Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-24T00:47:18.620Z Has data issue: false hasContentIssue false

The emergence of cardiovascular disease during urbanisation of Africans

Published online by Cambridge University Press:  22 December 2006

HH Vorster*
Affiliation:
Faculty of Health Sciences, Potchefstroomse Universiteit vir Christelike Hoër Onderwys, Potchefstroom 2520, South Africa
*
*Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

To review the available data on risk factors for cardiovascular disease (CVD), the influence of urbanisation of Africans on these risk factors, and to examine why stroke emerges as a higher risk than ischaemic heart disease (IHD) in the health transition of black South Africans.

Design:

A review of published data on mortality from and risk factors of CVD in South Africans.

Setting:

South Africa.

Subjects:

South African population groups and communities.

Methods:

The available data on the contribution of stroke and IHD to CVD mortality in South Africa are briefly reviewed, followed by a comparison of published data on the prevalence and/or levels of CVD risk factors in the different South African population groups. The impact of urbanisation of black South Africans on these risk factors is assessed by comparing rural and urban Africans who participated in the Transition and Health during Urbanisation of South Africans (THUSA) study.

Results and conclusions: The mortality rates from CVD confirmed that stroke is a major public health problem amongst black South Africans, possibly because of an increase in hypertension, obesity, smoking habit and hyperfibrinogenaemia during various stages of urbanisation. The available data further suggest that black South Africans may be protected against IHD because of favourable serum lipid profiles (low cholesterol and high ratios of high-density lipoprotein cholesterol) and low homocysteine values. However, increases in total fat and animal protein intake of affluent black South Africans, who can afford Western diets, are associated with increases in body mass indices of men and women and in total serum cholesterol. These exposures may increase IHD risk in the future.

Type
Research Article
Copyright
Copyright © CABI Publishing 2002

References

1: Anon. Statistics South Africa 2000 [Online]. Available at http://www.statssa.gov.za/RELEASES/DEMOGRAP/2000/po302.htm. Accessed 10 September 2001.Google Scholar
2: Anon. Health and related indicators. In: Ntuli, A, Crisp, N, Clarke, E, Barron, P, eds. 2000 South African Health Review. Durban: Health Systems Trust, 2000; 467–77.Google Scholar
3Bradshaw, D, Masiteng, K, Nannan, N. Health status and determinants. In: Ntuli, A, Crisp, N, Clarke, E, Barron, P, eds. 2000 South African Health Review. Durban: Health Systems Trust, 2000; 89124.Google Scholar
4Bradshaw, D, Bourne, D, Schneider, M, Sayed, R. Mortality patterns of chronic diseases of lifestyle in South Africa. In: Fourie, J, Steyn, K, eds. Chronic Diseases of Lifestyle in South Africa. Medical Research Council (MRC) Technical Report. Tygerberg: MRC, 1995; 531.Google Scholar
5Murray, CJL, Lopez, AD. Alternative visions of the future: projecting mortality and disability, 1990–2020. In: Murray, CJL, Lopez, AD, eds. The Global Burden of Disease. Boston, MA: World Health Organization/World Bank/Harvard University Press, 1996; 325–95.Google Scholar
6Wyndham, CH. Mortality from cardiovascular diseases in the various population groups in the Republic of South Africa. S. Afr. Med. J. 1979; 56: 1023–30.Google ScholarPubMed
7Broderick, JP, Brott, T, Tomsick, T, Husster, G, Miller, R. The risk of subarachnoid and intercerebral hemorrhaeges in blacks as compared to whites. N. Engl. J. Med. 1992; 326: 733–6.Google Scholar
8Yach, D. Smoking: review of research and identification of future priorities. In: Fourie, J, Steyn, K, eds. Chronic Diseases of Lifestyle in South Africa. Medical Research Council (MRC) Technical Report. Tygerberg: MRC, 1995; 5160.Google Scholar
9Seftel, HC, Raal, FJ, Joffe, BI. Dislipidaemia in South Africa. In: Fourie, J, Steyn, K, eds. Chronic Diseases of Lifestyle in South Africa. Medical Research Council (MRC) Technical Report. Tygerberg: MRC, 1995; 6171.Google Scholar
10Venter, CS, Vorster, HH, Silvis, N, Kruger, A, Mia, F, Seftel, HC. Determinants of plasma fibrinogen in South African communities. In: Ernst, E, Koenig, W, Lowe, GDO, Meade, TW, eds. Fibrinogen: A “New” Cardiovascular Risk Factor. Vienna: Blackwell-MZV, 1992; 166–71.Google Scholar
11Vorster, HH, Jerling, JC, Steyn, K, Badenhorst, CJ, Slazus, W, Venter, CS, Jooste, PL, Bourne, LT. Plasma fibrinogen of black South Africans: the BRISK study. Public Health Nutr. 1998; 1(3): 169–76.CrossRefGoogle ScholarPubMed
12Vorster, HH, Wissing, MP, Venter, CS, Kruger, HS, Kruger, A, Malan, NT, De Ridder, JH, Veldman, FJ, Steyn, HS, Margetts, BM, MacIntyre, U. The impact of urbanization on physical, physiological and mental health of Africans in the North West Province of South Africa: the THUSA study. S. Afr. J. Sci. 2000; 96: 505–14.Google Scholar
13Van Rooyen, JM, Kruger, HS, Huisman, HW, Wissing, MP, Margetts, BM, Venter, CS, Voerster, HH. An epidemiological study of hypertension and its determinants in a population in transition: the THUSA study. J. Hum. Hyperten. 2000; 14: 779–87.Google Scholar
14James, S, Vorster, HH, Venter, CS, Kruger, HS, Nell, TA, Veldman, FJ, Ubbink, JB. Nutritional status influences plasma fibrinogen concentration: evidence from the THUSA survey. Thromb. Res. 2000; 98: 383–94.CrossRefGoogle ScholarPubMed
15Malan, MM. Fibrin network characteristics of obese African women. PhD thesis, PU vir CHO, Potchefstroom, 1999; 1233.Google Scholar
16Loktionov, A, Vorster, H, O'Neill, I, Nell, T, Bingham, SA, Runswick, SA, Cummings, JH. Apolipoprotein E and methylene tetrahydrofolate reductase genetic polymorphisms in relation to other risk factors for cardiovascular disease in UK Caucasians and black South Africans. Atherosclerosis 1999; 145(1): 125–35.Google Scholar
17Ubbink, JB, Vermaak, WJH, Delport, R, Van der Merwe, A, Becker, PJ, Potgieter, H. Effective homocysteine metabolism may protect South African blacks against coronary heart disease. Am. J. Clin. Nutr. 1995; 62: 802–8.CrossRefGoogle ScholarPubMed
18Vorster, HH, Bourne, LT, Venter, CS, Oosthuizen, W. Contribution of nutrition to the health transition in developing countries: a framework for research and intervention. Nutr. Rev. 1999; 57(11): 341–9.CrossRefGoogle Scholar
19Ralph, A. Dietary reference values. In: Garrow, JS, James, WPT, eds. Human Nutrition and Dietetics, 9th ed. London: Churchill Livingstone, 1994; 782–96.Google Scholar