The emergence of cardiovascular disease during urbanisation of Africans.
OBJECTIVE
To review the available data on risk factors for cardiovascular disease (CVD), the influence of urbanisation of Africans on these risk factors, and to examine why stroke emerges as a higher risk than ischaemic heart disease (IHD) in the health transition of black South Africans.


METHODS
A review of published data on mortality from and risk factors of CVD in South Africans.


METHODS
South Africa.


METHODS
South African population groups and communities.


METHODS
The available data on the contribution of stroke and IHD to CVD mortality in South Africa are briefly reviewed, followed by a comparison of published data on the prevalence and/or levels of CVD risk factors in the different South African population groups. The impact of urbanisation of black South Africans on these risk factors is assessed by comparing rural and urban Africans who participated in the Transition and Health during Urbanisation of South Africans (THUSA) study.


CONCLUSIONS
The mortality rates from CVD confirmed that stroke is a major public health problem amongst black South Africans, possibly because of an increase in hypertension, obesity, smoking habit and hyperfibrinogenaemia during various stages of urbanisation. The available data further suggest that black South Africans may be protected against IHD because of favourable serum lipid profiles (low cholesterol and high ratios of high-density lipoprotein cholesterol) and low homocysteine values. However, increases in total fat and animal protein intake of affluent black South Africans, who can afford Western diets, are associated with increases in body mass indices of men and women and in total serum cholesterol. These exposures may increase IHD risk in the future.
Vorster
H H
HH
Faculty of Health Sciences, Potchefstroomse Universiteit vir Christelike Hoër Onderwys, South Africa. vgehhv@puknet.puk.ac.za
D001741:Black or African American; D044383:Black People; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D002784:Cholesterol / Q000097:blood; D004032:Diet / Q000009:adverse effects; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D019456:Health Transition; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008297:Male; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013019:South Africa / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D014505:Urban Population; D014507:Urbanization
D005340:Fibrinogen; D002784:Cholesterol