CARDIOVASCULAR JOURNAL OF AFRICA • Volume 34, No 1, January–April 2023 AFRICA 25 In Table 3, cardiometabolic risk factors and the MetS are compared by gender. Reference ranges from the IDF and ATPIII, indicated in Table 2, were used to compute the proportions. Cardiometabolic risk factors observed were hypertension (66%), obesity (21%), abdominal obesity by WC (46%), abdominal obesity by WHtR (72%), and elevated levels of cholesterol (15%) and glucose (7%), while the prevalence of the MetS was 17%. Significant differences of prevalence were observed for BMI, WC and WHtR. Table 4 shows the association of cardiometabolic risk factors and the MetS with age. Fifty-nine per cent of the participants were below 35 years of age and 35% were aged between 35 and 59 years, while 6% were aged 60 years and above. Reference ranges for the IDF and ATPIII, indicated in Table 2, were used to compute the proportions. The prevalence of hypertension, overweight, obesity, and abdominal obesity by WC, WHR and WHtR increased significantly with age. The prevalence of the MetS was higher among those aged between 35 and 59 years (28%) and ≥ 60 years (60%), compared to participants aged < 35 years (10%) (p ≤ 0.0001). The likelihood of abdominal obesity (by WC) increased with age (35–59 years) (AOR = 4.17, 95% CI: 1.75–9.56) and being married (AOR = 3.02, 95% CI: 1.19–7.64), but was less likely among males (AOR = 0.11, 95% CI: 0.05–0.25). Being 35 to 59 years (AOR = 2.79, 95% CI: 1.09–7.16) and married (AOR = 4.11, 95% CI: 1.34–12.65) was associated with an increased risk for abdominal obesity (by WHtR), but was less likely in males (AOR = 0.23, 95% CI: 0.11–0.52). Hypertension was associated with being ≥ 60 years old (AOR = 3.78, 95% CI: 1.06–13.42) (Table 5). The relationship between the MetS and selected independent variables is presented in Table 6. In the bivariate logistic regression analysis, gender (p = 0.026), age (p ≤ 0.0001), marital status (p = 0.001), alcohol use (p = 0.030) and tobacco use (p = 0.055) were associated with the MetS. After adjustment, multivariate analysis showed that the odds of having the MetS were 5.02 times higher for participants aged between 35 and 59 years (AOR = 5.02, 95% CI: 2.24–11.23) and 6.57 times higher Table 1. Demographic characteristics of the participants Variables Category Frequency Percentage Age groups (years) < 35 35–59 ≥ 60 186 109 20 59 35 6 Marital status Ever married Single Cohabiting 47 90 23 29 56 14 Employment Yes No 30 29 19 81 Receiving social grant Yes No 60 97 38 62 Household income No income < R5 000 ≥ R5 000 14 114 28 9 73 17 Parity 0 1–2 > 2 21 86 51 13 55 32 Household members 1–4 ≥ 5 123 35 78 22 Visited healthcare facility No Within 6 months One/over a year 65 40 54 41 25 34 Alcohol use Yes No 56 104 35 65 Tobacco use No Cigarettes Snuff/pipe/other 129 23 8 81 14 5 Table 2. Comparison of medians of cardiometabolic risk factors stratified by gender Variables All, median (IQR) Males, median (IQR) Females, median (IQR) Normal RR p-value Age (years) 35 (25–42) 34 (26–39) 35 (24–44) ≥ 18 0.325 BMI (kg/m2) 25.9 (22.1–28.2) 24.0 (21.4–25.3) 27.8 (23.2–30.4) ≥ 19 ≤ 24.99 ≤ 0.0001* WC (cm) 84.5 (75–93) 82.1 (72–90) 87.1 (74–95) ≥ 80 F; ≥ 94 M 0.026* WHR 0.84 (0.78–0.88) 0.87 (0.80–0.91) 0.81 (0.74–0.85) > 0.85 F; > 0.90 M 0.001* WHtR 0.52 (0.44–0.57) 0.50 (0.43–0.53) 0.55 (0.48–0.61) < 0.5 0.02* SBP (mmHg) 136 (113–145) 138 (135–150) 133 (120–141) < 130 0.02* DBP (mmHg) 86 (79–94) 88 (81–95) 85 (77–93) < 85 0.008* Cholesterol (mmol/l) 4.5 (4.0–5.0) 4.7 (4.0–5.2) 4.4 (3.9–4.8) < 5 0.094 Glucose (mmol/l) 5.9 (4.9–6.6) 5.9 (4.7–5.7) 6.0 (.5.0–6.5) ≤ 7.8 0.814 BMI, body mass index; WC, waist circumference; WHR, waist–hip ratio; WHtR, waist-to-height ratio; SBP, systolic blood pressure; DBP, diastolic blood pressure; IQR, interquartile range; RR, reference range; F, females; M, males. *Indicates significant difference. Table 3. Cardiometabolic risk factors and the MetS stratified by gender Variables All n (%) Male n (%) Female n (%) p-value Blood pressure Normal Hypertension 112 (34) 217 (66) 48 (31) 109 (69) 64 (37) 108 (63) 0.205 BMI Normal Underweight Overweight Obesity 172 (55) 6 (2) 76 (24) 66 (21) 107 (69) 3 (2) 30 (19) 16 (10) 65 (40) 3 (2) 46 (28) 50 (30) ≤ 0.0001* WC Normal Abdominal obesity 86 (54) 73 (46) 61 (74) 21 (26) 25 (32) 52 (68) ≤ 0.0001* WHR Normal Abdominal obesity 116 (73) 43 (27) 60 (73) 22 (27) 56 (73) 21 (22) 0.950 WHtR Normal Abdominal obesity 45 (28) 114 (72) 33 (40) 49 (60) 12 (16) 33 (40) ≤ 0.0001* Cholesterol Normal Elevated 136 (86) 23 (15) 67 (83) 14 (17) 69 (88) 9 (12) 0.303 Glucose Normal Elevated 297 (93) 24 (7) 142 (92) 13 (8) 155 (93) 11 (7) 0.549 MetS No Yes 273 (83) 56 (17) 136 (86) 21 (13) 137 (80) 35 (20) 0.093 BMI, body mass index; WC, waist circumference; WHR, waist–hip ratio; WHtR, waist-to-height ratio; SBP, systolic blood pressure; DBP, diastolic blood pressure; MetS, metabolic syndrome; n, number of participants; %, percentage. *Indicates significant difference.
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