Estimating the burden of disease attributable to high cholesterol in South Africa in 2000.
OBJECTIVE
To estimate the burden of disease attributable to high cholesterol in adults aged 30 years and older in South Africa in 2000.


METHODS
World Health Organization comparative risk assessment (CRA) methodology was followed. Small community studies were used to derive the prevalence by population group. Population-attributable fractions were calculated and applied to revised burden of disease estimates for the relevant disease categories for each population group. The total attributable burden for South Africa in 2000 was obtained by adding the burden attributed to high cholesterol for the four population groups. Monte Carlo simulation-modelling techniques were used for uncertainty analysis.


METHODS
South Africa.


METHODS
Black African, coloured, white and Indian adults aged 30 years and older.


METHODS
Mortality and disability-adjusted life years (DALYs) from ischaemic heart disease (IHD) and ischaemic stroke.


RESULTS
Overall, about 59% of IHD and 29% of ischaemic stroke burden in adult males and females (30+ years) were attributable to high cholesterol (>or= 3.8 mmol/l), with marked variation by population group. High cholesterol was estimated to have caused 24,144 deaths (95% uncertainty interval 22,404 - 25,286) or 4.6% (95% uncertainty interval 4.3 - 4.9%) of all deaths in South Africa in 2000. Since most cholesterol-related cardiovascular disease events occurred in middle or old age, the loss of life years comprised a smaller proportion of the total: 222,923 DALYs (95% uncertainty interval 206,712 - 233,460) or 1.4% of all DALYs (95% uncertainty interval 1.3 - 1.4%) in South Africa in 2000.


CONCLUSIONS
High cholesterol is an important cardiovascular risk factor in all population groups in South Africa.
Norman
Rosana
R
Burden of Disease Research Unit, South African Medical Research Council, Tygerberg, Cape Town. rosana.norman@mrc.ac.za
Bradshaw
Debbie
D
Steyn
Krisela
K
Gaziano
Thomas
T
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D017281:Cost of Illness; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D013019:South Africa / Q000453:epidemiology