Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-22T06:24:52.376Z Has data issue: false hasContentIssue false

Plasma fibrinogen of black South Africans: the BRISK study

Published online by Cambridge University Press:  01 September 1998

HH Vorster*
Affiliation:
Department of Nutrition, PU for CHE, Potchefstroom, 2520, South Africa
JC Jerling
Affiliation:
Department of Nutrition, PU for CHE, Potchefstroom, 2520, South Africa
K Steyn
Affiliation:
Division for Chronic Diseases of Lifestyle, MRC, Tygerberg, 7505, South Africa
CJ Badenhorst
Affiliation:
Division for Chronic Diseases of Lifestyle, MRC, Tygerberg, 7505, South Africa
W Slazus
Affiliation:
Department of Haematology and Pathology, Faculty of Medicine, US, Stellenbosch, 7600, South Africa
CS Venter
Affiliation:
Department of Nutrition, PU for CHE, Potchefstroom, 2520, South Africa
PL Jooste
Affiliation:
National Research Programme for Nutrition Intervention, MRC, Tygerberg, 7505, South Africa
LT Bourne
Affiliation:
Division for Chronic Diseases of Lifestyle, MRC, Tygerberg, 7505, South Africa
*
*Corresponding author: E-mail [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 describe the distribution of plasma fibrinogen and relationships with other risk factors for coronary heart disease (CHD) and stroke in the black population of the Cape Peninsula.

Design:

A cross-sectional survey of a stratified proportional sample of randomly selected black men and women.

Setting:

Households in Gugulethu, Langa, Nyanga, New Crossroads, KTC, Old Crossroads and Khayelitsha in the Cape Peninsula, South Africa.

Subjects:

One subject per household (352 men and 447 women), aged 15–64 years, voluntarily participated. Visitors, pregnant, lactating, ill, mentally retarded and intoxicated subjects were excluded.

Results:

Mean fibrinogen (thrombin time coagulation method) of men and women were higher than published data for Europeans but slightly lower than values of black Americans. Women aged 45–54 years had the highest level (3.13 ± 0.89g1−1) and men aged 15–24 years had the lowest (2.13 ± 0.88g1−1). Fifteen per cent of the men and 12% of the women had a level greater than 1 standard deviation of the mean for their age group. Univariate and multivariate analyses revealed significant (P< 0.05) positive correlations of fibrinogen with smoking habit, age, body mass index (BMI), total and low-density lipoprotein (LDL) cholesterol, triglycerides, blood pressure and white blood cell count, and significant negative correlations with high-density lipoprotein (HDL) cholesterol, gamma glutamyl transferase (GGT), serum iron and ferritin. The correlations with BMI, serum lipoproteins, iron, ferritin, and GGT suggest that nutritional status and therefore diet influences plasma fibrinogen.

Conclusions:

Relatively high fibrinogen levels, tending to cluster with other, including diet-related, risk factors for CHD and stroke, were observed in black South Africans. It is suggested that fibrinogen may contribute to the high stroke incidence of this population group.

