The global cardiovascular diseases risk pattern in a peri-urban working-class community in South Africa. The Mamre study.
OBJECTIVE
To describe the cardiovascular disease (CVD) risk factors and the global burden of CVD risk in a peri-urban, working-class community of Mamre near Cape Town. To identify additional variables in the data set associated with the global CVD risk factor score. The latter was calculated using the major CVD risk factors in formulas derived from the Framingham global CVD risk calculations. Such variables could possibly be used for global CVD risk calculations, instead of depending on biochemical estimates for these calculations.


METHODS
In a random population-based sample of 976 people aged 15 years and older, data on demography, smoking, physical activity, and alcohol use were collected. Blood pressure (BP), anthropometry, levels of serum glucose and lipids, and low-density lipoprotein cholesterol (LDL) particle sizes were also determined. These data allowed calculation of the global CVD risk profile with the Framingham study's formula. The data are age-standardized to the colored (mixed ancestry) population according to the 1996 South African census.


RESULTS
The global CVD risk score suggested that men and women had a 5.2% and 4.2% probability, respectively, of having a CVD event in the next 10 years, while for those 55 years of age and older, the probability increased to more than 30% and 25%, respectively. Hypertension was found in 22% of men and 16% of women. Sixty-two percent of the men and 44% of the women smoked cigarettes, while 6% and 5% had diabetes, respectively. Hypercholesterolemia was present in 47% of men, and 46% of women. Small-dense LDL particles were present in 26% of men and 14% of women. A number of easily measured CVD risk factors could explain 40.3% of the variation of the global CVD risk score. These include aspects of the medical history provided by the patient, the inverse of the amount of physical activity and weight measurements, as well as height, and waist circumference.


CONCLUSIONS
The people in Mamre have a high probability of suffering a CVD event in the next 10 years. Age and gender are the primary contributors to the global CVD risk score. The findings suggest the possibility of developing a global CVD risk score based on easily measured CVD risk factors for use in developing countries with limited resources.
Steyn
Krisela
K
Chronic Diseases of Lifestyle Unit, Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa. ksteyn@mrc.ac.za
Levitt
Naomi S
NS
Hoffman
Margaret
M
Marais
A David
AD
Fourie
Jean M
JM
Lambert
Estelle V
EV
Gaziano
Thomas A
TA
Kepe
Lulama
L
Lombard
Carl J
CJ
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D012923:Social Class; D013019:South Africa / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data*