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A cross-sectional study of vascular risk factors in a rural South African population : data from the Southern African Stroke Prevention Initiative (SASPI)

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Thorogood, Margaret, Connor, Miles, Tollman, Stephen, Lewando Hundt, Gillian, Fowkes, Gerry and Marsh, Jennifer. (2007) A cross-sectional study of vascular risk factors in a rural South African population : data from the Southern African Stroke Prevention Initiative (SASPI). BMC Public Health, Vol.7 (No.326). ISSN 1471-2458

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Official URL: http://dx.doi.org/10.1186/1471-2458-7-326

Abstract

Background: Rural sub-Saharan Africa is at an early stage of economic and health transition. It is
predicted that the 21st century will see a serious added economic burden from non-communicable disease
including vascular disease in low-income countries as they progress through the transition. The stage of
vascular disease in a population is thought to result from the prevalence of vascular risk factors. Already
hypertension and stroke are common in adults in sub-Saharan Africa. Using a multidisciplinary approach
we aimed to assess the prevalence of several vascular risk factors in Agincourt, a rural demographic
surveillance site in South Africa.
Methods: We performed a cross sectional random sample survey of adults aged over 35 in Agincourt
(population ≈ 70 000). Participants were visited at home by a trained nurse who administered a
questionnaire, carried out clinical measurements and took a blood sample. From this we assessed
participants' history of vascular risk, blood pressure using an OMRON 705 CP monitor, waist
circumference, body mass index (BMI), ankle brachial index (ABI), and total and HDL cholesterol.
Results: 402 people (24% men) participated. There was a high prevalence of smoking in men, but the
number of cigarettes smoked was small. There was a striking difference in mean BMI between men and
women (22.8 kg/m2 versus 27.2 kg/m2), but levels of blood pressure were very similar. 43% of participants
had a blood pressure greater than 140/90 or were on anti-hypertensive treatment and 37% of participants
identified with measured high blood pressure were on pharmacological treatment. 12% of participants had
an ABI of < 0.9, sugesting the presence of sub-clinical atheroma. 25.6% of participants had a total
cholesterol level > 5 mmol/l.
Conclusion: We found a high prevalence of hypertension, obesity in women, and a suggestion of
subclinical atheroma despite relatively favourable cholesterol levels in a rural South African population.
South Africa is facing the challenge of an emerging epidemic of vascular disease. Research to establish the
social determinates of these risk factors and interventions to reduce both individual and population risk
are required.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Faculty of Social Sciences > School of Health and Social Studies Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Blood-vessels -- Diseases -- South Africa, Peripheral vascular diseases -- South Africa, Hypertension -- South Africa
Journal or Publication Title:	BMC Public Health
Publisher:	BioMed Central Ltd.
ISSN:	1471-2458
Official Date:	13 November 2007
Volume:	Vol.7
Number:	No.326
Identification Number:	10.1186/1471-2458-7-326
Status:	Peer Reviewed
Access rights to Published version:	Open Access
Funder:	Wellcome Trust (London, England)
Grant number:	ref 0647/Z/01/Z
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URI:	http://wrap.warwick.ac.uk/id/eprint/253