Type
Research Article
Copyright
Copyright © The Nutrition Society 1998

References

1Steyn, K. A policy proposal to manage chronic diseases of lifestyle in South Africa. S. Afr. Med. J. 1992; 82: 220–1.Google ScholarPubMed
2Popkin, BM. The nutrition transition in low-income countries: an emerging crisis. Nutr. Rev. 1994; 52: 285–98.CrossRefGoogle ScholarPubMed
3Wilhelmsen, L, Svärdsudd, K, Korsan-Bengsten, K, Larsson, B. Fibrinogen as a risk factor for stroke and myocardial infarction. N. Engl. J. Med. 1984; 311: 5001–505.CrossRefGoogle ScholarPubMed
4Meade, TW, Brozovic, M, Charkrabarti, RR, et al. Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study. Lancet 1986; 2: 533–7.CrossRefGoogle ScholarPubMed
5Kannel, WB, Wolf, PA, Castelli, WP. D'Agostino, RB. Fibrinogen and risk of cardiovascular disease. J. Am. Med. Assoc. 1987; 258: 1183–6.CrossRefGoogle ScholarPubMed
6Yarnell, IWG, Fehilly, AM, Milbank, J, Kubicki, AJ. Eastham, R, Haynes, TM. Determinants of plasma lipoproteins and coagulation factors in men from Caerphilly, South Wales. J. Epidemiol. Comm. Health. 1983; 37: 137–40.CrossRefGoogle ScholarPubMed
7Assman, G, Schulte, H. Results and conclusions of the prospective cardiovascular Münster (PROCAM) Study. In: Asmann, G, ed. Lipid Metabolism Disorders and Coronary Heart Disease. Munich: MMV Medizin Verlag, 1993: 1967.Google Scholar
8Folsom, AR, Wu, KK, Conlan, MG. Fibrinogen and cardiovascular risk in the atherosclerosis risk in communities (ARIC) study. In: Ernst, E, Koenig, W, Lowe, GDO, Mcade, TW. eds. Fibrinogen: a ‘New’ Cardiovascular Risk Factor. Vienna: Blackwell-MZV, 1992: 124–9.Google Scholar
9Erikson, H, Wilhelmsen, L, Welin, L, Larsson, B, Svärdsudd, , Tibblin, G. 21-year follow-up of CVD and total mortality among men born in 1913. In: Ernst, E, Koenig, W, Lowe, GDO, Meade, TW, eds. Fibrinogen: a ‘New’ Cardiorvascular Risk Factor. Vienna: Blackwell-MZV, 1992: 115–19.Google Scholar
10Tarallo, P, Henny, J, Gueguen, R, Siest, G. Reference limits of plasma fibrinogen. Eur. J. Clin. Chem. Clin. Biochem. 1992; 30: 745–51.Google ScholarPubMed
11Folsom, AR, Wu, KK, Davis, CE, Conlan, MG, Sorlie, PD, Szklo, M. Population correlates of plasma fibrinogen and factor VII. purative cardiovascular risk factors. Atherosclerosis 1991; 91: 191205.CrossRefGoogle Scholar
12Lee, AJ, Smith, WCS, Lowe, GDO. Tunstall-Pedoe, H. Plasma fibrinogen and coronary risk factors: the Scottish Heart Health Study. J. Clin. Epidemiol. 1990; 43: 913–19.CrossRefGoogle ScholarPubMed
13Cook, NS, Ubben, D. Fibrinogen as a major risk factor in cardiovascular disease. Trends Pharm. Sci. 1990; 11: 444–51.CrossRefGoogle Scholar
14Humphries, SE, Cook, M, Dubowitz, M, Stirling, Y, Meade, TW. Role of genetic variation at the fibrinogen locus in determination of plasma fibrinogen. Lancet 1987; 1: 1452–55.CrossRefGoogle ScholarPubMed
15Ernst, E. The role of fibrinogen as a cardiovascular risk factor. Atherosclerosis 1993; 100: 112.CrossRefGoogle ScholarPubMed
16Iso, H, Folsom, AR. Sato, S, et al. Plasma fibrinogen and its correlates in Japanese and US population samples. Arterioscl. Thromb. 1993; 13: 783–90.CrossRefGoogle ScholarPubMed
17Venter, CS, Vorster, HH. Silvis, A. Mia, F. Seftel, HC. Determinants of plasma fibrinogen levels in South African communites. In: Ernst, E, Koenig, W. Low, CDO, Meade, TW. eds. Fibrinogen: a ‘New‚ Cardiovacular Risk Factor. Vienna: Blackwell-MZV. 1992: 166–71.Google Scholar
18Steyn, K. Fourie, J, eds. BRISK Study Methodology. Coronary Heart Disease Risk Factor Study in the African Population of the Cape Peninsula. Technical report no. I. Medical Research Council, Parow, 1991: 144.Google Scholar
19Steyn, K, Jooste, PL, Bourne, L, et al. Risk factors for coronary heart disease in the black population of the Cape Peninsula. S. Afr. Med. J. 1991; 79: 480–5.Google ScholarPubMed
20Osterud, B. How to measure factor VII and factor VII activation. Haemostasis 1983; 13: 161–8.Google ScholarPubMed
