15.3)
3 (3.1)
25 (17.4)
10 (17.2)
Regular alcohol consumption,
n
(%)
87 (22.0)
20 (20.4)
10 (10.4)
51 (35.4)
6 (10.3)
SBP
≥
140 mmHg and/or DBP
≥
90 mmHg,
n
(%)
196 (49.5)
42 (42.9)
60 (62.5)
66 (45.8)
28 (48.3)
Diabetes mellitus (type 1 or 2),
n
(%)
258 (65.2)
86 (87.8)
75 (78.1)
61 (42.4)
36 (62.1)
Diabetes mellitus type 2,
n
/
n
(%)
253/395 (64.1)
85/97 (87.6)
71 (74.0)
61 (42.4)
36 (62.1)
Dyslipidaemia (diagnosis or history) (physician defined),
n
(%)
390 (98.5)
98 (100.0)
92 (95.8)
143 (99.3)
57 (98.3)
Family history of CVD,
d
n
(%)
151 (38.1)
43 (43.9)
18 (18.8)
71 (49.3)
19 (32.8)
Hypertension (diagnosed/history of),
n
(%)
322 (81.3)
82 (83.7)
86 (89.6)
103 (71.5)
51 (87.9)
Familial hypercholesterolaemia,
e
n/n
(%)
8/130 (6.2)
0/46 (0.0)
1/41 (2.4)
1/27 (3.7)
6/16 (37.4)
Medical history
CAD (documented),
n
(%)
135 (34.1)
28 (28.6)
10 (10.4)
72.0 (50.0)
25 (43.1)
ACS/MI,
n
(%)
88 (22.2)
16 (16.3)
6 (6.3)
47 (32.6)
19 (32.8)
Stroke (any),
n
(%)
15 (3.8)
1 (1.0)
4 (4.2)
7 (4.9)
3 (5.2)
Peripheral artery disease,
n
(%)
18 (4.5)
3 (3.1)
4 (4.2)
8 (5.6)
3 (5.2)
Congestive heart failure,
n
(%)
13 (3.3)
0 (0.0)
6 (6.3)
7 (4.9)
0 (0.0)
Chronic kidney disease (GFR
<
60 ml/min/1.73 m
2
),
n
(%)
27 (6.8)
9 (9.2)
5 (5.2)
12 (8.3)
1 (13.8)
ACS: acute coronary syndrome; ATP: Adult Treatment Panel; BMI: body mass index; CAD: coronary artery disease; CVD: cardiovascular disease; DBP: diastolic
blood pressure; GFR: glomerular filtration rate; MI: myocardial infarction; SBP: systolic blood pressure; SD: standard deviation.
a
Patients without a serious pathology classifying them as very high or high cardiovascular risk, and in whom the SCORE could not be calculated owing to missing data.
b
Subject is not regularly involved in moderate (walking/cycling/gardening) or strenuous exercise (jogging/football/vigorous swimming) for
≥
four hours each week.
c
Individuals who smoked any tobacco in the previous 12 months or who quit during past year.
d
Coronary and/or vascular disease
<
55 years of age in male and
<
60 years in female first-degree relatives.
e
Dutch Lipid Clinics criteria: definite or probable.