Author + information
- Thiago Jardim,
- Sheridan Reiger,
- Stephen Tollman,
- F. Xavier Gomez-Olive,
- Alisha Wade,
- Ryan Wagner and
- Thomas Gaziano
Background: Prevalence of cardiovascular risk factors and primary prevention strategies in Sub-Saharan Africa have been previously reported, but data on secondary prevention of cardiovascular disease (CVD) is needed to inform care strategies. This study assessed CVD management in South Africa's rural Northeast adjacent to the country's border with Mozambique.
Methods: We recruited adults aged ≥ 40 years residing in the Agincourt sub-district of Mpumalanga Province, a setting covered by an established health and demographic surveillance system. In-person interviews were conducted at households by trained local fieldworkers to obtain socioeconomic and clinical data, anthropometric measures, blood pressure (BP), HIV-status, point-of-care glucose and lipid levels. CVD was defined by self-report of angina/myocardial infarction/stroke or angina defined by Rose Criteria.
Results: Out of 5,059 subjects, 657(13%) met CVD diagnostic criteria with angina counting for 80.7% of the diagnoses, stroke 22.7% and myocardial infarction 3.3%. Those with CVD were more likely to be female, older, with higher body mass index (BMI), greater waist circumference, higher total cholesterol, and non-smoker when compared to the non-CVD population. Independent predictors of CVD were female sex (OR 1.38; 95%CI 1.09 – 1.74) and age (OR 1.01; 95%CI 1.00 – 1.02). Risk factor control ranged from 93.9% for tobacco abstinence to 30.6% for appropriate waist-hip ratio. Higher rates of patients with BMI < 25kg/m2 (42.0 × 32.1%, p – 0.038) and BP < 140 × 90 mmHg (61.3 × 48.7%, p – 0.012) were found in the HIV positive patients; smoking rates were lower (92.0 × 96.3%, p – 0.046) in migrant subjects. More than 56% of those with CVD had ≤ 2 risk factors controlled and 4.4% had all of them under control. Three or more risk factors controlled were more frequent in males when compared to females (54.6 × 36.3% – p<0.001), in contrast, less than 1 risk factor controlled was more frequent in females (28.7 × 15.3% – p<0.001).
Conclusions: This analysis of the HAALSI study demonstrates that CVD is currently being poorly managed in this rural South Africa region and that there are significant opportunities to improve secondary prevention in this population.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Traditional and Novel Factors Used to Assess the Risk of, and Used for the Treatment of, Coronary Artery Disease
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1126-334
- 2017 American College of Cardiology Foundation