21Stat Soft Incorporated. Complete Statistical System (CCS). Stat Soft Inc. 1991, Tulsa, OK 74104.Google Scholar
22Møller, L. Kristensen, TS. Plasma fibrinogen and ischemic heart disease risk factors. Arterioscler. Thromb. 1991; 11: 344–50.CrossRefGoogle ScholarPubMed
23Balleisen, L, Bailey, J, Epping, PH, Schulte, H, Van de Loo, J. Epidemiological study on factor VII, factor VIlI and fibrinogen in an industrial population I. Thromb. Hemost. 1985; 54: 475.Google Scholar
24Farinaro, E. Prevention of coronary heart disease: scientific background and new clinical guidelines. In: Asmann, G. ed. Lipid Metabolism isorders and Coronary Heart Disease. Munich: MMV Medizin Verlag, 1993: 69139.Google Scholar
25Vorster, HH, Venter, CS. Fibrinogen as risk factor for coronary heart disease. Cardiovasc. J. S. Afr. 1994; 5: 117–24.Google Scholar
26Kannel, WB. CHD risk factors: a Framingham Study update. Hosp. Pract. 1990; 25: 119–27.CrossRefGoogle ScholarPubMed
27Luria, MH, Erel, J, Sapoznikov, D, Gotsman, MS. Cardiovascular risk factor clustering and ratio of total cholesterol to high-density lipoprotein cholesterol in angiographically documented coronary artery disease. Am. J. Cardiol. 1991; 67: 131–6.CrossRefGoogle ScholarPubMed
28Ernst, E. Oral contraceptives, fibrinogen and cardiovascular risk. Atherosclerosis 1992; 93: 15.CrossRefGoogle ScholarPubMed
29Walker, ARP, Adam, A, Kustner, HGV. Changes in total death rate and in ischaemic heart disease death rate in interethnic South African populations. S. Afr. Med. J. 1993; 83: 602–5.Google ScholarPubMed
30Sherman, AJ. Coronary heart disease in black Americans; suggestions for research on psychosocial factors. Am. Heart. J. 1984; 3: 833–8.Google Scholar
31Vermaak, WJH. Ubbink, JB, Delport, R, Becker, PJ, Bissbort, SH, Ungerer, JPJ. Ethnic immunity to coronary heart disease? Atherosclerosis 1991; 89: 155–62.CrossRefGoogle ScholarPubMed
32Franz, RC, Meiring, JL. Coetzee, WJC. Ethnic differences in the haemostatic, fibrinolytic and lipographic patterns. S. Afr. J. Surg. 1980; 18: 58–9.Google Scholar
33Jerling, JC, Vorster, HH, Oosthuzen, W, Silvis, N, Venter, CS. Differences in plasminogen activator inhibitor I activity between blacks and whites may be diet related. Haemostusis 1993; 24: 364–8.Google Scholar
34Wyndham, 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
35Joubert, J. The MEDUNSA Stroke Data Bank. An analysis of 304 patients seen between 1986 and 1987. S. Afr. Med. J. 1991; 80: 567–70.Google Scholar
36Broderick, JP, Brott, T, Tomsick, T, Huster, G, Miller, R. The risk of subarachnoid and intracerebral hemorrhages in blacks as compared with whites. N. Engl. J. Med. 1992; 326: 733–6.CrossRefGoogle ScholarPubMed
37Kittner, SJ, White, LR, Losonczy, KG, Wolf, PA, Hebel, JR. Black-white differences in stroke incidence in a national sample. J. Am. Med. Assoc. 1990; 264: 1267–70.CrossRefGoogle ScholarPubMed
38Gaines, KJ, Chesney, C, Van der Zwaag, R, Cape, C. Racial differences in coagulation studies in stroke. Neurol. Res. 1992; 14: 103–8.CrossRefGoogle ScholarPubMed
39Carter, LR, Walton, SE, Knowles, MK, Wing, S, Tyroler, HA. Social inequality of stroke mortality among US black populations, 1968 to 1987. Ethn. Dis. 1992; 2: 343–51.Google ScholarPubMed
40Casper, M, Wing, S, Strogatz, D. Variation in the magnitude of black - white differences in stroke mortality by community occupational structure. J. Epidemiol. Comm. Health 1991; 45: 302–6.CrossRefGoogle ScholarPubMed
41Markowe, HLJ. Marmot, MG, Shipley, MJ, et al. Fibrinogen: a possible link between social class and coronary heart disease. Br. Med. J. 1985; 291: 1312–14.CrossRefGoogle ScholarPubMed
42Netterstrøm, B, Søndergård, k, Damsgaard, MT, Olsen, O, Sjøl, A. Job strain and cardiovascular risk factors; a cross sectional study of employed Danish men and women. Br. J. Ind. Med. 1991; 48: 584689.Google ScholarPubMed