Prognostic values of modifiable risk factors for cardiovascular events in South African health promotion

PLoS One. 2022 Aug 10;17(8):e0271169. doi: 10.1371/journal.pone.0271169. eCollection 2022.

Abstract

Background: Cardiovascular diseases (CVDs) are increasing at an alarming rate among the South African population. This study aimed to determine the prognostic value of modifiable CVD risk factors for fatal and non-fatal events to inform cardiovascular health promotion practices in the South African public health system.

Methods: Data was collected from individuals participating in the South African leg of a multi-national prospective cohort study. Binary logistic regression was applied to estimate odds of total, non-fatal and fatal cardiovascular events.

Results: Binary logistic regression analyses identified age as a predictor of non-fatal and fatal CV events, with ORs of 1.87 to 3.21, respectively. Hypertension increased the odd of suffering a non-fatal CV event by almost two and a half (OR = 2.47; 95% CI = 1.26, 4.85). Moreover, being physically active reduced the odd of non-fatal CVD events by 38% (OR = 0.62; 95% CI = 0.46, 0.83 for 1 Standard deviation increase of the weighted physical activity index score (WPA)). On the one hand, gamma-glutamyltransferase (GGT) was associated with a higher fatal cardiovascular disease risk OR = 2.45 (95% CI = 1.36, 4.42) for a standard deviation increase.

Conclusions: Elevated blood pressure, GGT, and physical activity have significant prognostic values for fatal or non-fatal CV events. These findings emphasise the importance of highlighting hypertension and physical activity when planning cardiovascular health education and intervention programmes for this population, with attention to the monitoring of GGT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases*
  • Health Promotion
  • Humans
  • Hypertension* / complications
  • Hypertension* / epidemiology
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • South Africa / epidemiology
  • gamma-Glutamyltransferase

Substances

  • gamma-Glutamyltransferase

Grants and funding

This work was supported by: 1. South Africa Netherlands Research Programme on Alternatives in Development [08/15]; https://www.nwo.nl/en/researchprogrammes/south-africa-netherlands-research-programme-alternatives-development-sanpad-0 2. South African National Research Foundation [NRF GUN numbers 2069139, FA2006040700010]; https://www.nrf.ac.za/ 3. South African Medical Research Council; https://www.samrc.ac.za/funding/samrcfunding 4. PB: North-West University, Faculty of Health Sciences, Potchefstroom, South Africa; http://health-sciences.nwu.ac.za/auther 5. IMK*: Population Health Research Institute, ON, Canada. https://www.phri.ca/research-categories/cvd-prevention/ This study is the South African leg of the multi-national PURE study, orchestrated by Prof Dr Salim Yusuf (SY), Executive Director of the Population Health Research Institute (PHRI). SY conceptualised the international study design and methods for data collection. * IMK is the National Leader for South Africa and has secured seed funding from PHRI for data collection and analysis. None of the authors of this manuscript received salaries or other funding from commercial companies.