Cardiovascular Journal of Africa: Vol 32 No 5 (SEPTEMBER/OCTOBER 2021)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 32, No 5, September/October 2021 AFRICA 237 Cardiovascular Topics The spectrum, prevalence and in-hospital outcomes of cardiovascular diseases in a South African district hospital: a retrospective study Philasande Mkoko, Senlika Naidoo, Mak Niazi, Atiqa Tahira, Xolile Godlwana, Ntsikelelo Ndesi, Thina Majola, Martha Pepino, Luyanda Mbanga, Zimasa Vuyo Jama, Nowshad Alam, Brian Mbhele, Lokuthula Maphalala, Mpiko Ntsekhe Abstract Introduction: The increasing prevalence of cardiovascular risk factors in South African rural communities is well reported. However, the prevalence of cardiovascular disease (CVD) leading to hospital admission and related in-hospital mortal- ity in rural and semi-rural hospitals is unknown. Methods: We conducted a retrospective review of hospital records for patients admitted to the Department of Internal Medicine at Dora Nginza Hospital in Port Elisabeth, South Africa between 1 April and 31 October 2016. The study focused on patients who received a primary diagnosis of CVD. Results: During the seven-month study period, 4 884 patients were admitted to the unit, 1 325 of whom received a primary diagnosis of CVD, giving a prevalence of 27%. Patients with CVD had a mean (standard deviation) age of 60 (± 15) years, 32% of this patient population was younger than 55 years and 65% were female. Furthermore, 94% had a background medical history of systemic hypertension and 30% of diabetes melli- tus. The three leading cardiovascular causes of hospital admission were stroke (38%), hypertensive heart disease plus heart failure (33%), and hypertensive emergency/urgency (18%). In-hospital outcome: 12.4% of patients admitted for CVD died during the index hospitalisation and strokes were responsible for 70% of the deaths. Conclusion: The prevalence of CVD in this cohort was high and accounted for significant morbidity and mortality. Systemic hypertension was a leading risk factor in our cohort and we need to intensify efforts to diagnose and treat systemic hypertension. Keywords: cardiovascular disease, low-income country, in-hospi- tal outcomes Submitted 27/8/19, accepted 14/4/21 Published online 10/6/21 Cardiovasc J Afr 2021; 32 : 237–242 www.cvja.co.za DOI: 10.5830/CVJA-2021-016 South Africa is undergoing an epidemiological transition that is characterised by an increasing prevalence of cardiovascular risk factors and disease in urban, semi-urban and rural parts of the country. 1,2 This increasing epidemic has led to growing calls for closer monitoring of non-communicable diseases (NCDs) and improved prevention and treatment strategies to be prioritised. 3 The challenges that sub-Saharan nations will have to overcome to tackle this epidemic of NCDs are significant. The countries are characterised by widespread socio-economic disparities, and significant geographic differences in access to and availability of healthcare resources, such as diagnostic and therapeutic services. 4,5 There is also a significant shortage of physicians and healthcare workers that is particularly pronounced in rural and semi-urban areas. While there is a growing body of population-based data on the increasing burden of NCDs and cardiometabolic risk factors in South Africa, there is little published information on the impact of the epidemiological transition on the burden of cardiovascular disease-related hospital admissions and in-hospital case fatality rates in health facilities situated in rural Cardiac Clinic, Groote Schuur Hospital, Cape Town, South Africa Philasande Mkoko, MB ChB, MMed (UCT), FCP (SA), Cert Cardio (SA), mkkphi002@myuct.ac.za Department of Medicine, Dora Nginza Provincial Hospital, Port Elizabeth, South Africa Senlika Naidoo, MB ChB Mak Niazi, MB ChB Atiqa Tahira, MB ChB Xolile Godlwana, MB ChB Ntsikelelo Ndesi, MB ChB Martha Pepino, MB ChB Cardiac Clinic, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa Thina Majola, MB ChB Luyanda Mbanga, MB ChB Zimasa Vuyo Jama, MB ChB, MMed, FCP (SA) Prof Mpiko Ntsekhe, MD, PhD Faculty of Health Sciences, Walter Sisulu University, East London; Department of Medicine, Nginza Hospital, Port Elizabeth, South Africa Dr Nowshad Alam, MB ChB Brian Mbhele, MB ChB, FCP (SA) Dr Lokuthula Maphalala, MB ChB, MMed, FCP (SA)