CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 3, April 2013
AFRICA
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rheumatic heart disease with penicillin in
South African children with pharyngitis:
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Kovacs AH, Verstappen A. The whole
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11. Yach D. From Framingham to the
South African studies in the international literature
Considerations of ethnicity
and gender in chronic
diseases of lifestyle
The current global attention directed at
non-communicable diseases (NCDs) is
being driven at the highest levels, with
the World Health Assembly adopting the
important new global target of a 25%
reduction in preventable NCD deaths by
2025 (the 25 by 25 goal). SouthAfrica, and
indeed sub-Saharan Africa, is currently
a melting pot of confounding factors
affecting both risk and prevalence of
chronic diseases of lifestyle, now reaching
epidemic proportions in the developing
world. Addressing social and economic
inequalities among disadvantaged groups,
regulation of the food, drink, alcohol and
tobacco industries, and learning from the
lessons of the HIV and TB epidemics are
all vital to tackling NCDs on a national
and international level.
Further confounding factors in
diagnosis and medical management of
NCDs need to be considered in that
sometimes profound differences in risk
factors are evident based on ethnicity
and gender. Many guidelines developed
by North American and European bodies
are not necessarily appropriate for use
in the developing world. South African
publications in the international literature
consider some of these concerns.
Urban black women at greater
risk of chronic heart failure with
a younger age of onset
Changing dietary habits and consequent
nutritional deficiencies are having a
significant impact on the health status
of individuals living with chronic heart
failure (CHF) in Soweto. Interesting
findings of Dr Pretorius’ study can be seen
in the demographic profile of the Sowetan
population living with heart failure.
1
Contrary to European findings, in an
urban cohort of black Africans, more
women present with CHF than men.
Furthermore, the mean age of onset
for women is lower than for men in
the Soweto study, as well as occurring
at a younger age (5–10 years) than in
European counterparts.
1.
Pretorius S. The impact of dietary habits
and nutritional deficiencies in urban African
patients living with heart failure in Soweto,
South Africa – A review.
Endocrin Metab
Immune Disord Drug Targets
2013:
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(1).
Jan 15 [Epub ahead of print].
Ethnic variations in the role
of adipose tissue on insulin
resistance in women
Compared to their white counterparts,
urban black women experience a dispro-
portionately higher prevalence of type 2
diabetes (T2D), as well as higher levels of
the major risk factors of obesity and insu-
lin resistance. Numerous mechanisms have
been postulated as to what underlies the
increased risk of T2D. Julia Goedecke from
the UCT/MRC Research Unit for Exercise
Science and Sport Medicine, SAMRC and
colleagues from the Department of Human
Biology and Department of Medicine at
UCT have published a review on the role
of adipose tissue in insulin resistance in
women of African ancestry.
1
Centralisation of body fat, specifically
increased visceral adipose tissue (VAT), is
Framework Convention on Tobacco Control.
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omega-3 (n-3) fatty acids, and progression
of subclinical atherosclerosis: preventing
fetal origins of disease? The Cardiovascular
Risk in Young Finns Study.
Am J Clin Nutr
2013;
97
(1): 58–65.
13. Mensah GA, Mayosi BM. The 2011 United
Nations high-level meeting on non-commu-
nicable diseases: the Africa agenda calls
for a 5-by-5 approach.
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2013;
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(2): 77–79.
14. Weisse AB. Cardiac surgery: a century of
progress.
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2011;
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486–490.
15. Hoosen EG, Cilliers AM, Hugo-Hamman
CT, Brown SC, Lawrenson JB, Zuhlke L,
et al
. Paediatric cardiac services in South
Africa.
S Afr Med J
2011;
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Drug Trends in Cardiology
