CARDIOVASCULAR JOURNAL OF AFRICA • Vol 21, No 2, March/April 2010
88
AFRICA
aetiologies for CHF in our study population were idiopathic
cardiomyopathy (CMO), ischaemic CMO and hypertensive heart
failure. Of the 24% diagnosed with ischaemic CMO, 45% were
black African and 55% were other races combined (thereof 12%
Asian Indians, 10% coloureds and 33% white Africans). Other
causes of CHF included post partum CMO (5% of patients), a
condition more commonly found in Africa.
2
Treatment adherence
Standard CHF treatment included beta-blockers (84%), ACE
inhibitors (74%), loop diuretics (93%), spironolactone (64%)
and cardiac glycosides (24%). Other medications commonly
prescribed in patients with CHF included potassium supple-
ments (54%), aspirin (47%), lipid-lowering agents (33%),
warfarin (19%), hypoglycaemic agents, thiamine supplements
and calcium antagonists (14%), and the anti-arrhythmic agent
amiodarone (7%). Study participants were prescribed a mean of
6
±
2 individual medications.
Overall, 82% of the study participants reported that they
were compliant with their prescribed medication (Fig. 2) and
16% acknowledged not taking
≥
75% of their prescribed CHF
treatment. There was a difference between men and women with
85 versus 75% of participants, respectively, rating themselves as
medication compliant.
Although adherence to follow-up appointments given by the
attending cardiologist was good (Fig. 2), there was a poor adher-
Fig.1. Aetiology of CHF in the total study population.
Other
2%
Idiopathic CMO
31%
Arrhythmia
5%
Ischemic CMO
24%
Hypertensive HF
22%
Valvular
CMO
7%
Inflammable
CMO
4%
Peripartal
CMO
5%
TABLE 1. SOCIODEMOGRAPHICAND CLINICAL PROFILE
Total (%)
(
n
=
200)
Men (%)
(
n
=
109)
Women (%)
(
n
=
91)
Black African (%)
(
n
=
157)
Other races (%)
(
n
=
43)
Education profile
None
16 (8.0)
9 (8.3)
7 (7.7)
14 (8.9)
2 (4.6)
Standard 1–5
43 (22)
18 (17)
25 (28)
42 (27)
1 (2.3)
Standard 6–10
93 (47)
49 (45)
44 (48)
72 (46)
21 (49)
Matriculation/post matriculation
42 (21)
30 (28)
12 (13)
25 (16)
17 (40)
Employment status
Employed
54 (27)
37 (34)
17 (19)
39 (25)
15 (35)
Unemployed
57 (29)
30 (27)
27 (30)
49 (31)
8 (19)
Retired
89 (45)
42 (39)
47 (51)
69 (44)
20 (47)
Living environment
Alone
18 (9.0)
12 (11)
6 (6.6)
13 (8.3)
5 (12)
Perceived practical support
Not at all
36 (18)
21 (19)
15 (17)
28 (18)
8 (19)
A little or some
36 (18)
17 (16)
19 (21)
34 (22)
2 (4.6)
A lot
124 (62)
68 (62)
56 (62)
91 (58)
33 (77)
Perceived emotional support
Not at all
16 (8.0)
14 (13)
2 (2.2)
12 (7.6)
4 (9.3)
A little or some
41 (21)
23 (21)
18 (20)
32 (20)
9 (21)
A lot
137 (69)
66 (61)
71 (78)
108 (69)
29 (67)
Clinical profile
Mean LVEF (%)
±
SD
32
±
8
32
±
8
33
±
8
32
±
8
34
±
7
NYHA class II/III
180 (90)
97 (89)
83 (91)
141 (90)
39 (91)
NYHA class IV
5 (2.5)
2 (1.8)
3 (3.3)
4 (2.5)
1 (2.3)
Newly diagnosed HF
60 (30)
32 (29)
28 (31)
21 (13)
6 (14)
Treated for HF
>
1 year
140 (70)
77 (71)
63 (69)
136 (87)
37 (86)
Prior admission for HF
169 (85)
92 (86)
77 (85)
135 (86)
34 (79)
Prescribed treatment
Beta-blocker
168 (84)
93 (85)
75 (82)
129 (82)
39 (91)
ACE inhibitor
148 (74)
79 (72)
69 (76)
117 (75)
31 (72)
Loop diuretic
185 (93)
97 (89)
88 (97)
150 (96)
35 (81)
Spironolactone
127 (64)
68 (62)
59 (65)
103 (66)
24 (56)
Cardiac glycoside
47 (24)
25 (23)
22 (24)
41 (26)
6 (14)
