Contemporary risk factors associated with ischaemic heart disease in central South Africa: a single-centre study

Michelle Butler; Lezelle Botes; Stephen Brown; Francis Smit

doi:10.5830/CVJA-2023-053

Contemporary risk factors associated with ischaemic heart disease in central South Africa: a single-centre study

Cardiovasc J Afr. 2023 Nov 6:34:1-6. doi: 10.5830/CVJA-2023-053. Online ahead of print.

Authors

Michelle Butler¹, Lezelle Botes², Stephen Brown³, Francis Smit⁴

Affiliations

¹ Department of Cardiology, University of the Free State, Bloemfontein, South Africa; Robert WM Frater Cardiovascular Research Centre, University of the Free State, Bloemfontein, South Africa.
² Department of Health Sciences, Central University of Technology, Free State, Bloemfontein, South Africa; Robert WM Frater Cardiovascular Research Centre, University of the Free State, Bloemfontein, South Africa.
³ Department of Paediatric Cardiology, University of the Free State, Bloemfontein, South Africa; Robert WM Frater Cardiovascular Research Centre, University of the Free State, Bloemfontein, South Africa. Email: Gnpdscb@ufs.ac.za.
⁴ Department of Cardiothoracic Surgery, University of the Free State, Bloemfontein, South Africa; Robert WM Frater Cardiovascular Research Centre, University of the Free State, Bloemfontein, South Africa.

PMID: 37930348
DOI: 10.5830/CVJA-2023-053

Abstract

Background: Deaths from non-communicable diseases have increased in sub-Saharan Africa over the years, with limited data on coronary artery disease (CAD) and the risk factors thereof. The objective of this study was to investigate modifiable and non-modifiable risk factors in central South Africa in patients with CAD.

Methods: Patients with angiographically confirmed CAD who were evaluated in the catheterisation laboratory for the first time over a two-year period (2016 - 2017) were included. Data were extracted from the patients' medical records.

Results: Four hundred and eighty-two patients met the inclusion criteria, presenting at a mean age of 58.4 ± 10.8 years, and were predominantly male (66%). Females were significantly older than the males (60.3 ± 9.6 vs 57.4 ± 11.1 years; p < 0.05). The mean age at presentation was comparable between ethnic groups, except Asian patients who presented at a significantly younger age compared to Caucasians (49.8 ± 10.5 vs 59.1 ± 10.8 years; p < 0.05). Hypertension (91%) was the most common risk factor, followed by smoking (67%) and obesity (41%). Black Africans demonstrated a higher incidence of hypertension when compared to Caucasians (96 vs 87%; p < 0.05). Smoking was more prevalent in Caucasians than black Africans (68 vs 55%; p < 0.05) and occurred more commonly in males than females (73 vs 55%; p < 0.05). Most patients presented with acute coronary syndrome (ACS) (72%), mainly with ST-elevation myocardial infarction (STEMI) (36%). The majority of patients presenting with ACS were in the age group 51 - 60 years. The ACS risk-factor profile was similar to that of the total study group.

Conclusion: CAD was present in all ethnic groups, and modifiable and non-modifiable risk factors were similar to the classical risk factors described worldwide. Minor interracial differences were observed and hypertension was the most prevalent risk factor recorded in central South Africa. Most patients with CAD presented with ACS, particularly STEMI. Recognition of the risk factors associated with CAD would contribute to improved planning of healthcare systems and increased awareness of CAD.

Keywords: acute coronary syndrome; coronary artery disease; modifiable risk factors; non‐modifiable risk factors; risk factors.