AFRICA Cardiovascular Journal of Africa • SAHS Biennial Congress 2024 20 Submission ID: 1649 Introduction Progress has been made in reducing the global burden of hypertensive heart diseases attributable to metabolic risk factors. These factors include high SBP, low density lipoprotein cholesterol (LDL-C), high BMI, high fasting plasma glucose, low bone mineral density, and kidney dysfunction. However, the prevalence and trajectories over time of these metabolic factors have not been analyzed in lower income countries. Methods We conducted a descriptive epidemiological analysis to evaluate the above risk factors for South Africa using data from the Global Burden of Disease (GBD) Study. We analyzed changes from 1990 to 2021 and trajectories of risk-specific summary exposure values (SEVs). An SEV is a risk-weighted prevalence of exposure ranging from 0-100, where 0 represents a scenario in which the entire population is exposed at the minimum level or risk and 100 indicates that the entire population is exposed at the maximum level of risk determined using systematic literature reviews. We analyzed annualized rates of change (AROCs) of SEVs over the study period. National and province-level estimates together with 95% Uncertainty Intervals (UIs) were generated. Statistically, the GBD uses a theoretical minimum risk exposure level (TMREL) derived from epidemiological evidence for individual risk factors. SEVs were used to calculate population attributable fraction, i.e., proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL. Results SEVs for metabolic risk factors for hypertensive heart diseases in South Africa increased linearly from 19.5 (95% UIs: 17.6-22.0) in 1990, to 29.9 (27.0-32.4) in 2019, to 30.9 (27.8-33.3) in 2021, and AROC of 0.58% (0.46-0.69). Relative to males, females had an approximately a 10-unit higher SEV for hypertensive heart diseases in 1990 and an approximately 15-unit higher increase in 2021. Country-wide and all provinces exceeded the global SEV of 13.0(11.6-14.8) for 1990 and 20.9(18.9-22.9) in 2021. Seven provinces had SEV exceeding 30% with the highest in KwaZulu Natal and North-West. Conclusion Metabolic risk factors contribute increasingly to hypertensive disease in South Africa. Interventions should prioritize high SBP and low LDL cholesterol. Behavioural and dietary factors should be analysed alongside metabolic factors to better and timely inform public health policies and practice. Name: Presenting Author Information Article Category Abstract Title University of Massachusetts Boston phil.gona@umb.edu English Abstract Researchers/Clinicians - Early, mid & senior career Trends in summary exposure values attributable to top six elevated metabolic risk factors for hypertensive heart diseases in South Africa between 1990 and 2021: the Global Burden of Disease Study. Author Affiliation: Email: Philimon Gona Science Theme Population Authors Name & Surname Title Expertise Affiliation Email Country Philimon N Gona Professor Statistical Methods for Epidemiology University of Massachusetts Boston phil.gona@umb.edu United States Clara M Gona Associate Professor Nursing & Global Health Massachusetts General Hospital Institute of Health Professions Gcgona1@mgb.org United States Lebo Gafane-Matemane Associate Professor Cardiovascular Physiology North-West University, Potchefstroom Lebo.Gafane@nwu.ac.za South Africa Sowmya R Rao Research Scientist Biostatistician/ Research Scientist Boston University sowmya.rao@gmail.com United States Ali H Mokdad Professor Global Health University of Washington Medical School mokdaa@uw.edu United States ORAL PRESENTATION
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