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Int J Cardiol. 2012 Jul 12;158(2):205-10. doi: 10.1016/j.ijcard.2011.01.022. Epub 2011 Feb 24.

Elevated risk factors but low burden of heart disease in urban African primary care patients: a fundamental role for primary prevention.

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  • 1Preventative Health, Baker IDI Heart and Diabetes Institute, Melbourne, Australia. simon.stewart@bakeridi.edu.au

Abstract

BACKGROUND:

Few data describe the case burden of heart disease and cardiovascular risk factors relative to other conditions in urban Africans seeking primary health care.

METHODS:

A clinical registry captured data on 1311 consecutive primary care patients (99% African) from two primary care clinics in Soweto, South Africa. Those with suspected sub-clinical heart disease had more advanced cardiologic assessment.

RESULTS:

Overall, 862 women (66%, 41 ± 16 years) and 449 men (38 ± 14 years) were studied. Whilst more men were smokers (47% vs. 14%; OR 5.23, 95% CI 4.01-6.82), more women were obese (42% vs. 14%; OR 4.54, 95% CI 3.33-5.88); blood glucose levels doubling with age in obese women. Although 33% were hypertensive, only 4.9% had type 2 diabetes (n=45), heart disease (n=10) and/or cerebrovascular disease (n=12). Overall, 16% (n=205) had an abnormal 12-lead ECG with more men than women showing a major abnormality (24% vs. 11%; OR 2.63, 95% CI 1.89-3.46). Of 99 cases (7.6%) subject to advanced cardiologic assessment, 29 (2.2%) had newly diagnosed heart disease: including hypertensive heart failure (13 women vs. 2 men, OR 4.51 95% CI 1.00-21.2), coronary artery disease (n=3), valve disease (n=3), dilated cardiomyopathy (n=3) and 2 cases of acute myocarditis.

CONCLUSIONS:

These data demonstrate a relatively low burden of heart disease in urban African patients seeking primary health care. Alternatively, high antecedent risk, particularly among obese women, highlights a key role for enhanced primary prevention.

Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

[PubMed - indexed for MEDLINE]
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